Public awareness, news promptness and the measles outbreak in Hong Kong from March to April, 2019

Abstract

Background: Globally, a resurgence of measles during the last decade may be attributed to many factors. An unexpected measles outbreak occurred in Hong Kong, and infected 29 airport staff between March and April 2019. The authority updated public on new cases daily, a public enquiry telephone/online platform was set up on March 23, and an emergent vaccination programme was launched targeting unvaccinated airport staff. We aimed to study this measles outbreak and its related factors.

Methods: We quantified the transmissibility of the outbreak by the time-varying effective reproduction number, R_eff(t), and inferred the time-varying basic reproduction number, R₀(t). We examined the statistical associations between local public awareness or reporting delay and the R₀(t).

Results: Our estimated average R₀ is 10.7 with 95% CI of 6.0–29.2. We found that R₀(t) was negatively associated with the level of public awareness and the level of promptness of situation updates on new cases.

Conclusion: Public awareness via situation updates helped to control the outbreak. The medical effects of the vaccination programme was not soon enough to cause the immediate shutting down of the outbreak, but it boosted herd immunity to prevent future airport outbreaks in the next few years.

Keywords:

• Measles
• outbreak
• reproduction number
• public awareness
• Hong Kong
• airport

Ethical approval

Since all cases data and information in this work were collected via public domains [6], the ethical approval or individual consent is not applicable.

Author contributions

SZ conceived the study, carried out the analysis and drafted the first manuscript. SZ, LH and DH revised the manuscript. DH supervised the project. All authors read the manuscript, and gave final approval for publication.

Disclosure statement

The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Data availability

All data used in this work were collected from the Centre for Health Protection (CHP) [4,6], the government of Hong Kong, and the Hong Kong international airport (HKIA) [12]. All data sources are publicly available.