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Measles Outbreak Demonstrates Japan Lacks a Cohesive Disease Emergency Preparedness Strategy

Measles is a highly contagious, potentially fatal viral disease. In the case of measles, it is necessary to be vaccinated at least twice, usually during the first year of life and again at around 5 years of age.1 During 2000 to 2016, measles vaccination prevented over 20 million deaths worldwide.2 Yet it remains one of the leading causes of mortality among young children, with a mortality rate of 0.1%, even in developed countries.3 Japanese government managed to officially eliminate endemic transmission of measles in March 2015. Annual outbreaks have been occurring regularly in Japan, although almost exclusively from imported sources. Young adults of 20 years or older have accounted for more than 70% of cases since 2015 measles outbreak. On March 20, 2018, an overseas visitor was diagnosed with measles in Japan’s southernmost Okinawa Prefecture and this was followed by reports from other prefectures in a generally northward spread. We examined the correlation between the number of measles vaccinations given in the Navitas Clinic in Shinjuku, Tokyo in relation to Japan’s mass media coverage during the 2018 outbreak. The clinic is conveniently located in a shopping area within the Shinjuku train station complex in Tokyo, handling 3 to 4 million passengers daily. In the Navitas Clinic, between April 1 to May 31 in 2018, 844 people (381 males, 463 females) with a median age of 35 (range, 1-86) received a measles vaccination. Of those vaccinated, 688 received a combination vaccine for measles and rubella (MR), while 156 received a vaccine for measles, mumps, and rubella (MMR).