While Palau remains one of the last nations to be free of the global pandemic, the last months of 2020 have seen recurring outbreaks of chickenpox, the vast majority among children.

The Ministry of Health (MOH) has said that the number of reported chickenpox cases in 2020 has surpassed the number of cases in the previous three years, with this year seeing 46 reported cases compared to the fewer than ten cases in 2019. Sixty-five percent of cases occurred in children under 18 years old, with places like daycare centers serving as hotspots for person-to-person transmission.

The number of cases spiked in October, when 15 patients, roughly a third of the year’s overall number, sought medical care for chickenpox. November saw a total of six cases, and so far December has seen two cases pending review.

But the MOH says that the real number might be significantly higher, with the only recorded cases being those who sought medical care through the MOH system, in the Belau National Hospital and community health centers or public health clinics. The numbers do not include those who received care in private clinics or did not seek health care at all.

Chickenpox is considered a highly-contagious disease, spreading easily from one person to another through close contact, particularly if the person has not had chickenpox before or has never been vaccinated. Someone infected with chickenpox is contagious one to two days before rashes appear, and generally it takes around two weeks for someone exposed to chickenpox to develop them themselves.

While vaccination is generally considered the best protection against chickenpox, the chickenpox vaccine is not currently included in Palau’s Childhood Immunization Schedule, which does vaccinate against diseases like the flu and measles. The MOH has said that transmission of the disease can also be prevented by good hygiene measures, such as “washing hands with soap and water, not sharing utensils, and regularly cleaning high-touch surfaces”.  

At a workshop conducted by the MOH last week to update community stakeholders on the status of COVID, MOH representatives asserted that, while Palau remains free of coronavirus, practicing the normal safety measures against virus transmission will help to protect against the spread of other communicable diseases. Some public facilities, such as Bank of Hawaii in Koror, are continuing to enforce social-distancing measures. But these measures have generally been relaxed in Palau in the past few months.  

While the number of chickenpox cases in Palau this year is high compared to recent years, it is only about half of the number of recorded cases in 2016, which saw nearly 90 cases of chickenpox.

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