Measles Outbreak in Samoa Kills 6. Schools Closed. State of Emergency Declared
(R) The measles virus pictured under a microscope. PHIL / CDC
The Pacific Island nation of Samoa declared a state of emergency this week, closed all of its schools and limited the number of public gatherings allowed after a measles outbreak has swept across the country of just 200,000 people, according to Reuters.
The tiny country that is just south of the equator in the Pacific ocean, half way between New Zealand and Hawaii, has seen at least 716 suspected cases of measles, over 40 percent have required hospitalization. The six deaths were mostly infants under two, according to Reuters.
Nearly 100 people remain hospitalized with 15 in intensive care. The National University of Samoa, the island's only university, told students to stay home and indefinitely postponed exams, according to the New Zealand Herald.
The government announced that official plans for compulsory measles, mumps and rubella (MMR) immunizations would be published on Monday, according to Deutsche Welle.
"MMR vaccinations for members of the public who have not yet received a vaccination injection is now a mandatory legal requirement for all of Samoa," it said.
Also, on Friday, the Samoan government declared that measles vaccinations would be mandatory. It also planned to limit exposure by prohibiting children under 17 gathering in public or entering medical centers unless they are sick, according to the New York Times.
However, vaccinations rates in Samoa are extremely low. The numbers plummeted after two nurses incorrectly mixed a vaccine with an anesthetic, which killed two infants, the Australian Broadcasting Corporation reported. The immunization rate fell to as low as 30 percent last year from about 60 percent in 2016, according to figures from the World Health Organization, as The New York Times reported.
Those numbers stand in stark contrast to the nearby islands of Fiji, Tonga and American Samoa where outbreaks have been reported, but nearly 90 percent of children have been immunized, which is near the requisite number needed to prevent an epidemic, as the New York Times reported.
"The way it is going now and the poor (immunization) coverage, we are anticipating the worst to come," said Samoa's Director General of Health Leausa Take Naseri, as Reuters reported. He added that the children who died had not been vaccinated.
Experts have criticized the Samoan government for a slow and inadequate response to the outbreak.
"It's as bad as you're seeing and probably worse," said Dr. Helen Petousis-Harris, a vaccinologist at the University of Auckland in New Zealand, as the New York Times reported. "This is very much out of control."
Nearby countries have offered nurses and vaccinations to help stop the outbreak. Winston Peters, the New Zealand foreign affairs minister, said today that his country would send 18 more vaccination nurses, upping their total to 30, along with 3,000 units of the vaccine.
"Measles is highly contagious, and the outbreak has taken lives in Samoa," Peters said in a statement, as Reuters reported. "It is in everybody's interests that we work together to stop its spread."
Australia also sent medical aid and 26 practitioners with supplies and a portable intensive care unit. American Samoa announced that travelers coming from Samoa must provide proof of measles vaccination or they will be denied entry, according to the New York Times.
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With more than 1.7 million confirmed cases of COVID-19 in the United States and more than 100,000 deaths from the virus, physicians face unprecedented challenges in their efforts to keep Americans safe.
They also encounter what some call an "infodemic," an outbreak of misinformation that's making it more difficult to treat patients.
