2019–2020 New Zealand measles outbreak

Measles epidemic affecting New Zealand

2019–2020 New Zealand measles outbreak

Map of confirmed measles cases in New Zealand during the 2019–2020 outbreak by district health board (DHB)

Date| 1 August 2019 – 21 February 2020[1]

* Christchurch

16 February – 16 May 2019[2]

* Auckland

28 February 2019 – 7 February 2020[3]
Casualties
|  Country|  Cases (conf)|  Deaths|  Last update

|
|
|

New Zealand|  2,194|  2*| [1]
Australia|  74|  0| [4][5][6]
Fiji|  24|  0| [7]
Total|  2,093
(see note 1)|  2*|
As of 24 February 2020[update]

The 2019–2020 New Zealand measles outbreak was an epidemic that primarily affected the Auckland region.[8] It was the largest measles outbreak in the country since the introduction of the second dose of MMR vaccine to the New Zealand National Immunisation Schedule in 1992. An outbreak in 1991 caused an estimated tens of thousands of cases, followed by another outbreak in 1997 with 2,169 reported cases. [9]

The D8 strain was confirmed to be the main strain of the epidemic,[10][11] although the B3 strain was also detected,[12] and the epidemic has spread to several other countries. In Samoa more than 72 people have died.[13] Cases in Tonga and Fiji have also been recorded, and an outbreak in Perth began in October 2019 after a New Zealander visited while infectious.[14] In New Zealand, two unborn fetuses in second trimester died as a result of the outbreak.[15]

## Response

[edit]

The New Zealand Government was criticised for its response to the epidemic, particularly due to shortages in the supply of vaccines.[16][17] Scientists also criticised the Ministry of Health for not acting on previous recommendations to conduct national 'catch-up' campaigns with the MMR vaccine prior to the outbreak.[18]

In 2017, the New Zealand Health Ministry produced documents highlighting the urgent need to increase measles immunisation among young people, stating that a "systematic, programmatic approach" was needed to address an immunity gap.[19] In 2018, Dr Nikki Turner, Chair of the National Measles Verification Committee, met to discuss the immunisation gap. It was noted damage was historical and immunisation rates had improved but by 2019 the gap had not been fully addressed. Many young people were unaware of their vaccination status, indicating that poor record keeping contributed to ineffective delivery.[20] David Haymen and Turner concluded that the best way to close the immunity gap was to undertake a formal catch-up programme.[21]

Research into the 2019 measles epidemic traced its history and showed it was young infants who were most at risk, followed by teenagers and adults under the age of 30.[20] Analysis by the Immunisation Advisory Centre found that individuals born between 1982 and 2007 had low immunization rates, and vaccination records are incomplete for that period as the National Immunisation Register was introduced in 2005.[22] The research also suggested management strategies such as a national campaign targeting at-risk age groups; establishment of systems to ensure adequate supplies of vaccines; provision of support for their delivery at the practice level; and creative use of community facilities to improve accessibility.[citation needed]

During the COVID-19 pandemic in New Zealand, it became apparent that in the drive to obtain a vaccine for that outbreak, there was a stall in getting measles vaccination programmes rolled out effectively. Dr. Nikki Turner warned that because of this disruption, it was possible that there would be "bigger problems with children dying from measles, and the damage from measles, than Covid."[23]

Although New Zealand has had a high demand for the MMR vaccine, resulting in a shortage, there has also been an increase in the number of people who have declined the vaccine since 2017.[24]

## Cases

[edit]

As of 24 February 2020, there had been 2,194 cases of measles reported throughout New Zealand since 1 January 2019.[1] Auckland had been the worst-hit region, with 1,736 cases alone.[1] The New Zealand government activated the National Health Coordination Center in August 2019 to respond to the outbreak.[25]

