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Advisory on Measles in Fiji

30th August 2022,

On 1st July, The Ministry of Health and Medical Services announced that cases of measles were detected in Fiji. The cases were identified upon presenting to medical facilities in the Northern and Central Divisions with a fever and a rash and testing positive at the Fiji CDC Laboratory.

Samples from the cases were subsequently sent to the WHO Regional Reference Laboratory for measles at the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Melbourne for additional testing. The first round of tests performed with the same test used in Fiji also produced positive results. An additional round of tests was conducted using a more specific measles test and all samples produced negative results. After consultation between experts within the Ministry of Health and Medical Services, VIDRL, and WHO, it has been concluded that none of the 10 is cases of measles. So far this year, there are no confirmed cases of measles in Fiji.

The initial tests used to diagnose measles are serological tests, which are designed to detect antibodies to the measles virus, and not the measles virus itself. There are known factors, including antibodies from other infections, that can result in testing positive on the serological tests when the individual does not have measles; this is known as a false positive. False positive results on serological tests are more likely to happen in places where measles has been eliminated, or occurs at a very low rate, like in Fiji. In response to these test results, the Ministry of Health and Medical Services is working with WHO to establish additional testing methods in order to enable rapid and even more accurate diagnosis in Fiji. The Ministry will maintain measles surveillance to detect cases quickly. Any person testing positive in Fiji using the current testing method will be managed as a suspected case of measles until definitive results are received from the reference laboratory.

“Measles is one of the world’s most contagious viral diseases, causing serious illness and death. However, measles is preventable through vaccination, with two doses of the vaccine providing almost 100% protection against measles,” explained Dr Mark Jacobs, WHO Representative to the South Pacific and Director of WHO’s Division of Pacific Technical Support. “It is, therefore, crucial – not only in Fiji but across the Pacific – that targeted immunization efforts continue and that surveillance systems are strengthened to reduce the risk of measles outbreaks. We are confident in the health security systems in place in Fiji, including the surveillance and the laboratory capacity in the country. WHO will continue to provide technical and logistical support to the Fiji Ministry of Health and Medical Services to address measles, COVID-19 and other diseases as needed.”

According to Dr James Fong, the Permanent Secretary for Health and Medical Services “Similar to many countries in the world, Fiji’s routine childhood immunisation coverage for diseases such as measles has dropped due to the pandemic. This means that we have a significant number of children under the age of 5 who are not vaccinated and are vulnerable to measles infection. This is also the age group most at risk of severe disease if infected with measles. Therefore, though there have been no confirmed cases of measles detected in Fiji this year, the supplementary immunisation activity (SIA) for measles, mumps and rubella (MMR) is extremely necessary and will continue. Proactively moving forward with ensuring that every child in the 6 months to 5 years age group has received their MMR vaccine during this campaign will help to prevent future outbreaks.”

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