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Published Date: 2018-01-23 14:58:06
Subject: PRO/EDR> Measles update (06): Americas, Europe, Asia/Pacific
Archive Number: 20180123.5576951
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1] USA, Illinois (Chicago, O'Hare International airport)
[2] Guatemala

[3] Ukraine

[4] Indonesia (Papua)
[5] Indonesia (Papua)
[6] Afghanistan (Ghor province)
[7] Philippines

[1] USA, Illinois (Chicago, O'Hare International airport)
Date: Thu 18 Jan 2018
Source: The Car News Insider [edited]

Another case of measles exposure has been reported at O'Hare International Airport, the 2nd instance there in 5 days. The infected person was at O'Hare International Airport's Terminal 5 on [9 Jan 2019] and could have exposed others at the airport to the disease between 8:30 a.m. and noon that day, according to a statement from the Illinois Department of Public Health.

Hospitals and healthcare facilities are working to identify all possible areas of exposure and notify susceptible patients, staff, and visitors.

The 1st reported case in 2018 involved a passenger on a flight that landed at Terminal 5 [Wed 10 Jan 2018] morning. Health officials said the 2 did not become infected while at O'Hare airport but had already contracted measles. The timelines for exposure at the office plaza [are listed in the report at the URL above].

In the [Wed 10 Jan 2018] case, after arrival, the affected individual did not leave the airport and departed on a domestic flight several hours later. People who have not received a measles vaccination are asked to get themselves checked.

For more information about measles, contact your health care provider, or visit the Illinois Department of Public Health website. The agency said that passengers who have not been vaccinated could start to develop symptoms as late as [31 Jan 2018]. At highest risk are people who have not been vaccinated, state officials said. "Getting vaccinated not only protects you, it protects others around you who are too young to get the vaccine or can't receive it for medical reasons".

The Centers for Disease Control and Prevention (CDC) states that measles is "a serious, highly contagious disease" that is "easily" spread through the air when an infected person coughs or sneezes. The department says there's no measles outbreak at O'Hare, which served 78 million passengers in 2016. The CDC states that most measles cases in the USA result from global travel, and warned travelers to make sure they are protected against the disease before they go overseas.

Communicated by:

[See ProMED mail Measles update (04): Europe, USA 20180115.5561190 for report on 1st case at O'Hare airport in 2018.

A Healthmap/ProMED of the United States can be found at - Mod.LK]

[2] Guatemala
Date: Sun 21 Jan 2018
Source: Informe21 [in Spanish, trans. KS, edited]

The Human Rights Ombudsman in Guatemala (PDH), Jordán Rodas Andrade, warned today [Sun 21 Jan 2018] that the case of measles confirmed by the health authorities of the country is due to low vaccination coverage dating from 2014. Vaccination coverage (...) in girls and boys from 12 to 23 months in the metropolitan area is 69.9 percent", which had a "downward trend of 1.9 percentage points", said the ombudsman.

The PDH added that "until the epidemiological week 40 [1 - 7 Oct 2017], the coverage" did not exceed 25 percent ", according to the Department of Epidemiology of the Ministry of Public Health and Social Assistance (MSPAS).

"Maintaining the coverage at 90 percent or more according to international norms and standards is what guarantees the interruption of the circulation of autochthonous viruses," such as measles, the magistrate of conscience warned in his statement.

Given the "latent risk" this implies for the country, after the Health portfolio confirmed the case of measles in a 17 year-old Guatemalan student, who was infected with the virus on his trip to Germany between November [2017] and the 1st days of the year [2018], the PDH demanded the Ministry comply with "the national public health surveillance protocol".

He also urged him "immediately" to carry out the "active search of cases at the institutional level, maintain the epidemiological cord, strengthen active surveillance and strengthen recovery actions of the vaccination scheme."

The confirmed case of measles is the 1st detected in the Central American country in the last 20 years.

As indicated by the Health portfolio in a statement released this [Sat 20 Jan 2018], in Germany more than 800 cases were detected between 2016 and 2017, while in the Americas reported 201; 119 in the United States; 45 in Canada; 34 in Venezuela and 3 in Argentina.

Communicated by:
ProMED-mail Rapporteur Kathryn Soderholm

[On 27 Sep 2016, PAHO/WHO declared The Region of the Americas as the 1st in the world to have eliminated measles. This achievement culminated a 22-year effort involving mass vaccination against measles, mumps and rubella throughout the Americas. The declaration of measles' elimination was made by the International Expert Committee for Documenting and Verifying Measles, Rubella, and Congenital Rubella Syndrome Elimination in the Americas. The announcement came during the 55th Directing Council of the Pan American Health Organization/World Health Organization (PAHO/WHO), which was attended by ministers of Health from throughout the Americas.

