Pago Pago, AMERICAN SAMOA — American Samoa now has 11 confirmed measles cases, and while all daycare centers will remain closed this week, all public schools and the majority of private schools reopened yesterday, with medical professionals from the Health Department visiting campuses to ensure all students have received the required immunization shots.

During Sunday’s cabinet briefing on the measles update at the Emergency Operations Center, Gov. Lolo Matalasi Moliga urged Health officials to provide “precise recommendations” on the next step to be taken, and not be dictated by outside pressure.

Before the meeting was aired Sunday night on KVZK-TV, the government broadcaster made several announcements, based on information from a cabinet briefing, that all daycare centers would remain closed this week — Jan. 6 to 10 — and would reopen Jan. 13th.

According to DoH’s latest update, there are 34 suspected measles cases recorded at LBJ Medical Center and 33 samples have already been tested by a laboratory in Hawai’i, in which 11 have been confirmed — an increase of one from the last briefing on Dec. 29, 2019.

There is one more sample pending testing in Hawai’i and DoH is awaiting results.

LBJ chief medical officer, Dr. Iotamo Salepaga said the new confirmed case is a  2-year-old child, who was born here but taken by family to Apia at 5-months old and later returned to the territory.

DoH officials explained that like all other suspected measles cases, DoH carried out “contact tracing” and monitored the 2-year-old, visiting families and others who came in contact with the child. All family members have been immunized and DoH continues to follow-up and monitor, as the toddler has already been discharged from the hospital.

MMR COVERAGE

DoH provided an update on MMR overall coverage for daycare centers, ECE, elementary and secondary schools, as of Jan. 5, 2020 and it shows that the number of children and students getting the required MMR shots has improved.

For example, for children 12 months and older, who are required to have their first MMR dose, there are now only 245 left to be immunized out of 13,781. For  students 4 years and older, who are required to have completed their two MMR shots, the latest update is that only 988 students — out of 12,686 total — need to get both doses.

DoH director Motusa Tuileama Nua said DoH recommended that daycare centers close for one more week as a precaution. Saleapaga quickly questioned this decision, pointing out that both DoH and LBJ already met more than a week ago and recommended re-opening the centers as well as schools on Jan. 6th. (This was shared during the Dec. 29th cabinet briefing).

Motusa acknowledged the previous agreement but noted that the latest development with the 2-year-old confirmed case, prompted reconsideration. Human and Social Services director, Muavaefa’atasi John Suisala shared that following the previous cabinet briefing, DHSS started working with the 22 daycare centers to ensure they are prepared for re-opening on Jan. 6th. DHSS checked on immunization records for both children and staff.

From that review, he said  21 centers are prepared to reopen; 54% of children attending daycare have proof of immunization; and 51% of daycare center employees have also had their immunization shots and are prepared to return to work.

Muavaefa’atasi said his department works in conjunction with recommendations from DoH and agreed with the recommendation to shut down the centers for one more week.

But Saleapaga said there are no specific reasons provided for continued closure of the daycare centers, as the decision was already made.

DoH’s Dr. Saipale Fuimaono explained that due to the measles outbreak, the immunization age for children was lowered to 6 months, and kids being served at daycare centers include babies of this age group or younger. He said they are the most vulnerable for measles.

Closing the daycare centers for one more week was a precautionary recommendation from DoH to ensure that all eligible children get their shots, he said.

PRECISE RECOMMENDATION

Motusa didn’t give any specific recommendation to the governor and the cabinet to consider regarding the next step to take, or changes to be made to the current emergency declaration due to the measles outbreak.

Instead he provided information and data from Samoa on their measles outbreak and presented it to the governor for a final decision, with which the governor was not pleased. “We take the lead from your recommendation, including the medical professionals and it’s best that the recommendation is precise on what’s the next step,” Lolo said, noting that people’s “political will” of what they want done, does not come into play in making decisions that affect people’s lives.

“Don’t say ‘to present to the governor for a final decision’,” Lolo said. “Our decisions and recommendations” are not to be made when “we are pressured by people who want their permits” signed so they can enter the territory. “We have to make sure the decisions we make will protect the lives of our people,” he continued. “Our decisions will not be influenced by Samoa or other local residents who pressure us.”

Lolo, as an example, said he has noticed applications for permits presented to the Governor’s Office for his final approval/signature, already have the DoH signature.

“If Health signs off on the application, it gives me the indication that it’s okay for them to come in. Don’t force signing off on permit applications because others have signed it,” he said, and noted that at this time, “there are no changes to our current policy.”

Motusa offered his apologies and said he will communicate again with his counterparts in Samoa for further discussions and provide a full report later. Lolo also requested a more specific break down in numbers of those immunized in Samoa, which has a population of more than 200,000

IMMUNIZATION CONTINUES

Motusa announced that DoH is continuing immunizations this week:

The Tafuna Health Center and Fagaalu Well Baby Clinic is for children 6 months to 19-years old. Both clinics open from 8a.m to 4p.m.

For adults, it’s the Leone Health Center and Amouli Health Center from 8a.m to 4p.m; the Haleck Professional Building in Tafuna from 8a.m to 12p.m; and DHSS at Utulei from 8a.m to 2p.m.

For more information call the measles hotline: 633-5871/633-5872.

UPDATE ON THE MEASLES OUTBREAK — SAMOA

 (HEALTH EMERGENCY OPERATION CENTRE) — January 6, 2020 —The Ministry of Health confirms a cumulative total of 5,697 measles cases have been reported to the Disease Surveillance Team, since the outbreak started.

Currently the outbreak is declining with 30 new cases reported between Dec. 29, 2019 and Jan. 5, 2020.

As of 8.30a.m January 5, 2020, there were 16 measles currently admitted at the Tupua Tamasese Meaole Hospital (TTMH) including 4 critically ill children in ICU/HDU.

The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,860. Of that, 1,761 (95%) patients have recovered and been discharged.

To date, 83 measles related deaths have been recorded. There were 2 fatalities (one infant and one adult) between December 29, 2019 and January 5, 2020.

There are currently no travel restrictions or vaccination requirement for those traveling to Samoa. Additionally, proof of MMR vaccination is not currently required for Samoans traveling to Australia, New Zealand, or the United States.

Only travelers to American Samoa are required to provide proof of vaccination for MMR.