Earlier this month, we watched Gov. Josh Green bring back his infamous whiteboard (sorry for the Covid-19 flashback), to provide an update on the rise of measles cases nationwide.
“Measles spread quickly, can lead to severe complications, and put our most vulnerable — our keiki, kūpuna, pregnant women and those with weakened immune systems — at risk,” Green said in the caption of a March 12 Instagram post.
“The best protection for our keiki and our entire community is vaccination. Two doses of the MMR vaccine are 97% effective at preventing infection and stopping the spread of this dangerous virus,” he continued. “Vaccines have saved millions of lives, and thanks to them, measles was once eliminated in the U.S. — but now, low vaccination rates are allowing it to return.”
At the time of the post, Hawaiʻi had 0 reported measles cases, though Green mentioned his trip as Lieutenant Governor leading a medical mission to Samoa to assist with a measles outbreak in 2019.
How common are measles cases in Hawai‘i? According to the most recent summary of reported cases of notifiable diseases by the state Department of Health, 24 cases of measles were reported for both non-residents and residents over a 10-year period from 2014 to 2023. Last year, two cases of measles were reported by residents.
So far this year, there have been no confirmed cases of measles in the Islands.
As of March 13, a total of 301 confirmed measles cases were reported in the U.S., where 17% were hospitalized and one death has been confirmed and another is under investigation, per the Centers for Disease Control and Prevention. There were 126 confirmed cases for ages 5-19, 103 cases for ages 5, 63 adults and 9 unknown ages. The CDC notes, majority of cases were unvaccinated or unknown.
According to CDC data, the last major spike in measles cases nationwide came in 1990, with 27,800 cases. The disease has been nearly nonexistent in the U.S. since 1997, which saw 141 cases. Years that stand out for noticeable increases include 2014 (667 cases) and 2019 (1,274 cases).
So if not measles, what are the most common infectious diseases in the Islands? The 10-year summary for Hawaiʻi reveals that sexually transmitted infections were among the most common diseases besides the flu and food borne illness.
According to DOH and the CDC, Hawai‘i's most common infectious diseases, by cumulative cases from 2014 to 2023, have been:
- Chlamydia: 67,937
- Influenza: 64,290
- Gonorrhea: 14,310
- Campylobacteriosis: 6,271
- Salmonellosis: 2,635
DOH also noted that the 2023 case count for chlamydia was 6,251, while gonorrhea was 1,818.
“Hawaiʻi's 2023 rates of gonorrhea and chlamydia are less that the rates for the U.S. as a whole; however, these infections can cause serious health problems and robust prevention, testing and treatment services are important,” DOH said by email. “This summary is current through 2023. The 2024 case data are being reviewed and finalized and will be made publicly available later this calendar year.”
Aloha State Daily asked the state department more about how they are addressing such diseases.
What do you want readers to know about DOH's programs or activities that address these diseases in Hawaiʻi?
DOH conducts surveillance and investigations on most of the notifiable conditions in the HAR Title 11, Ch. 156, Communicable Diseases. Specific surveillance programs include Foodborne disease, Healthcare Associated Infections, Influenza and Respiratory Diseases, Vaccine Preventable Diseases, STIs, Zoonotic and Vector borne diseases, and other reportable conditions, including emerging infections like Avian Influenza.
Investigations include interviewing case-patients, assessing risk factors, providing control and prevention guidance and outreach to cases and contacts, and working with community partners and healthcare to mitigate disease spread. DOH utilizes investigations, testing, and contact tracing to identify and rapidly respond to clusters and outbreaks.
We were surprised to see STIs so prominent on the list, is that an area you're focused on? How is DOH prioritizing chlamydia and gonorrhea prevention, among the other diseases with high case counts?
Yes. DOH's Harm Reduction Services Branch (HRSB) works diligently to prevent and identify cases of gonorrhea and chlamydia and help people access testing and treatment. HRSB also focuses on additional sexually transmitted infections (STIs) of public health significance such as syphilis and HIV.
To accomplish this work, HRSB partners with many different organizations on all islands, as well as other parts of DOH and the CDC. Some of HRSB's efforts beyond cluster investigations and surveillance include health care provider education, providing resources to local clinics for free testing, ongoing public outreach and education, monitoring for drug resistant gonorrhea cases, free clinical services at the DOH STI clinic at Diamond Head Health Center and promoting DoxyPEP – a new tool for preventing bacterial STIs. Chlamydia and gonorrhea are common infections that often have mild or no symptoms but can cause serious health problems. Both chlamydia and gonorrhea are treatable. People who are sexually active should talk to their medical provider about whether they should be tested for chlamydia, gonorrhea, and other STIs.
While not as common as gonorrhea and chlamydia, syphilis has been rapidly increasing across Hawaiʻi and the nation since 2019 and is a cause for public health concern. Babies born to pregnant women with syphilis are at risk of congenital syphilis, a severe, debilitating illness. As part of its overall efforts to combat STIs, DOH continues extensive efforts to identify and treat cases of syphilis in the population and decrease the cases of congenital syphilis in Hawaiʻi.
For DOH information about the measles, click here. For STI's, click here.
Kelsey Kukaua Medeiros can be reached at kelsey@alohastatedaily.com.
