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The Fijian Ministry of Health and Medical Services is closely monitoring the developments surrounding the 2019 novel coronavirus in Wuhan China. We are also following advice by the World Health Organisation with regards to prevention of spread of this newly identified virus. An advisory group of relevant experts, including the WHO, have met and advised on response to the current situation. In accordance with these recommendations, the response in Fiji will be based on evidence and international best practice, while adapting to our local context.

What is the Ministry doing?

Our response is multilayered with focus on mitigation of spread in Fiji through: early identification of cases at the international borders and in the community, targeted awareness for high-risk persons (e.g those who have travelled to the outbreak area), awareness for the general public to reduce their risk, and readiness of our health staff to respond to any cases.

International border control is one part of our response, and we are working with the relevant stakeholders, including airport authorities and airlines, to enhance existing mechanisms for detecting ill travellers at the international point of entry. As routine procedure airlines are required to report if there are ill passengers on board. If a flight reports an ill passenger, they are assessed by health staff on the ground and managed as appropriate.

There are no direct flights from Wuhan to Fiji. However, we do have flights from Hong Kong and Singapore that may serve as connections from passengers from Wuhan. Therefore, we are introducing additional health screening measures for passengers disembarking from flights that originate in Hong Kong and Singapore. Passengers on these flights will be met upon disembarkation by our officers, who will review the health declaration on immigration cards and request information on recent travel to Wuhan. Passengers who have recently traveled to Wuhan and are suspected to have the disease will be managed according to existing protocols. Travellers from Wuhan who are not ill will be given information about the disease and what to do if they develop symptoms later. These measures may change as the situation develops.

Border health screening may not absolutely prevent cases from entering Fiji because a person who has been exposed to the virus may be completely well for about 7-14 days before they have any symptoms of the disease. Therefore, we have also alerted our healthcare workers in an advisory to keep alert for anyone presenting with symptoms of the disease who has history of travel to Wuhan. Early detection and response will help prevent any further spread in Fiji.

What can you do?

We are advising against travel to Wuhan in Hubei province China.

There is currently no vaccine against this new disease, but we advise Fijians to practice the following hygiene measures that will also prevent infection with a number of other diseases:

• Cover your mouth and nose with tissue, sleeve, or elbow when coughing or sneezing. Throw the tissue into a close bin after use. Clean hands after coughing and sneezing and when caring for the sick
• Wash your hands with soap and running water if visibly dirty. If your hands are not visibly dirty, wash them with soap and water or use an alcohol based hand cleanser.

The Ministry of Health and Medical Services will continue to monitor the developing situation and will provide updates accordingly.

Measles outbreak for Serua/Namosi declared over

The Serua/Namosi measles outbreak declared on November 7^th 2019 is now at an end. A total of 12 cases of measles were reported from Serua/Namosi during the outbreak. No new cases have been reported since the end of November, and more than 42 days (two incubation periods) have passed since the last case. The outbreak in Serua/Namosi was brought to an end in less than a month from the time it was declared through the massive response efforts of the Serua/Namosi Sub-divisional Health Team, which included the vaccination of 96% of the subdivision’s population. The people of Serua/Namosi are also to be commended for heeding the Ministry’s advice and coming forward to be vaccinated.

Case update

The measles outbreak remains ongoing for the rest of Central Division. However, weekly reported cases have decreased and there have been no new cases reported since the last update on January 9^th. The respective sub-divisional outbreak response teams will continue to respond to new cases as they arise.

The case count remains at 28, and all cases are from the following areas in the Central Division:

• 12 cases from the Serua/Namosi Subdivision (Wailali, Wainadoi, Navunikabi, and Makosoi Deuba)
• 9 cases from Suva Subdivision (Toorak, Nabua, Samabula, Vatuwaqa, Sakoca in Tacirua, Wailekutu and Naikorokoro Village in Lami).
• 3 cases from Rewa Subdivision (Koronivia, Nasilai Village Nakelo, Davuilevu).
• 4 cases from Naitasiri Subdivision (Saumakia Village)

The 3-month-old baby reported in previous updates has now been discharged home from CWM Hospital. All cases to date have recovered, and there are no measles patients currently admitted in hospital. There have been no deaths.

