On May 10, 2024, the Turks and Caicos Islands (TCI) reported two (2) laboratory-confirmed cases of measles despite having a national measles vaccination coverage rate of 95%. This coverage rate is similar to that of St. Kitts and Nevis. It must be highlighted that the Caribbean subregion was the first area in the world to have eliminated measles in 1991. However, some islands have experienced imported cases of measles between 1991 and 2019. This trend is expected to continue.
Currently, there are prolonged measles outbreaks occurring in the United Kingdom, the United States of America, and other health regions globally. The Federation, like other member states, is at increasing risk of importation of the virus from countries in our tourism source markets where the virus continues to circulate. The re-emergence of measles and other vaccine-preventable diseases is occurring because of disruption in routine vaccination program activities post the COVID-19 pandemic and other factors like vaccine hesitancy.
The Federation benefits from daily flights to and from the USA and weekly flights to and from London. An unsuspected, traveller can import the virus to our islands and cause the disease to spread among locals, who are unvaccinated.
Measles is a vaccine preventable, viral disease, that is highly contagious. It is spread by airborne droplets or via direct contact with secretions from the nose, mouth, and throat of infected individuals. The incubation period which is the period between exposure to the virus and the onset of the first symptoms is approximately 10 to 12 days. The symptoms include high fever, generalized rash all over the body, stuffy nose, and reddened eyes. The characteristic rash starts on the face and behind the ears before spreading, and usually consists of raised, non-itchy spots that eventually evolve into blotchy patches. The Kolpik spots are peculiar spots located on the mucosal surfaces inside the mouth and are considered to be diagnostic of measles. Infected persons are infectious starting from four days before the appearance of the rash and infectiousness persists for about four days post-rash onset.
Measles can cause serious complications, including severe diarrhoea, ear infections, pneumonia, blindness, encephalitis or swelling of the brain, and even death, particularly in children with nutritional problems, and who are immunocompromised.
The Ministry of Health (MOH) is being proactive in augmenting its expanded program on immunization (EPI) by scaling up its vaccine outreach initiatives. The aim is to reach all the unvaccinated children to increase our vaccination coverage rate. We also will target frontline workers to encourage them to check their measles vaccination status. The aim is to have high-risk individuals check their immunization cards, contact their respective health centres to verify their immunization status, and accept the measles vaccine if needed. Again, measles is a vaccine preventable disease.
The Ministry of Health (MOH) has strengthened its surveillance system and its capacity to promptly detect and treat suspected cases of measles. The MOH also can track potential contacts. The Ministry of Health is using this medium to assure the public that the measles (MMR) vaccine is safe.
The Federation is preparing for the Music Festival and Culturama. Let us partner together to increase the national measles vaccination coverage rate to mitigate the impact of the importation of measles.
Office of the Chief Medical Officer
May 21, 2024