When Leaders and Doctors Spread Misinformation<p>When people in charge of towns, cities, states, and countries spread misinformation, the potential for belief in misinformation to result in policies can have harmful effects.</p><p><a href="https://www.northwell.edu/find-care/find-a-doctor?q=Bruce+E.+Hirsch%2C+MD&insurance=&location=&query_type=provider&physician_partners=false&default_view=list&gender=&language=&sort=relevancy" target="_blank">Dr. Bruce E. Hirsch</a>, attending physician and assistant professor in the infectious disease division of Northwell Health in Manhasset, New York, says an example of this is when President Trump informed the public he was taking hydroxychloroquine as a preventive measure.</p><p>"To approach this enormous challenge, we need some intellectual honesty and clarity, and to disregard expertise and to make decisions and model decisions based on hunches is inviting us to handle challenges on the basis of rumor and uninformed opinion. The magnitude of that error is epic," Hirsch told Healthline.</p><p>Stukus agrees, noting that the harm of this proclamation is documented.</p><p>"Early on when the president touted the benefits of hydroxychloroquine and azithromycin, people started to hoard this medicine, and state boards had to shut it down because they were getting so many prescriptions for this unproven therapy that it was not available for those who truly needed it, such as those who have lupus and autoimmune conditions," Stukus said.</p><p>He adds that calls to poison control centers increased after the president suggested using disinfectant to prevent contracting the new coronavirus.</p>
Listen to Science, Even When it Changes<p>When recommendations change or evidence flip-flops, skepticism may arise. However, Stukus says change is the beauty of science.</p><p>"That shows us that we can evolve, and if the evidence shows that our prior thoughts were incorrect, we need to be able to change our recommendations and advice based upon the best quality of evidence at the time," he said.</p><p>Pierre agrees.</p><p>"Science is an iterative process, whereby we arrive at facts and truth through repeated and controlled observations. That means that it's inherently self-correcting as we revise conclusions based on ongoing research. Scientific facts aren't immutable dogma chiseled on a tablet. They change based on the best available evidence we have at a given point in time," he said.</p><p>Because research of COVID-19 has only been underway for 6 months, information is evolving rapidly, and new information may contradict old.</p><p>"There's still much we don't know about exactly how [COVID-19] spreads, what effects it has on the body, or how to best treat it. That means that the best available evidence is preliminary, but that doesn't mean that we should ignore it or turn to other sources of information or opinion as if they're just as valid," Pierre said.</p><p>He explains that conspiracy theories based on mistrust lead to vulnerability to misinformation.</p><p>If people mistrust science because it sometimes "changes its mind," Pierre said, "that shouldn't be used to embrace other opinions based on no evidence at all, which are typically selected based on confirmation bias: what we want to believe rather than what the objective evidence supports."</p>
Where to Find the Best Information<p>Stukus says to start with the <a href="https://www.cdc.gov/coronavirus/2019-nCoV/index.html" target="_blank">CDC</a> and <a href="https://www.nih.gov/health-information/coronavirus" target="_blank">NIH</a>. Then check with your local health officials, because COVID-19 guidelines may vary depending on where you live.</p><p>If you can't find information you need or have questions specifically related to you, call your primary care doctor.</p><p>"Your personal doctor should always be a resource for individual specific questions because they know best how to apply all the nuances retaining to your health, and how to incorporate all the other general [COVID-19] recommendations," Stukus said.</p><p><a href="https://www.eehealth.org/find-a-doctor/b/boyd-laura-b/" target="_blank">Dr. Laura Boyd</a>, primary care physician at Edward-Elmhurst Health Center in Elmhurst, Illinois, says her clinic receives a lot of calls about COVID-19.</p><p>"Most doctors' offices are receiving calls and answering questions, and doing phone or video visits to help clarify and/or order testing over the phone based on patients' symptoms. It is always best to call your doctor's office first instead of worrying about symptoms and waiting too long to seek treatment," she told Healthline.</p><p>If your primary care doctor has limited testing, she suggests looking on your state's public health website for available testing sites.</p><p>With a lot of unknowns related to this virus and disease, Boyd says many patients are feeling overwhelmed and anxious for a treatment.</p><p>"Unfortunately, there is no specific medication recommended for COVID for outpatient. There are a lot of ongoing studies with various drugs going on within the hospital setting. Patients should always contact their doctors about their specific symptoms as they can treat the symptoms that go along with COVID, but there is no cure," Boyd said.</p><p>While we wait for treatment and a vaccine, Hirsch, who treats patients hospitalized for COVID-19 complications on a daily basis, says everyone can do their part by washing hands, wearing a mask, and staying 6 feet apart.</p><p>"As an infectious disease doctor working in the hospital, I see the damage of the pandemic and the worst cases of what's happening. We are trying to get the best possible outcome and confronting this overwhelming biologic reality of this terrible epidemic the best we can," Hirsch said.</p><p>Everyone at home can help in the fight too, he adds.</p><p>"Follow information that is science- and evidence-based, and avoid that which is not," he said.</p>
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