A doctor leading New Zealand's medical response to the measles epidemic in Samoa says the virus is still taking children's lives but he's hopeful the mass vaccination programme is beginning to help.
The death toll from Samoa's epidemic today reached 70, with 87 per cent aged 4 or younger.
The Government ordered a shutdown of the nation last Thursday and Friday to try to cope with the epidemic. Samoa's government said on Sunday it had vaccinated about 90 per cent of the population.
Hawke's Bay's Dr Alan Wright is the clinical team leader for the New Zealand Medical Assistance Team, "Bravo", the second rotation to help in Samoa with the outbreak.
Wright is running the response at Leulumoega District Hospital, with all other patients diverted for treatment to a smaller clinic near Faleolo Airport on Upolu.
There was now a flattening-off in severity of presentations and the rate of new cases appeared to have peaked, he said.
"From a national perspective, the vaccination campaign has been dramatically successful from what I can see in terms of numbers ... Numbers are still reasonably high [but] the overall numbers across the country are just starting to drop down to 110 new presentations a day."
However, some children presenting for treatment had been desperately sick for days with serious infections.
"It's overwhelming pneumonia. There are bugs around in the community that are great opportunists.
"And if you get a child that's debilitated by the measles virus between the age of 1 and 4,when their immune system's not flash anyway and their nutritional status may not be perfect, then they're just sitting targets. And once the infections take hold, it's pretty hard. You're chasing your tail trying to catch up with them."
New Zealand, the UK and Israel are sending dozens more nurses and doctors to Samoa to assist with the epidemic.
There have been nearly 4700 cases of measles diagnosed since October.
The UK government said in a statement 14 medics would arrive on Sunday to relieve a team that arrived two weeks ago.
"The medical system here is under the most enormous amount of strain, with the hospital operating far, far beyond its usual capacity," said Becky Platt, a paediatric nurse with the UK Emergency Medical Team.
"The local staff have been working around the clock for weeks and weeks on end, many of them without proper breaks or any days off. Some of them are absolutely on their knees."
Israel's Foreign Ministry said a team of about 10 Israeli doctors and nurses from the Sheba Medical Centre arrived on Monday and would be deployed for about two weeks to Tupua Tamaese Meaole Hospital.
"Our goal is to help the people of Samoa and represent the state of Israel," said Yitshak Kreiss, director general of the centre, the largest hospital in Israel.
Porirua provider Pacific Health Plus said it sent one medical volunteer to Samoa on Monday and another would arrive this week, in a joint project with the Pacific Co-operation Foundation.
Earlier, Prime Minister Tuilaepa Sailele Malielegaoi said more than 20,000 vaccines were administered over the space of the two-day lockdown designed to stem the tide of the devastating epidemic, with vaccination teams visiting households to administer injections.
The measles vaccine can take about two weeks to provide immunity to the disease.
Meanwhile, the World Bank has given Samoa a US$3.5 million ($5.3m) grant to support the response to the outbreak.
The World Bank said it was deeply saddened by the loss of life in Samoa.
It said the grant was available under an agreement that gives the government access to emergency funding in the event of a national emergency.
In addition, the bank has approved a US$9.3m grant to improve Samoa's health system over the next five years.
The bank said the Samoa Health System Strengthening Program aimed to improve the country's ability to prevent outbreaks of communicable diseases such as measles, and stem the rise of non-communicable diseases such as diabetes.
The programme would help ensure Samoan families, particularly those in rural areas, had access to trained physicians and quality health services.
The numbers
• 70 Death toll from the measles epidemic
• 87 Per cent of fatalities aged 4 or younger
• 90 Per cent of Samoa vaccinated after a big push last week