Project Aim

This report was commissioned by the Ministry in early 2020 to consider the health system's response to the 2019 measles outbreaks and was conducted by Dr Gerard Sonder and Dr Suitafa Debbie Ryan. 

The review was tasked with reflecting on how the system responded, and continues to respond, to the outbreak, and to identify opportunities to strengthen future respoPolicynses, and identifying what went well and what could be improved to help manage future disease outbreaks with special consideration for equity issues.

The 2019 measles outbreak was the largest since 1997, started in February 2019 and lasted more than a year. After at least 18 virus introductions, 2185 cases were notified spread over 17 District Health Board regions.

Most cases were among Pacific people (896/2185 = 41%) and in Counties Manukau District (1156/2185 = 53%), the area with the largest, most deprived Pacific population. The Pacific population had this highest estimated incidence (234 per 100,000) followed by Māori (67 per 100,000) and European New Zealanders (17 per 100,000)

The outbreak started in Auckland District, followed by cases in Waitemata District, before it reached Counties Manukau where it saw an exponential increase in cases in the large Pacific population.

This increase coincided with the move to Phase 3 in the management of the outbreak by the Public Health Service, during which contact tracing had stopped because the PHS had exhausted its resources after months of intensive contact tracing in the two other districts.

The report includes a set of recommendations to improve the health system’s ability to prevent and respond to measles and other disease outbreaks.

Objectives