The public are urged to continue to take the following precautions:

• If you or a loved one are in a measles vaccination target group and have not been vaccinated during this campaign please do get vaccinated now.
• Avoid non-essential travel to the outbreak areas of Sakoca in Tacirua, Naikorokoro Village in Lami, Saumakia Village in Naitasiri, Nasilai Village in Nakelo.
• If you are holding an event or gathering with international visitors, or participants from an outbreak area, please strongly encourage them to get vaccinated against measles at least two weeks before travel. This especially applies to visitors traveling from other countries with measles outbreaks i.e. New Zealand, Samoa, Tonga, American Samoa, Kiribati, and Papua New Guinea.

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Measles information

Transmission

Measles is a highly infectious airborne viral disease that spreads easily through the air through breathing, coughing, and sneezing. You are at risk of getting measles if you breathe the same air as someone with the disease and you are not immune. You are not immune if you have not been vaccinated, or you have never had the disease.

Symptoms

The symptoms of measles are:

Fever and a rash with any of the following: runny nose, sneezing, cough, red/watery eyes, white spots inside the mouth. The rash starts after the other symptoms and spreads all over the body.

Treatment

There is no specific antiviral treatment for measles, as it is your body’s immune system that fights off the disease. Most people recover from a measles infection in 8-10 days with rest, and ensuring that they are eating and drinking to avoid dehydration.

Complications

Some people infected with measles develop severe complications such as pneumonia (infection of the lungs) or encephalitis (brain swelling). These people require hospitalization. Children under the age of five, babies younger than one-year old, pregnant women, adults over the age of twenty, and those with compromised immune systems are most at risk of complications.

Prevention

A safe and effective vaccine exists for measles. The Ministry of Health and Medical Services provides measles vaccine free to children. Since 2003, all children in Fiji are offered two (2) doses of the combination measles-rubella vaccine – starting from twelve months of age. Fiji’s immunization coverage for children is good, and the Ministry also conducted a supplemental campaign in 2017 for all one to ten-year olds. Please ensure your children have received at least two doses of the measles vaccine according to the Fiji immunization schedule. This information should be in your child’s ‘Fiji Child Health Record’ (which is a booklet/card every child born in Fiji is provided) for children under the age of 5, and the school health card for school aged children.

Measles in Fiji

Because we have an effective immunization program, measles is rare in Fiji. However, outbreaks around the world, including in neighbouring countries, still puts Fiji at risk of having cases of measles.

EXPRESSION OF INTEREST

Non-Government Organisation (NGO) Grant Round 2019/20

The Ministry of Health & Medical Services (MINISTRY) is seeking Expressions of Interest (EOI) from relevant Non-Government Organisations (NGO) to provide services in coordination with MINISTRY in priority areas.

Grant Pool
The total grant pool is up to $500,000 and proposal budgets will take into account the services provided with a maximum budget of $150,000 per NGO. Depending on the quality of proposals & budget submitted that meets the grant round criteria, the total grant pool will be distributed across selected NGOs that fulfill all criteria.

Length of the grant
The funding round is aligned to 2019/20 financial year.

Priority Areas
1. Counselling Services
2. Ambulance Services
3. Long term care for elderly, chronically ill, terminally ill and people with a disability
4. Primary Health Screening Service

Selection Criteria
 Must be a Fijian NGO and registered under the Charitable Trust Act – international NGOs are not eligible to apply. With all applicable documentation as requested in the proposal format.
 Ability to articulate clear results that contribute to health program outcomes.
 Not replicating services of MINISTRY or other providers, but extending services to the most disadvantaged, marginalized and vulnerable groups including women and those with a disability, particularly those in rural and remote communities.
 Able to incorporate child protection approaches, have a current child protection policy and be compliant with the Child Welfare Decree and the Child Protection Interagency guidelines.
 More than 7 years previous experience in the identified work area.
 Strong Financial Systems that are documented in a finance manual and policy.
 Audited financial report for the last two years (annual report must be provided).
 Previous experience in implementing grants, managing donor funds and accounting for such funding.
 Have a demonstrated commitment to the objectives of “Universal Health Coverage”. Able to incorporate strong approaches that ensure services reach all people regardless of gender, ethnicity, social status, disability, location and age.
 Able to work collaboratively with MINISTRY (not replicating services, reporting through MINISTRY systems and processes, sharing data and resource, joint decision-making).

Please email ikhan001@govnet.gov.fj to obtain Expression of Interest document that contains the selection criteria, proposal and budget templates.

