Measles, Mumps, and Rubella Vaccine. Photo Credit: GETTY IMAGES.
The V.I. Department of Health is actively responding to a concentrated outbreak of hand, foot and mouth disease in the St. Thomas/St. John district, while also preparing for a potential measles outbreak amid rising cases on the U.S. mainland. Health Commissioner Justa Encarnacion shared both updates during her appearance before the Committee on Health, Hospitals and Human Services on Tuesday, where she outlined the territory’s public health response and urged vigilance in the face of dual infectious disease threats.
As of April 19, 272 of the 277 recorded cases of HFMD had come from the district, she noted during her status update.
A highly contagious viral illness, HFMD commonly affects children under the age of five. “Symptoms include fever, sore throat, and painful mouth sores that may blister and a rash on hands and feet,” shared the commissioner.
“In response to the outbreak, the V.I. Department of Health launched a coordinated public awareness effort to promote proper hygiene practices and help control the rapid spread of HFMD,” explained Ms. Encarnacion. A series of public alerts were issued when the DOH became aware of the centralized outbreak.
With the number of cases of HFMD still on the rise, Ms. Encarnacion says the department continues to urge heightened hygiene and precaution. “Our Epidemiology Division continues to provide phone consultations and in-person visits for direct observation and infection control training to affected daycares and schools,” she explained. It’s an approach that DOH prefers over temporarily shuttering schools where students have been infected. No vaccines are available for HFMD, and parents of infected children are urged to prioritize their comfort while keeping them at home until their symptoms have appropriately resolved in keeping with the established medical guidelines.
Though a young child who had contracted HFMD later died, the Department of Health says it is currently “not able to say whether or not it was related to hand, foot and mouth disease.”
Several lawmakers, including committee chair Senator Ray Fonseca, were concerned about the concentration of the outbreak in St. Thomas. “That's where the first one occurred,” Ms. Encarnacion explained briefly. Once they became aware of increased cases, the department ramped up prevention efforts on St. Croix, where only five cases have been recorded to date.
“You've actually seen a decrease in numbers, and that is because we implemented various strategies,” said Ms. Encarnacion to Senator Hubert Frederick, who wondered whether public service announcements were reaching all sections of society.
Meanwhile, the measles threat remains at bay, although DOH remains on high alert as cases continue to rise on the mainland. “We are alarmed by the high rate of transmission, and while no cases have been reported in the territory, we feel it is a matter of when, not if,” Ms. Encarnacion told lawmakers.
Measles, which can be prevented or mitigated against via vaccination, commonly includes symptoms like high fever, cough, runny nose, inflamed eyes and sore throat, tiny white spots inside the mouth, and a red blotchy rash. As of April 19th, the Centers for Disease Control and Prevention has recorded 800 cases across 25 states, and three associated deaths have been reported.
“Our primary concern is the unvaccinated population aged 12 months to six years,” Ms. Encarnacion testified. In the USVI, only 44.32% of that age group is vaccinated, leaving more than half at increased risk. Unvaccinated pregnant women and individuals with compromised immune systems are also more susceptible to contracting measles.
“The measles, mumps and rubella vaccine, or MMR, is safe and proven to be the most effective, providing 97% protection against measles,” Commissioner Encarnacion advised. MMR vaccines are currently widely available at clinics, pharmacies, and other healthcare providers.
“With the growing measles crisis, the arrival of spring break, and the upcoming summer travel season, the department has been actively emphasizing the importance of staying up to date on the MMR vaccination,” she told the committee. Those traveling to areas with measles outbreaks should be especially cautious. The department is in the process of issuing letters “urging parents with an approved vaccination exemption to vaccinate their children.”
“A measles outbreak in the territory would present a significant public health risk by overwhelming healthcare resources,” Ms. Encarnacion warned. “The U.S. Virgin Islands’ limited hospital capacity will face challenges in managing measles cases.” Complications from measles can be severe, according to the commissioner, including “ear infections leading to hearing loss, pneumonia, encephalitis and even death.”
Legislators, too, have urged the unvaccinated population to take the necessary steps to boost their immunity. “There is a very low chance of you becoming infected with it after you've been vaccinated,” noted Senator Carla Joseph.
Senator Milton Potter, who observed that tourists could potentially carry a measles infection to the territory, wondered what steps could be taken in that regard. “Is it practical to suggest that at some point, there is some requirement with regard to travelers coming to the territory to demonstrate proof that they've been vaccinated?” he asked.
Recalling that a similar arrangement was instituted during the Covid-19 pandemic, Ms. Encarnacion promised that “we'll continue to be as feisty and as strong as possible to protect our community.”
