Indonesia reports 17 deaths in measles outbreak, launches vaccine drive

News brief

A measles outbreak centered in Indonesia’s East Java has sickened more than 2,000 children, 17 of them fatally, prompting the launch of an immunization campaign today in the country’s hot spot, the Associated Press reported. 

MMR vaccine
digicomphoto / iStock

The outbreak has been under way for the past 8 months, and 16 of the patients who died are from Sumenep district, according the report, which cited data from the Sumenep District Health Agency.

Indonesia is grappling with a gap in childhood immunization, with just 72% of children younger than age 5 receiving the measles vaccine last year, well below the 95% population coverage needed to prevent outbreaks. For some provinces, the measles immunization rate is below 50%. 

Indonesia experienced a large measles outbreak in 2018 in Papua province that was complicated by religious concerns that the measles, mumps, and rubella vaccine contained pork. Indonesian health officials have called on residents, community officials, and religious leaders to support immunization efforts in Sumenep, which is targeting 78,000 children ages 9 months to 6 years. 

The outbreak is occurring against the backdrop of a global rise in cases, including in North America.

Transit exposures in New Jersey’s latest case

In US developments, the New Jersey Department of Health on August 22 announced a measles infection in a resident of Hudson County who had close contact with a confirmed patient who is not a resident of the state. Officials emphasized that there are no links to earlier cases and that New Jersey is not experiencing a measles outbreak.

Officials said the patient traveled on public transportation between August 13 and 15 while infectious and that they are working with local officials on contact-tracing efforts. New Jersey has reported seven cases this year. 

CDC: Rare Salmonella strain from bearded dragons caused 2024 US outbreak, still circulates

News brief
Bearded dragon on child's arm
Kent Kanouse / Flickr cc

People who live with or handle pet bearded dragons are at continued risk for Salmonella infection, conclude the authors of a study on a 2024 outbreak published last week in Morbidity and Mortality Weekly Report.

The US Centers for Disease Control and Prevention (CDC) and federal and local health authorities investigated a 27-case, 14-state outbreak in 2024 caused by reptile-transmitted Salmonella Cotham. They also referenced a 2012-14 outbreak of 160 cases in 35 states caused by a genetically related strain.

Originally imported from Australia, bearded dragons have a "beard" of spikes on the throat that inflates in response to stimuli such as stress or fear.

Most infections in young children

In the 2024 outbreak, 72% of those sickened reported contact with a bearded dragon or lizard in their household or one they visited in the 7 days before symptom onset. Children younger than 5 years, particularly infants, accounted for 65% of the 26 confirmed cases; most had bearded dragons in the home but no direct contact, although they were exposed to animal living areas or a person with contaminated hands or clothing.

Caregivers [should] prevent young children from indirect reptile contact by restricting reptiles from roaming freely, separating reptiles and supplies from food preparation areas, and washing hands and changing clothes after handling reptiles and before holding infants.

Two of six parents who were re-interviewed said their reptiles were allowed to roam freely, and two reported washing baby bottles and reptile supplies in the same sink. No parents of young children knew that reptiles can transmit Salmonella. In total, 42% of patients with confirmed illness were hospitalized; hospitalization status was unknown for two patients.

Whole-genome sequencing of two bearded dragon specimens collected in 2024 and three from 2012-14 confirmed that they were related and that the rare strain continued to circulate among commercially sold bearded dragons. 

The CDC worked with pet industry representatives to disseminate information about biosecurity best practices to bearded-dragon suppliers and retailers, including a common supplier identified in the traceback investigation.

CDC officials recommended that "caregivers prevent young children from indirect reptile contact by restricting reptiles from roaming freely, separating reptiles and supplies from food preparation areas, and washing hands and changing clothes after handling reptiles and before holding infants."

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