Due Date
All EOIs will be treated in strict confidence and must be received no later than 4.00 pm on 31st January 2020 addressing the full Selection Criteria Outlined in the EOI document, and using the templates provided.

EOI for CSO Grant Round 2019_20

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Case update

Since the last update on December 26^th, 2019 there are now 27 confirmed cases of measles. The latest confirmed cases are a 12 year old from Sakoca in Tacirua who is linked to a previous case in the same area, and a 39 year old from Nasole in Nasinu who was admitted at CWM Hospital and later discharged home.

The 3-month-old baby reported in previous updates is still admitted at CWM Hospital. All other confirmed cases have recovered or are recovering well under home isolation.

All 27 cases are from the following areas in the Central Division:

• 12 cases from the Serua/Namosi Subdivision (Wailali, Wainadoi, Navunikabi, and Makosoi Deuba)
• 8 cases from Suva Subdivision (Nabua, Samabula, Vatuwaqa, Sakoca in Tacirua, Wailekutu and Naikorokoro Village in Lami).
• 3 cases from Rewa Subdivision (Koronivia, Nasilai Village Nakelo, Davuilevu).
• 4 cases from Naitasiri Subdivision (Saumakia Village)

Measles is a highly contagious disease; therefore, non-essential travel to Sakoca in Tacirua, Naikorokoro Village in Lami, Saumakia Village in Naitasiri, Nasilai Village in Nakelo Rewa, and Serua/Namosi, and is strongly discouraged.

National Measles Immunisation Campaign Update

The national measles immunisation campaign was temporarily suspended on December 27^th 2019 due to Tropical Cyclone Sarai and will restart in all divisions by Monday January 6^th. The national campaign will continue to target people who are most at risk of being infected by measles and spreading the disease. Since the outbreak was declared on Thursday 7 November 2019, around 328,000 people in Fiji have been immunised against measles.

To date all confirmed cases of measles have been within the Central Division, and as of December 24^th 2019 over 200,000 people in this division have been vaccinated. The Central Division has also reached the goal of 95% vaccination coverage during the campaign for the target groups of 6mth-5 year olds and 19-39 year olds. With time, reaching this coverage goal is expected to result in a reduction of cases and an eventual end to the outbreak in Central Division. However, cases continue to be reported, and the public is advised to keep listening to advice from the Ministry of Health and Medical Services regarding avoidance of non-essential travel to affected areas and mass gatherings.

Vaccination for the target groups will still be offered at health centres in Central Division, and also used in response to newly reported cases. If you are in a target group and have not been vaccinated yet please come forward to be vaccinated now. We are especially urging parents of children aged 6 months to 5 years of age to get their children vaccinated against measles during this campaign, even if the child has received all routine vaccinations according to the national immunisation schedule. Children under the age of 5 are most at risk of being infected by measles and developing the complications of the disease.

The Western, Northern, and Eastern Divisions will continue the measles immunisation campaign with the aim of vaccinating at least 95% of people in the target groups. Our teams will continue to work to reach every person eligible for the vaccine through house to house visits, at health centres, and immunisation outreach posts – a list of outreach posts will be made available to the public in an advisory shortly.

The national Measles campaign is targeting people who are most at risk of being infected by measles and spreading the disease:

• All children aged 6 months to 5 years regardless of prior vaccination history
• All people born between 1980 and 2000 (19 to 39-year olds who should have ID available if asked)
• Any child who has not received 2 doses of a measles vaccine according to the national immunisation schedule
• Any child aged 12 and 18 months in Fiji who are due their routine measles immunisation according to the national immunisation schedule
• Any person travelling overseas (with evidence of travel i.e. a travel itinerary or ticket)
• All health care workers
• All airport and port-of-entry workers, and hotel staff

The only exceptions to those in the above groups are pregnant women, children under the age of 6 months, those with compromised immune systems (including those on immunosuppressive medication/treatment), and those with a known allergy to the vaccine. These people should not be vaccinated.

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Measles information

Transmission

Measles is a highly infectious airborne viral disease that spreads easily through the air through breathing, coughing, and sneezing. You are at risk of getting measles if you breathe the same air as someone with the disease and you are not immune. You are not immune if you have not been vaccinated, or you have never had the disease.

Symptoms

The symptoms of measles are:

Fever and a rash with any of the following: runny nose, sneezing, cough, red/watery eyes, white spots inside the mouth. The rash starts after the other symptoms and spreads all over the body.

