The following was posted last month by Dr. Andy Bennett on Facebook (see our links section). Since this post you may have seen that the measles epidemic has worsened and that our region has run out of oxygen. Please keep us in your prayers.
Many of you may know by now that there is a measles epidemic in PNG. There is a vaccination program here, but coverage isn’t complete. We’ve been seeing up to about 15 new cases per day in Outpatients or in ER. We try very hard to provide outpatient care, and not admit many of these to the hospital, as isolation and protection of other patients is complicated. But some of these kids (and a few adults) are very sick, and require IVs or oxygen.
After considering several options, we have turned half of B Ward into a dedicated measles ward. We strung a curtain across, and have moved supplies into the area, to minimize the need to go back and forth. We’re reminding our staff of good isolation procedures.
We are trying to catch up on vaccinations. As I said, PNG has a vaccination program, but due to many factors, it is not as effective as we would wish. There is wide-spread lack of awareness of the importance of vaccination, or of availability, or proper timing. The Melanesian culture (like many non-Western cultures) doesn’t put as much importance on advance preparation. When immediate consequences aren’t obvious, there is a tendency to wait. Well, now folks are seeing friends and family come down with measles, and there is a big rush for vaccine. We don’t have an unlimited supply, but with certain restrictions and priorities, we are vaccinating all we can. Fortunately, the vaccine provides some protection very quickly. Even after exposure (within 72 hours) it reduces the chances of infection, and reduces the severity of the illness.
Other problems of vaccination programs in any small country include decisions about timing. The ideal time, in terms of effectiveness, is after 12 months of age. But, if there is an epidemic, that leaves small babies vulnerable. So, different countries work out different compromises. In PNG, the policy is to give the first measles vaccine at 6 months, then give a booster at 9 months. I feel that it would be better to give the booster at 12 or 15 months, but since so many get the shots late, the paper policy may not make much difference.
Then there is the matter of getting the vaccine safely to the people. It has to be refrigerated consistently. If left unrefrigerated, it loses it potency quickly. No matter how well we do maintaining “cold chain”, we don’t really know how well those who have handled it before have done.
Measles is a nasty disease. It can be tricky to diagnose. There is very little that can be done to treat it. There are numerous complications of the illness, some of which don’t show up until years after the initial infection.
So, please pray for us, and especially for the vulnerable kiddos of PNG. May this epidemic prove to be brief and mild.