SINGAPORE: Measles is back in the spotlight after the United States reported more than 1,000 cases and three deaths to date.
Known as one of the most contagious diseases in the world, measles spreads easily through respiratory droplets when an infected person breathes, coughs or sneezes. Common symptoms include high fever and a rash, though in severe cases, the illness can lead to complications and even death.
Singapore eliminated measles in 2018. However, 10 cases have already been recorded this year as of the week ending May 10, according to the Ministry of Health’s weekly infectious disease bulletin. That is just one short of the 11 cases logged throughout all of 2024.
Does this signal a local resurgence? Experts say no – but regional and global trends still warrant attention.
Why are measles cases surging in the region?
Southeast Asia is seeing a significant rise in measles cases. Malaysia had 156 confirmed cases in the first three months of this year, according to a World Health Organization (WHO) report in April on the measles situation.
Thailand has reported more than 1,110 cases, while Vietnam has reported a staggering 40,000 suspected cases and five deaths as of mid-March.
Dr Alex Cook from the National University of Singapore's (NUS) Saw Swee Hock School of Public Health attributed the regional surge to COVID-19's disruption of routine immunisation programmes. Many children missed their scheduled measles vaccines during the pandemic, leaving them vulnerable, he said.
The WHO estimated that more than 100,000 people worldwide, most of them children under five, died from measles in 2023.
Are the latest numbers in Singapore a cause for concern?
Not at this point, said infectious disease experts CNA spoke to.
Dr Cook said that Singapore's case numbers have historically fluctuated. During the pandemic, for instance, there were 12 cases in 2020, zero in 2021 and four in 2022. By contrast, more than 100 cases were reported in both 2016 and 2019.
This year's numbers are "completely unremarkable", said Dr Cook, who is also NUS' vice-dean of global health.
"It is not like the measles outbreaks in the US caused by parents neglecting the health of their children by failing to protect them with vaccines."
Could imported cases spark a local outbreak?
Professor Ooi Eng Eong, from the emerging infectious diseases programme at Duke-NUS Medical School, said that imported measles cases could occasionally lead to locally acquired infections. However, these are typically isolated due to Singapore’s high vaccination rates.
Both Dr Cook and Prof Ooi stressed that an actual outbreak in Singapore is unlikely.
Some countries that have seen a re-emergence of measles have low vaccination rates against measles, said Prof Ooi.
Measles is highly transmissible and requires about 95 per cent population immunity to prevent outbreaks.
According to WHO immunisation data, 97 per cent of Singaporean children receive at least one dose of the measles, mumps, and rubella (MMR) vaccine annually. About 92 per cent receive both recommended doses.
Those who have received two doses are highly unlikely to develop measles, Prof Ooi said.
Dr Cook also pointed out that previous outbreaks in Singapore have remained “self-limiting” due to high community immunity.
The last major outbreak here occurred in the 1990s. It was swiftly brought under control by a 1997 catch-up immunisation drive targeting those who had missed out on the mandatory measles vaccination introduced in 1985.
Is the MMR vaccine still effective?
Singapore mandates two MMR doses for children starting at 12 months. Adults who have not been vaccinated or lack evidence of past infection or immunity are also advised to get vaccinated under the National Adult Immunisation Schedule.
For healthy individuals, the immunity from two MMR doses is long-lasting. However, those on immunosuppressive treatments, such as chemotherapy or medication for organ transplant rejection, may need a booster, Prof Ooi said.
Dr Cook described the mandatory vaccination programme as a “game changer”, offering over 95 per cent protection – higher than many other vaccines, including those for influenza, dengue and COVID-19.
Local infection rates are much higher in babies between six and 12 months old – before they are given the vaccine – compared with other age groups, he said.
Should you get another jab?
If you’ve only had one dose of the MMR vaccine, consider getting the second, especially if you’re a teenager or young adult. While measles tends to be milder in older age groups, you’re still at risk.
"The only way to prevent measles is to be vaccinated," Prof Ooi emphasised.
If you’ve had two MMR doses, you’re in the clear, both experts agreed. If not – or if you’re not sure – consult your doctor.
Want an issue or topic explained? Email us at digitalnews [at] mediacorp.com.sg. Your question might become a story on our site.
