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Editorial : Tackling measles outbreak with composure

【明報專訊】AMID outbreaks of measles in places like Europe, America, Japan and the Philippines, infection cases in Hong Kong have also surpassed normal levels in recent months, resulting in a scramble for vaccines and some clinics raising injection fees to take advantage of the demand.

The viruses of measles are highly infectious. It is estimated that before the mid-20th century 2.6 million people died of measles every year. Following the advent of vaccination against measles in the 1960s, the threat posed by measles reduced dramatically. According to the World Health Organisation, around 90,000 people died of measles in 2016 in the world, marking the first time that the number of cases per year had fallen below 100,000. The WHO estimates that vaccination reduced the death rate of measles globally by 84% between 2000 and 2016. Over the past two years, measles has become prevalent again, which is closely related with anti-vaccination sentiments in Europe and the United States. Social media has become a platform for disseminating misinformation, causing many people to wrongly believe that "vaccination is harmful" and prevent their children from being vaccinated. In Rockland County, a suburb of New York, US, which has entered a state of emergency recently due to an outbreak of measles, only 73% of people under the age of 18 are vaccinated. It is exactly why the WHO has earlier listed anti-vaccination as one of the ten threats to public health.

The definition of an "outbreak" of a disease is rather loose. According to the WHO, if the number of cases of infection of a particular disease is noticeably higher than normal in a particular place and a particular season, there is an outbreak of the disease. Last year there were only 15 measles cases over the whole year. In comparison, there have been over 30 cases in the first three months of this year, which is abnormal. According to the Department of Health, many people confirmed to have contracted the disease have been to the airport recently, either leaving Hong Kong for travelling or coming back from regions where there has been an outbreak. Also infected are pilots of other nationalities and people working in the airport.

All of a sudden, many people have been scrambling for vaccines "for their own peace of mind". The supply of vaccines has become strained instantly. The news that vaccines are out of stock in clinics has in turn deepened the worry that "the spread of the disease is unpreventable", triggering a vicious spiral of the scramble for vaccines. The truth, however, is that the overwhelming majority of Hong Kong people either have received vaccinations or have antibodies. According to the Centre for Health Protection, 98% or more of people from all age groups in Hong Kong above the age of five have antibodies against measles, while the percentage for the one to four age group is 95%. In other words, the likelihood of a family member contracting measles from a foreign domestic helper is in fact not high unless there is an infant under the age of one or a family member who has never received vaccination against measles.

Caution against the spread of disease is necessary, but over-reaction should be guarded against. Given the short supply of vaccines, it is necessary for the government to come up with ways to increase supply. The real problem facing Hong Kong today is not about vaccines, but about public sentiment. To calm people's nerves, the government should enhance its means of disseminating information to prevent unnecessary panic in society. Citizens should stay calm rather than fear their own shadows.

明報社評2019.03.29:合理合度應對麻疹 不能大意不要恐慌

歐美日菲等地出現麻疹疫潮,本港麻疹近月個案亦較正常為多,市面出現爭打疫苗情况,有診所更坐地起價。

麻疹病毒傳染性極強,上世紀中葉以前,每年估計有260萬人死於麻疹,隨着1960年代麻疹疫苗面世,麻疹威脅顯著下降。根據世衛資料,2016年全球有約9萬人死於麻疹,首次跌破每年10萬宗以下。世衛估計,在2000至2016年間,疫苗接種工作令全球麻疹死亡率下降了84%。近兩年麻疹疫潮復熾,與歐美反疫苗風氣有密切關係,社交媒體成了散播不實資訊平台,不少人誤信「打疫苗有害」,拒絕讓子女接種。以最近爆發麻疹疫潮進入緊急狀態的美國紐約市郊羅克蘭縣為例,縣內18歲以下人士,僅得73%有麻疹接種疫苗。早前世衛將反疫苗列為全球十大衛生威脅,原因亦在於此。

疫症爆發的定義頗為寬鬆,根據世衛說法,若一處地方或一個季節某一疾病的感染宗數,較正常預期明顯為多,即屬爆發。去年全年香港僅得15宗麻疹個案,相比之下,今年首3個月便錄得超過30宗,情况並不尋常。根據衛生署資料,很多確診者近期都曾出入機場,諸如出外旅遊,又或從爆發麻疹疫潮的地區來港,另外亦有外籍機師以及在機場工作的人染病。

一時間,不少人為求「買個安心」,都在張羅麻疹疫苗。疫苗供應頓變緊張,部分診所「斷貨」的消息,倒過來又加深了「疫疾蔓延無法預防」的恐懼,形成「搶疫苗」惡性循環,儘管現實是絕大多數港人都曾注射過麻疹疫苗,又或擁有抗體。根據衛生防護中心資料,本港5歲以上各年齡群組有麻疹抗體的比率高達98%或以上,即使1至4歲亦有95%。換言之,除非家中有未滿1歲的嬰兒、未有打過麻疹預防疫苗,否則外傭傳染僱主家人的機率其實亦不高。

防疫不能掉以輕心,然而亦要慎防反應過度。因應麻疹疫苗供應緊張,政府需要設法增加疫苗供應,當前香港真正面對的不是疫苗問題,而是人心問題,政府應改善資訊發放方法穩定人心,避免社會出現不必要恐慌。市民應保持冷靜,不要自己嚇自己。

■Glossary

composure : the state of being calm and in control of your feelings or behaviour

advent : the coming of an important event, person, invention, etc.

disseminate : to spread information, knowledge, etc. so that it reaches many people

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