Confirmed cases by District Health Board (24 February 2020)[1] Region  | Cases  | Hospitalised

|
|

Northland | 133 | 23
Waitematā | 306 | 129
Auckland | 274 | 108
Counties Manukau | 1,157 | 435
Waikato | 51 | 12
Lakes | 30 | 6
Bay of Plenty | 45 | 19
Tairāwhiti | 0 | 0
Taranaki | 8 | 3
Hawke's Bay | 26 | 8
Whanganui | 0 | 0
MidCentral | 10 | 0
Hutt Valley | 9 | 1
Capital and Coast | 24 | 7
Wairarapa | 1 | 0
Nelson Marlborough | 1 | 0
West Coast | 0 | 0
Canterbury | 44 | 17
South Canterbury | 2 | 0
Southern | 73 | 6
Total (nationwide)  | 2,194  | 774

## See also

[edit]

* Taylor Winterstein, Samoan anti-vaccination campaigner
* 2019 Samoa measles outbreak
* 2019 Tonga measles outbreak
* 2019 Philippines measles outbreak
* Chemophobia
* Measles resurgence in the United States
* Vaccination
* Vaccine hesitancy

## References

[edit]

1. ^ a b c d e "Measles weekly report" (PDF). Public Health Surveillance. 24 February 2020. Archived from the original (PDF) on 19 February 2020. Retrieved 4 March 2021.
2. ^ "Canterbury measles outbreak declared officially over". TVNZ. Retrieved 4 March 2021.
3. ^ "Measles weekly report" (PDF). Public Health Surveillance. 10 February 2020. Archived from the original (PDF) on 19 February 2020. Retrieved 4 March 2021.
4. ^ "Three cases of Measles in Australia". Nine News. 4 September 2019. Retrieved 6 September 2019.
5. ^ "2019 measles outbreak WA Information". WA Health. 18 October 2019. Retrieved 8 November 2019.
6. ^ "Measles outbreak hits Queensland". Seven News. 5 November 2019. Retrieved 8 November 2019.
7. ^ "Measles Outbreak declared in Fiji". Fiji Sun. 7 November 2019. Retrieved 8 November 2019.
8. ^ "2019 measles outbreak information". Ministry of Health NZ. Archived from the original on 2 October 2019. Retrieved 2 October 2019.
9. ^ Health New Zealand Te Whatu Ora. "New Zealand Immunisation Handbook". Retrieved 28 March 2025.
10. ^ Iannelli, Vincent; MD (13 May 2017). "Measles Vaccines vs Measles Strains". Vaxopedia. Retrieved 4 February 2021.
11. ^ "National Measles Response and Recovery Appeal, 6 December 2019 - Samoa". ReliefWeb. 8 December 2019. Retrieved 5 February 2021.
12. ^ "2019 Canterbury Measles Outbreak – A summary of cases" (PDF). New Zealand Community and Public Health. Archived (PDF) from the original on 16 February 2020. Retrieved 5 February 2021.
13. ^ "WHO/UNICEF Secretariat Supporting Measles Outbreak Preparedness and Response in the Pacific" (PDF). WHO. Retrieved 16 December 2019.
14. ^ Bell, Frances (2 October 2019). "Fears over growing and 'unprecedented' Perth measles outbreak linked to much bigger NZ one". ABC News. Retrieved 4 March 2021.
15. ^ "Amid Auckland's measles outbreak, two second-trimester unborn babies die". TVNZ. Archived from the original on 29 June 2021. Retrieved 2 October 2019.
16. ^ Fitzgerald, Katie. "Simon Bridges hits out at Government over measles outbreak handling". Newshub. Archived from the original on 2 October 2019. Retrieved 2 October 2019.
17. ^ Laird, Lindy (20 September 2019). "47 measles cases in North, MP says not enough action". Northern Advocate. ISSN 1170-0777. Retrieved 2 October 2019.
18. ^ Hancock, Farah. "'Shameful' measles outbreak predicted". Stuff. Retrieved 2 October 2019.
19. ^ "Measles outbreak: Call for national approach". www.scoop.co.nz. 18 July 2019. Retrieved 5 February 2021.
20. ^ a b "A measles epidemic in New Zealand: Why did this occur and how can we prevent it occurring again?". www.nzma.org.nz. Archived from the original on 19 February 2020. Retrieved 5 February 2021.
21. ^ "Joining the dots: What's really causing New Zealand's measles epidemics". RNZ. 25 May 2019. Retrieved 5 February 2021.
22. ^ Newton, Kate (25 May 2019). "Joining the dots: What's really causing New Zealand's measles epidemics". RNZ. Retrieved 27 March 2021.
23. ^ "Nikki Turner: Let's keep our eyes on the ball - The University of Auckland". www.auckland.ac.nz. Retrieved 5 February 2021.
24. ^ Patel, Manisha; Lee, Adria D.; Clemmons, Nakia S.; Redd, Susan B.; Poser, Sarah; Blog, Debra; Zucker, Jane R.; Leung, Jessica; Link-Gelles, Ruth; Pham, Huong; Arciuolo, Robert J.; Rausch-Phung, Elizabeth; Bankamp, Bettina; Rota, Paul A.; Weinbaum, Cindy M.; Gastañaduy, Paul A. (11 October 2019). "National Update on Measles Cases and Outbreaks — United States, January 1–October 1, 2019". MMWR. Morbidity and Mortality Weekly Report. 68 (40): 893–896\. doi:10.15585/mmwr.mm6840e2. PMC 6788396. PMID 31600181.
25. ^ Small, Zane; Lynch, Jenna. "'This is serious': National Health Coordination Centre activated over measles outbreak". Newshub. Archived from the original on 31 August 2019.