Measles is the 5th vaccine-preventable disease to be eliminated from the Americas, after the regional eradication of smallpox in 1971, poliomyelitis in 1994, and rubella and congenital rubella syndrome in 2015 (from

However, countries where measles is endemic still pose a risk to susceptible, non-immunized individuals in countries where measles has been eliminated, such as the case in this report. Since the beginning of 2017 and as of [28 Jun 2017], Germany has reported 766 cases. This is an increase of 15 cases since the CDTR [ECDC Health reports] on [30 Jun 2017]. In the same period in 2016, Germany reported 130 cases. Therefore, travelers to Germany are advised to take precautions and check their immunization status to measles.

A Healthmap/ProMED of Guatemala can be found at - Mod.LK]

[3] Ukraine
Date: Fri 19 Jan 2018
Source: Ukrinform [edited]

A total of 8 adults and children have died in Ukraine since the outbreak of measles, acting Health Minister Ulana Suprun has said. She was answering questions from the parliament's rostrum on [Fri 19 Jan 2018], a Ukrinform correspondent reports. "Yesterday [Thu 18 Jan 2018], we learned about another death from measles. This is a child who was not vaccinated. This is the 8th death case since the start of the outbreak," she said.

According to Suprun, 1285 adults and children have already caught measles in 2 weeks in 2018, compared to 4782 people with this disease in 2017.

She said that the largest number of cases of measles was registered in Ivano-Frankivsk, Chernivtsi, Zakarrpatia and Odesa regions and in the city of Kyiv.

At the same time, the minister said that there had been no fatality among over 1.3 million people who were vaccinated against measles last year [2017].

Communicated by:
ProMED-mail from HealthMap Alerts

[A Healthmap/ProMED of the Ukraine can be found at - Mod.LK]

[4] Indonesia (Papua)
Date: Tue 16 Jan 2018
Source: ABC News

Indonesian authorities are struggling to contain a months' long outbreak of measles in easternmost Papua province that has killed dozens of children.

Stefanus Lange, a doctor at a state-run hospital in Papua's Asmat district, said [Tue 16 Jan 2018] that cases first were detected in September [2017], but a lack of access to remote areas and the high mobility of villagers hampered treatment and vaccination efforts.

Dr Lange said 36 victims died in Pulau Tiga sub-district and 22 died in Agats, the main town and capital of Asmat district.

He said other obstacles to overcoming the disease are a lack of personnel and a failure to reach all districts in the affected area.

A team of more than 50 doctors and paramedics from the Indonesian military arrived [Tue 16 Jan 2018] in the province to help overcome the disease.

Communicated by:
ProMED-mail from HealthMap Alerts

[A Healthmap/ProMED of Indonesia can be found at - Mod.LK]

[5] Indonesia (Papua)
Date: Tue 23 Jan 2018
Source: The News [edited]

A deadly epidemic of measles has spread in the Indonesian province of Papua, and so far 100 children have lost their lives due to the disease.

It is reported that children in the remote province also suffer from malnutrition and there has been an outbreak of chickenpox [varicella] as well.

It was initially feared that some 68 deaths have occurred in the mountainous Oksibil district alone, however according to church leaders the death toll could be in hundreds.

In order to combat the disease, the government has launched a program, which some believe will do little to no good. However, arrangements have been made for citizens to fly from Asmat to the country's capital, by helicopter. The military and the government have provided necessities like food, medical equipment and vaccines to the victims.

Communicated by:

[A high proportion of children in the Indonesian province of Papua have not been vaccinated against measles, mumps, rubella, and varicella to the extent necessary to protect the population from infection. Lack of immunity plus malnutrition creates a serious health risk for the children in the region

It is hoped that the government's efforts to send food, medical equipment, and vaccines to the capital will help stop the outbreaks of these 2 vaccine-preventable diseases. The varicella vaccine is given by injection when children are between 12 and 15 months old, followed by a booster shot for further protection at 4 - 6 years of age.

A Healthmap/ProMED of Indonesia can be found at - Mod.LK]

[6] Afghanistan (Ghor province)
Date: Thu 18 Jan 2018, 7:50 PM
Source: Pajhwok Afghan News [edited]

Local health officials say 63 children died of measles and pneumonia diseases over the last 9 months in western Ghor province amid lack of child health specialists. The officials said despite taking measures to control the diseases, the number of children affected was increasing each day.

Dr. Jumma Gul Yaqobi, head of Ghor Civil Hospital, in an exclusive interview with Pajhwok Afghan News confirmed receiving 4700 children suffering from measles and pneumonia over the last 9 months. He said of the children, 58 lost their lives. He added that the number of children suffering from measles disease increased in last 2 months and 5 children had so far died of the disease in this period.

