Dr. Natalia Largaespada-Beer: “Measles is preventable with a vaccine.”
BELIZE CITY, Tues. Apr. 15, 2025
After 34 years, measles has re-emerged in Belize. Two imported cases were confirmed via laboratory testing on April 12 in two unvaccinated teenagers, both 17 years of age, a male and a female. One is from Cayo and the other from Corozal. However, the two cases are connected, since both teens were part of a group of 15 from four communities in Belize who travelled to Chihuahua, Mexico around January 5and returned at the end of March. They developed a fever and a rash on April 2and 3. The entire group has been placed in the required 21-day isolation; and thus far, the Ministry of Health and Wellness says 13 (11 of whom are vaccinated) remain asymptomatic.
Measles is a highly contagious disease caused by a virus and is spread person-to-person via droplets suspended in the air or lying on surfaces or through direct contact with nasal or throat secretions from infected persons. The reach of the transmission is 12 feet. The droplets can remain in the environment for two hours. Symptoms include high fever, dry cough, a runny nose, conjunctivitis and a rash that starts at the hairline and spreads to the chest, back, limbs and then to the rest of the body. During a virtual briefing on the concerning development, Technical Advisor for Maternal and Child Health, Dr. Natalia Largaespada-Beer highlighted that each infected person has the potential to infect 9 out of 10 persons.
The good news is, “Measles is preventable with a vaccine,” said Dr. Largaespada-Beer. That vaccine is the MMR2.
Data from the ministry of Health and Wellness showing MMR2 vaccination coverage by district
Check your vaccine cards
In 2024, Belize’s MMR2 (measles, mumps and rubella) vaccination coverage was at 83.9%, whereas the target is 95%. Some districts are farther behind than others in coverage, in particular the Cayo District (73.5%) and the Belize District (79%). Corozal has the highest coverage at 93.9%. The Health Ministry is hoping that, given the two cases that have now been confirmed in Belize, there will be an uptick in vaccination; however, Dr. Largaespada-Beer admitted that trust in vaccines has eroded since the COVID-19 pandemic. Nevertheless, the Ministry says that from January this year, it has been going into communities monthly to increase vaccine coverage, and it intends to ramp up its surveillance. In that regard, the Ministry is actively looking for cases and testing any suspected cases early. The public is also asked to report any suspected cases to the nearest health facility. The Ministry’s 0800-MOH-CARE hotline is also active.
With outbreaks in every region of the world, parents are being urged to ensure that their children are vaccinated. The MMR2 vaccine is administered in two doses for children – one at 12 months and the other at 18 months. Those adults who may not have their vaccine record and cannot recall if they were vaccinated for measles, are being advised to retake the vaccine. In addition, though, Dr. Largaespada-Beer reminded Belizeans about the benefits of post-exposure prophylaxis. She says there is a window of three days or 72 hours when someone who is exposed can take the vaccine and have 83% to 100% protection.
Belize currently has 39,000 doses of MMR2 vaccines and, if needed, the Ministry says Mexico has committed to supply the country with more.
The high-risk groups primarily being targeted for vaccination are unvaccinated children and teenagers, unvaccinated adults 20 – 59 years, adults over 60 years (to act as a booster given that their immune defenses can start to drop), unvaccinated healthcare workers, immune-compromised persons (persons with diabetes, with cancer, or HIV), pregnant women, and residents in communities with low vaccination coverage.
Apart from vaccination, good hygiene practices are encouraged to help prevent infection.
Rash caused by measles
No travel bans, but surveillance to be increased at entry points
Dr. Melissa Diaz-Musa, Director of Health and Wellness, reported that the Americas have seen a surge in measles, recording a significant increase between January and March this year compared to the same period in 2024.
Belizeans who are aware of the severity of the spread in Texas, USA, are concerned, given that there are direct flights from that state to Belize. As at last verification today, Texas had recorded 561 cases. Two unvaccinated children with no underlying health conditions have died this year from measles in Texas. The center of the outbreak is Gaines County in the western part of the state. The USA is now experiencing what is being described as the second-worst measles outbreak since it declared the disease eliminated in 2000. There are now cases in 24 states, with the total cases countrywide numbering over 700.
Dr. Largaespada-Beer does not believe that travel bans are the way to go. Nonetheless, Dr. Diaz-Musa explained that there are public health inspectors trained in surveillance at the borders and for cruise ships. They will now be required to enhance their surveillance, which means they are to actively look for cases and reach out to people who have been sick. In the case of the international airport, they review the report issued by the pilot just prior to landing that identifies any person who might have been ill on the flight. There will also be posters displayed at the airport.
Advice for travelers
The Ministry advises travelers to ensure they get vaccinated ideally 30 days prior to departure or at least two weeks before. Dr. Diaz-Musa informed that persons can be contagious 4 to 5 days prior to developing a rash and remain infectious 4 to 5 days after the rash. It is the expectation that if an unvaccinated person comes into contact with an infected person, more than likely they will be infected.
How concerning is measles compared to COVID-19?
Asked to compare how concerning measles is versus COVID-19, our health officials say that because of transmissibility, measles is more concerning. However, they emphasize that COVID-19 was a novel virus we knew nothing about, whereas for measles, there is an established vaccine that prevents spread and a large percentage of our population is already vaccinated.
As to the severity of the disease, epidemiologist Dr. Russell Manzanero emphasized that in high- risk groups (children, the elderly, pregnant women, those who are immune-compromised), individuals may have a more severe infection. He shared possible scenarios which could include complications like premature births for pregnant women, pneumonia, swelling of the brain and even death.
Whooping cough increasing in Mexico
For epidemiology week from March 30 to April 5, Mexico reported 2,549 probable cases of whooping cough, with 696 being clinically confirmed. Also being reported are 37 related deaths in 14 states. In Quintana Roo, there are 29 probable cases, of which 4 have been confirmed.
Asked if we ought to be concerned about this in Belize, Dr. Beer explained that Belize has had small outbreaks of whooping cough almost every year, and she attributes this to unvaccinated children. She informed, though, that whooping cough is included in their surveillance for vaccine- preventable diseases.
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