* v
* t
* e

2019–2020 measles outbreaks

>10,000 confirmed cases|

* Democratic Republic of the Congo (380,766, 7,018 deaths)
* Philippines (31,056, 415 deaths)

1,000 to 10,000 confirmed cases|

* Samoa (5,700, 83 deaths)
* New Zealand (2,194, 2 deaths)

<1,000 confirmed cases|

* Tonga (612)
* New York (423)
* Pacific Northwest (73)
* Kuala Koh (43, 15 deaths) (113 suspected)
* Freewinds (1)

Related: Measles resurgence in the United States

* v
* t
* e

Pandemics, epidemics and notable disease outbreaks

* List of epidemics and pandemics

Local|

| Ancient|

* Hittite plague (c. 1330 BC)
* Plague of Athens (429–426 BC)
* Antonine Plague (165–180 AD)
* Plague of Cyprian (250–266)

|

Post-
classical|

* Plague of Justinian (541–542)
* Roman Plague (590)
* Plague of Sheroe (627–628)
* Plague of Amwas (638–639)
* Plague of 664 (664–689)
* Japanese smallpox (735–737)
* Black Death (1346–1353)
* Sweating sickness (1485–1551)

Early
modern|

| 16th century|

* Influenza pandemic (1510)
* Mexican smallpox (1520)
* "Cocoliztli" epidemics in colonial Mexico (1545, 1576)
* Influenza pandemic (1557–1559)
* London plague (1563–1564)
* Maltese plague (1592–1593)
* London plague (1592–1593)

|

17th century|

* London plague (1603)
* Maltese plague (1623)
* Italian plague (1629–1631)
* Massachusetts smallpox (1633)
* Great Plague in the late Ming dynasty (1633–1644)
* Great Plague of Seville (1647–1652)
* Maltese plague (1655)
* Naples Plague (1656)
* Great Plague of London (1665–1666)
* Maltese plague (1675–1676)
* Great Plague of Vienna (1679)

18th century|

* Iceland smallpox epidemic (1707–1708)
* Great Northern War plague (1710–1712)
* Great Plague of Marseille (1720–1722)
* Great Plague of 1738 (1738)
* Russian plague (1770–1772)
* Persian Plague (1772)
* North American smallpox (1780–1782)
* Philadelphia yellow fever (1793–1798)

