• The measles outbreaks in the four Pacific Island and Territories (PICs) continues, but with fewer cases reported in the last week.
• A low level of transmission continues in American Samoa, Fiji, Samoa and Tonga, but the overall situation has stabilised.
• No further measles cases have been reported from Kiribati, while monitoring and surveillance is continuing
• The situation in other PICs is being closely monitored with on-site deployment of experts for surveillance and remote preparedness support from WHO, UNICEF, and other partners.
Summary by PIC
• American Samoa: no new laboratory confirmed measles cases have been reported; however, four suspected cases are pending results from Hawaii State Laboratory.
• Fiji: two new cases have been identified in the Central Division last week, one case was linked to a family member while another is being investigated for exposure.
• Kiribati: no new laboratory confirmed measles cases have been reported. Investigation of new suspected cases is ongoing, with on-site and remote technical support from WHO and UNICEF.
• Samoa: fewer cases and no deaths have been reported since 26 December 2019. Emergency Medical Teams (EMTs) are scaling down but some will remain into January.
• Tonga: number of cases decreasing, with fewer cases reported; all new cases are from the main Island of Tongatapu.
• The risk of importation of measles cases, the susceptibility of the population, as well as the risk of a local or largescale measles outbreak and corresponding need for partner support, continuously monitored in all other PICs. The risk of importation of cases in PICs remains moderate, as inter- and intra-island movement will start in January 2020, after the holiday season.
• WHO is deploying staff to several PICs with elevated risks related to measles and other infectious hazards, focusing on joint action planning and health security system strengthening. For the period of January to March 2020, these efforts will include Kiribati, the Commonwealth of the Northern Mariana Islands (CNMI), the Republic of the Marshall Islands (RMI), the Federated States of Micronesia (FSM) and Vanuatu.
• Availability of vaccines is currently monitored by UNICEF and WHO (Table 3) and a contingency plan is in place in case of additional demand.
Other emergency events in the PICs region
• Tropical Cyclone Sarai (category 2) has affected Fiji and Tonga.
• There are ongoing dengue outbreaks in Wallis & Futuna, the Kosrae and Yap States in the Federated States of Micronesia (FSM), the Republic of the Marshal Islands (RMI) and French Polynesia.
• Influenza outbreaks also reported in the RMI.
• Acute Diarrhoea and Vomiting (ADV), Rotavirus RDT-positive cases are reported in Kiribati this week. One death due to ADV has been investigated and reported.