Continue reading...
Known as one of the most contagious diseases in the world, measles spreads easily through respiratory droplets when an infected person breathes, coughs or sneezes. Common symptoms include high fever and a rash, though in severe cases, the illness can lead to complications and even death.
Singapore eliminated measles in 2018. However, 10 cases have already been recorded this year as of the week ending May 10, according to the Ministry of Health’s weekly infectious disease bulletin. That is just one short of the 11 cases logged throughout all of 2024.
Does this signal a local resurgence? Experts say no – but regional and global trends still warrant attention.
Why are measles cases surging in the region?
Southeast Asia is seeing a significant rise in measles cases. Malaysia had 156 confirmed cases in the first three months of this year, according to a World Health Organization (WHO) report in April on the measles situation.
Thailand has reported more than 1,110 cases, while Vietnam has reported a staggering 40,000 suspected cases and five deaths as of mid-March.
Dr Alex Cook from the National University of Singapore's (NUS) Saw Swee Hock School of Public Health attributed the regional surge to COVID-19's disruption of routine immunisation programmes. Many children missed their scheduled measles vaccines during the pandemic, leaving them vulnerable, he said.
The WHO estimated that more than 100,000 people worldwide, most of them children under five, died from measles in 2023.
Are the latest numbers in Singapore a cause for concern?
Not at this point, said infectious disease experts CNA spoke to.
Dr Cook said that Singapore's case numbers have historically fluctuated. During the pandemic, for instance, there were 12 cases in 2020, zero in 2021 and four in 2022. By contrast, more than 100 cases were reported in both 2016 and 2019.
This year's numbers are "completely unremarkable", said Dr Cook, who is also NUS' vice-dean of global health.
"It is not like the measles outbreaks in the US caused by parents neglecting the health of their children by failing to protect them with vaccines."
Related:
Could imported cases spark a local outbreak?
Professor Ooi Eng Eong, from the emerging infectious diseases programme at Duke-NUS Medical School, said that imported measles cases could occasionally lead to locally acquired infections. However, these are typically isolated due to Singapore’s high vaccination rates.
Both Dr Cook and Prof Ooi stressed that an actual outbreak in Singapore is unlikely.
Some countries that have seen a re-emergence of measles have low vaccination rates against measles, said Prof Ooi.
Measles is highly transmissible and requires about 95 per cent population immunity to prevent outbreaks.
According to WHO immunisation data, 97 per cent of Singaporean children receive at least one dose of the measles, mumps, and rubella (MMR) vaccine annually. About 92 per cent receive both recommended doses.
Those who have received two doses are highly unlikely to develop measles, Prof Ooi said.
Dr Cook also pointed out that previous outbreaks in Singapore have remained “self-limiting” due to high community immunity.
The last major outbreak here occurred in the 1990s. It was swiftly brought under control by a 1997 catch-up immunisation drive targeting those who had missed out on the mandatory measles vaccination introduced in 1985.
Is the MMR vaccine still effective?
Singapore mandates two MMR doses for children starting at 12 months. Adults who have not been vaccinated or lack evidence of past infection or immunity are also advised to get vaccinated under the National Adult Immunisation Schedule.
For healthy individuals, the immunity from two MMR doses is long-lasting. However, those on immunosuppressive treatments, such as chemotherapy or medication for organ transplant rejection, may need a booster, Prof Ooi said.
Dr Cook described the mandatory vaccination programme as a “game changer”, offering over 95 per cent protection – higher than many other vaccines, including those for influenza, dengue and COVID-19.
Local infection rates are much higher in babies between six and 12 months old – before they are given the vaccine – compared with other age groups, he said.
Should you get another jab?
If you’ve only had one dose of the MMR vaccine, consider getting the second, especially if you’re a teenager or young adult. While measles tends to be milder in older age groups, you’re still at risk.
"The only way to prevent measles is to be vaccinated," Prof Ooi emphasised.
If you’ve had two MMR doses, you’re in the clear, both experts agreed. If not – or if you’re not sure – consult your doctor.
Want an issue or topic explained? Email us at digitalnews [at] mediacorp.com.sg. Your question might become a story on our site.
Continue reading...