"Most of those losing lives were brought to the hospital late and were less than 1 year of age; the signs of this disease include fever, cough, runny nose, anorexia sweat and some other signs that could be found in children less than 9 months of age," he said.

Yaqobi pointed out that cold weather, non implementation of vaccine, poverty, malnutrition and parents carelessness were reasons behind the increase of the diseases. "It is known to all that Ghor is one of cold and economically poor province, some of its areas are influenced by militants who do not allow vaccination of children, families also pay less attention to their children's health, these reasons in general can increase diseases in children," he said.

On the other hand, a number of Ghor residents complained about lack of access to children's health specialists and said their patients remained hospitalized in the Ghor Civil Hospital for a long time without being cured.

[A father], who brought his child suffering from pneumonia to Ghor Civil Hospital, said he wandered in the hospital for 20 days to seek treatment for his child. "I came 20 days ago from Shahrak district to this hospital and since we are here waiting for our child to recover, but the doctors are careless about us, they check the patient only once in 24 hours, if someone has connections with the doctors, their patient is checked hourly," he said.

The Ghor Civil Hospital head agreed with these complaints to some extent and said there was no children specialist in the hospital where sometimes the number of child patients reached dozens. "This is why children's diseases are not properly diagnosed."

Provincial acting public health director, Abdul Latif Rahimi, also said they recently registered 54 cases of pneumonia in children from areas on the outskirts of Firozkoh city, the provincial capital and 2 of the children lost their lives.

He said 50 percent of children in Ghor did not receive pneumonia vaccination and that was the reason of the high number of children's deaths from the disease. "The number of deaths from these diseases is high but statistics could not be collected from some areas due to impassable routes," he said.

"We have 54 cases from areas on the outskirts of Firozkoh city, 2 persons died from measles disease. Pneumonia diseases has also increased and is rapidly spreading, that is because half of our children do not receive vaccination for several reasons including insecurity," he said.

Rahimi confirmed the absence of children's health professionals in Ghor Civil Hospital and said the public health department had tried to employ children' health doctors but none of them were interested in work in Ghor. "MoPH provides many privileges to children doctors, but they don't show interest to work in the provincial civil hospital", he said.

Ghor officials say the provincial civil hospital is the only hospital with 180 beds that provides health services to nearly a million population of the province.

Communicated by:
ProMED-mail from HealthMap Alerts

[It is not stated what proportion of the 4700 children have measles and what proportion pneumonia, but the number of children affected is unfortunately very high.

A Healthmap/ProMED of Afghanistan can be found at - Mod.LK]

[7] Philippines
Date: Mon 22 Jan 2018, 8:39 PM
Source: GMA News online [edited]

The Davao City Health Office on [Mon 22 Jan 2018] declared a measles outbreak in the city due to the rise in the number of people infected by the viral disease from November 2017 to January 2018.

Data from the health office showed that as of [Sat 6 Jan 2018], a total of 222 people have been found positive of the viral infection. Sixteen of those who tested positive were call center agents.

It was, however, noted that not all patients are residents of Davao City, but they are all hospitalized in the city.

Doctor Josephine Villafuerte, chief of the health office, said a total of 13 000 children aged 5 to 59 months have been vaccinated since the 1st case of measles was reported 2 weeks ago. "We wanted to avoid the spread of the virus," Villafuerte said in a press release.

She said the health office has been doing the following measures to avoid the spreading of the virus:

- Conduct immunization/booster of measles vaccine for children, 6 to 59 months.
- Conduct fixed site, house-to-house and health center measles immunization. Services are free.
- Increase information/education campaign on measles awareness.
- Advise establishments/workplaces that if an employee shows signs/symptoms of measles, they advise that employee not to report for work.

Villafuerte also reminded the public regarding the signs and symptoms of measles such as high fever, cough, colds, sore throat, inflammation of the eyes, skin rashes and white spots on the inner lining of the cheeks.

[Byline: Anna Felicia Bajo]

Communicated by:
ProMED-mail from HealthMap Alerts

[A Healthmap/ProMED of the Philippines can be found at - Mod.LK]

See Also

Measles update (05): Europe, Pacific-Asia, USA 20180118.5566770
Measles update (04): Europe, USA 20180115.5561190
Measles update (03): Europe, Pacific, USA 20180112.5556312
Measles update (02): Europe, South America 20180109.5547446
Measles update (01): Asia, Europe 20180105.5540575
Measles update (58): Australia, Sweden, Serbia, Nepal 20171229.5526586
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Measles update (56): Greece, UK, PAHO, USA, Australia 20171205.5485332
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Measles update (54): Asia, South America, Europe 20171113.5441554
Measles update (53): Africa, Asia, Southeast Asia, Eastern Europe 20171110.5435068
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