Modern|

| 19th century|

* Ottoman plague (1812–1819)
* Maltese plague (1813–1814)
* Caragea's plague (1813)
* Groningen epidemic (1829)
* Great Plains smallpox (1837–1838)
* Typhus (1847–1848)
* Copenhagen cholera (1853)
* Stockholm cholera (1853)
* Broad Street cholera (1854)
* Guam smallpox (1856)
* Pacific Northwest smallpox (1862–1863)
* Barcelona yellow fever (1870)
* Buenos Aires yellow fever (1871)
* Australia scarlet fever (1875–1876)
* Hong Kong plague (1894)

|

20th century|

* San Francisco plague (1900–1904)
* Manchurian plague (1910–1911)
* LA pneumonic plague (1924)
* Croydon typhoid (1937)
* NYC smallpox (1947)
* Wrocław smallpox (1963)
* Yugoslav smallpox (1972)
* London flu (1972–1973)
* Indian smallpox (1974)
* Surat plague (1994)
* Malaysian Nipah virus (1998–1999)

21st century|

* SARS (2002–2004)
* Midwest monkeypox (2003)
* Bird flu (2003–2005)
* Singaporean dengue (2005)
* Indian dengue (2006)
* Chikungunya outbreaks (2006)
* Pakistani dengue (2006)
* Iraqi cholera (2007)
* Zimbabwean cholera (2008–2009)
* Madagascar plague (2008–2017)
* Bolivian dengue (2009)
* Gujarat hepatitis (2009)
* Western African meningitis (2009–2010)
* Haiti cholera (2010–2019)
* Pakistani dengue (2011)
* Darfur yellow fever (2012)
* MERS (2012)
* Singaporean dengue (2013)
* Swansea measles (2013)
* Chikungunya (2013–2014)
* Western African Ebola (2013–2016)
* DR Congo Ebola (2014)
* Madagascar plague (2014)
* Odisha hepatitis (2014)
* Polio declaration (2014)
* Indian swine flu (2015)
* South Korean MERS (2015)
* Zika (2015–2016)
* Angolan yellow fever (2016)
* Yemeni cholera (2016–2022)
* Gorakhpur Japanese encephalitis (2017)
* Saudi Arabian MERS (2018)
* Kerala Nipah virus (2018)
* Équateur province Ebola (2018)
* Kivu Ebola (2018–2020)
* Madagascar measles (2018)
* Samoa measles (2019)
* Philippine measles (2019)
* Pacific NW measles (2019)
* New York measles (2019)
* Kuala Koh measles (2019)
* Tonga measles (2019)
* DRC measles (2019–2020)
* New Zealand measles (2019–2020)
* Singaporean dengue (2020)
* Uganda Ebola (2022–2023)
* Jamaica dengue (2023)
* Bangsamoro measles (2023–present)
* 2024 Latin American dengue
* Argentina (2024)

Global|

* First plague pandemic (541–767)
* Second plague pandemic (1348–19th century)
* Influenza pandemic (1510)
* Influenza pandemic (1557–1559)
* First cholera pandemic (1816–1826)
* Second cholera pandemic (1829–1851)
* Third cholera pandemic (1852–1860)
* Third plague pandemic (1855–1860)
* Fourth cholera pandemic (1863–1879)
* Fifth cholera pandemic (1881–1896)
* Russian flu (1889–1890)
* Sixth cholera pandemic (1899–1923)
* Spanish flu (1918–1920)
* encephalitis lethargica epidemic (1919–1930)
* Asian flu (1957–1958)
* Seventh cholera pandemic (1961–1975)
* Hong Kong flu (1968–1970)
* Russian flu pandemic (1977–1979)
* HIV/AIDS (1981–present)
* Swine flu (2009–2010)
* COVID-19 (2019–present)
* Mpox (clade II) outbreak (2022–2023)
* Mpox (clade Ib) epidemic (2023–2025)

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