Why we must be on guard against measles community outbreak

March 29, 2019 19:07
A measles vaccination station at the Hong Kong airport. Authorities are being urged to take further measures to guard against the measles virus following a surge in infections this year. Photo: CNSA

As of Thursday, the health department's Centre for Health Protection has received notification of 31 cases of measles infection in the city this year, already topping the full-year 2018 figure -- 15 -- for such cases.

Hong Kong is not alone in facing the epidemic. In recent months, measles outbreaks have been raging across a number of countries around the world, with Ukraine, the Philippines and Brazil being the hardest hit.

As for Japan, which has been one of the most popular destinations for Hong Kong holidaymakers in recent years, it has recorded 285 measles cases as of early March. Elsewhere, the United States has reported 268 confirmed cases.

Although the majority of locally born Hong Kong citizens have been vaccinated for measles, there is still a worrisome prospect of a large-scale community outbreak in the territory, given the density and mobility of the population here.

Besides, as some medical experts have pointed out, even if a person had received two doses of combined measles vaccines during his or her childhood as required, there is a chance that the immunity of the person to the virus may have declined with the passage of time.

Amid this situation, if anyone is planning to travel to high-risk countries or regions, it may be a good idea to take antibody testing first in order to find out if they are still immune to measles, and should get vaccinated immediately if they aren’t.

Meanwhile, as many foreign domestic helpers (FDHs) working in Hong Kong have come from countries where the overall measles vaccination rates are relatively low, and given the possibility that the workers may have frequent contact with people travelling to measles-affected regions, the risk of a massive measles outbreak among FDHs in the city cannot be ignored.

Worse still, since the FDHs are mostly family carers who may be taking care of high-risk individuals such as the elderly, or infants who are less than 12-months old and too young to get vaccinated, on a daily basis, it could mean dire consequences if the workers themselves get infected.

Given such risk, employers should consider getting their FDHs vaccinated -- in private clinics, if necessary.

As far as the public healthcare workers are concerned, they are likely to come into close contact with patients who have a long incubation period.

Mindful of the potential danger to which they are exposed, the Hospital Authority (HA) is already arranging for and encouraging unvaccinated healthcare workers to get measles jabs as soon as possible. This emergency measure is worthy of support.

Nevertheless, apart from vaccination, the HA must also prepare sufficient resources and support, as well as formulate a set of comprehensive quarantine measures and an alerting mechanism to make sure it can respond quickly and decisively in case of a full-scale measles outbreak in the city.

As demand for measles vaccines has been soaring in recent days, many doctors in private hospitals and family doctors in Hong Kong have said they are already running out of stock.

To address the pressing issue, the Food and Health Bureau and the Department of Health should stay in close touch with pharmaceutical companies in order to ensure stable and continued supply of measles vaccines.

At the departure and arrival checkpoints at the airport and railway terminals, authorities should step up efforts at sanitation and sterilization within the facilities, and also check the body temperature of all inbound and outbound tourists.

Also, arrival individuals should be reminded that they should declare any illnesses on their own.

As Easter holidays are around the corner, the government should consider issuing travel warnings on measles-ridden countries and regions.

In particular, the administration should warn that highly vulnerable individuals -- such as pregnant women, people with low immunity, and children under the age of one -- shouldn't travel to places when there have been significant measles outbreaks, as much as possible.

For healthy people who have to travel to these areas, they should seek professional advice according to their individual situation, and get vaccinated or receive a booster dose before starting their journey. If they come down with fever within three weeks after they have arrived at their destination, they must seek medical treatment immediately.

As for patients who have got infected and have measles rash, they should avoid going to school within four days after the onset to avoid spreading the virus to others.

This article appeared in the Hong Kong Economic Journal on March 28

Translation by Alan Lee with additional reporting

[Chinese version 中文版]

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Legislative councilor and head of nursing and health studies in the Open University of Hong Kong