Treatment

There is no specific antiviral treatment for measles, as it is your body’s immune system that fights off the disease. Most people recover from a measles infection in 8-10 days with rest, and ensuring that they are eating and drinking to avoid dehydration.

Complications

Some people infected with measles develop severe complications such as pneumonia (infection of the lungs) or encephalitis (brain swelling). These people require hospitalization. Children under the age of five, babies younger than one-year old, pregnant women, adults over the age of twenty, and those with compromised immune systems are most at risk of complications.

Prevention

A safe and effective vaccine exists for measles. The Ministry of Health and Medical Services provides measles vaccine free to children. Since 2003, all children in Fiji are offered two (2) doses of the combination measles-rubella vaccine – starting from twelve months of age. Fiji’s immunization coverage for children is good, and the Ministry also conducted a supplemental campaign in 2017 for all one to ten-year olds. Please ensure your children have received at least two doses of the measles vaccine according to the Fiji immunization schedule. This information should be in your child’s ‘Fiji Child Health Record’ (which is a booklet/card every child born in Fiji is provided) for children under the age of 5, and the school health card for school aged children.

Measles in Fiji

Because we have an effective immunization program, measles is rare in Fiji. However, outbreaks around the world, including in neighbouring countries, still puts Fiji at risk of having cases of measles.

27-12-19

National Measles Immunisation Campaign Update

The Ministry of Health and Medical Services wishes to advise members of the public that the national measles campaign has been temporarily suspended due to the adverse weather effects of Tropical Cyclone Sarai. Members of the public will be informed when the campaign will recommence.

Measles is very contagious.  To help stop the spread of the disease, the Ministry of Health and Medical Services continues to advise Fijians to take the following precautions:

• Avoid non-essential travel to Serua/Namosi, Nasilai Village Nakelo, Saumakia village in Naitasiri.  Non-essential travel includes all visits and gatherings.  If you need to travel to these areas, please get vaccinated against measles at least two weeks before travel.  Please avoid taking those that cannot get vaccinated (e.g. babies under the age of 6 months and pregnant women) to the outbreak areas.
• Avoid holding or attending large gatherings of people, especially in Central Division, but also those that bring participants from across the country or overseas (such as youth camps, religious gatherings, graduation ceremonies, sporting events, etc).  Measles can spread very easily among large groups of people if they are not immune, who can then take the disease back into their communities.
• If you are holding an event or gathering with international visitors, or participants from an outbreak area, please strongly encourage them to get vaccinated against measles at least two (2) weeks before travel.  This especially applies to visitors traveling from other countries with measles outbreaks i.e. New Zealand, Samoa and Tonga.

——————————————————————————

Measles information

Transmission

Measles is a highly infectious airborne viral disease that spreads easily through the air through breathing, coughing, and sneezing. You are at risk of getting measles if you breathe the same air as someone with the disease and you are not immune. You are not immune if you have not been vaccinated, or you have never had the disease.

Symptoms

The symptoms of measles are:

Fever and a rash with any of the following: runny nose, sneezing, cough, red/watery eyes, white spots inside the mouth. The rash starts after the other symptoms and spreads all over the body.

Treatment

There is no specific antiviral treatment for measles, as it is your body’s immune system that fights off the disease. Most people recover from a measles infection in 8-10 days with rest, and ensuring that they are eating and drinking to avoid dehydration.

Complications

Some people infected with measles develop severe complications such as pneumonia (infection of the lungs) or encephalitis (brain swelling). These people require hospitalization. Children under the age of five, babies younger than one-year old, pregnant women, adults over the age of twenty, and those with compromised immune systems are most at risk of complications.

Prevention

A safe and effective vaccine exists for measles. The Ministry of Health and Medical Services provides measles vaccine free to children. Since 2003, all children in Fiji are offered two (2) doses of the combination measles-rubella vaccine – starting from twelve months of age. Fiji’s immunization coverage for children is good, and the Ministry also conducted a supplemental campaign in 2017 for all one to ten-year olds. Please ensure your children have received at least two doses of the measles vaccine according to the Fiji immunization schedule. This information should be in your child’s ‘Fiji Child Health Record’ (which is a booklet/card every child born in Fiji is provided) for children under the age of 5, and the school health card for school aged children.

Measles in Fiji

Because we have an effective immunization program, measles is rare in Fiji. However, outbreaks around the world, including in neighbouring countries, still puts Fiji at risk of having cases of measles.