SA measles outbreak of concern, NICD warns as case surge hits 80% worldwide

Source: DynaMedex.

This is in the wake of outbreaks in five of nine provinces with more than 300 confirmed cases. The affected provinces are Limpopo, Mpumalanga, North West, Gauteng and the Free State.

Most confirmed measles cases, 44%, are affecting five- to nine-year-olds, with some 28% of cases among one- to four-year-olds and the remainder among people aged 10- to 42-years, UN's children's agency, Unicef SA confirmed.

With schools in South Africa currently re-opening for the 2023 academic year, teachers have been cautioned to look out for the signs of measles among learners.

The Department of Health's Foster Mohale said learners displaying symptoms should be sent home to contain the spread.

Unicef SA advised frontline health and social workers, and community, faith and civil society leaders, as well as educators and early childhood development practitioners to be on high alert for anyone showing symptoms, and to report this to the nearest health facility as soon as possible.

"Measles is an acute viral respiratory illness. It is characterised by a prodrome of fever (as high as 40.5 degrees Celsius) and malaise, cough, coryza, and conjunctivitis - the three 'C's - ...Koplik spots, followed by a maculopapular rash. The rash usually appears about 14 days after a person is exposed," the US Centers for Disease Control and Prevention explains.

"Patients are considered to be contagious from four days before to four days after the rash appears."

#Measles case are rising in ���� –UNICEF is supporting @HealthZA to improve immunisation systems & drive up vaccine demand, including providing cold chain equipment for 2000 health facilities. Danke @GermanyDiplo @AA_stabilisiert @GermanEmbassySA for helping to protect #EveryChild! pic.twitter.com/hnoRGIodQw

— UNICEF South Africa (@UNICEF_SA) December 23, 2022

The outbreak has been attributed to consistent lower than optimal vaccine coverage of routine measles 1 and 2 doses, which increases the risk of being infected and of spreading the disease, Unicef said in a media statement. "Covid-19 further interrupted childhood vaccinations in South Africa but catch-up campaigns in late 2020 and 2021 helped to recover levels to near pre-Covid levels."

Prevention and control of measles outbreaks can only be achieved through vaccination, the NICD stressed.

Vaccination records under scrutiny

"Caregivers and parents are advised to review their child’s vaccination records and confirm that they have received the measles vaccine. It is never too late to vaccinate – children who have not been vaccinated may receive the measles vaccine at any age over six months, and free of charge at primary health services," it reiterated.

As part of the outbreak response, Unicef SA is engaging ‘The Truck’, a multimedia messenger to travel across hotspot areas providing lifesaving information and to work with communities through health workers and other partners. Unicef SA is also collaborating with partners, including Unicef offices in neighbouring countries, to monitor and support any needed response in cross-border areas.

Unicef expressed its gratitude for the generous support provided by the governments of Germany and Japan to support and strengthen South Africa’s vaccine cold chain, management and risk communication, and community engagement work.

It is understood that the health departments in the respective provinces have commenced with or are planning immunisation campaigns, the NICD added. This is in spite of the number of specimens submitted in the last three weeks and the number of positive cases appearing to be decreasing in comparison with previous weeks.

How did a drop in public confidence in vaccination in Ukraine in 2008 lead to >130,000 #measles cases, 40 deaths and nearly US$ 140 million in economic damage worldwide? Gavi’s Dr Lee Hampton examines how this case illustrates the value of vaccine safety: https://t.co/5bgSA9CLwa

— Gavi, the Vaccine Alliance (@gavi) January 12, 2023

The immunisation campaigns are set to roll-out against the backdrop of an explosion of preventable diseases in Africa due to delays in vaccinating children, the World Health Organization (WHO) said, with measles cases jumping 400%.

Twenty African countries reported measles outbreaks in the first quarter of 2022, eight more than in the first three months of 2021.

The World Health Organization and Unicef announced in April last year in Geneva that measles cases surged by nearly 80% worldwide in 2022.

Unicef SA said globally some 25 million children are missing out on life-saving vaccines every year.

According to information released by the US Centers for Disease Control and Prevention, measles is caused by a single-stranded, enveloped RNA virus with 1 serotype.

"It is classified as a member of the genus Morbillivirus in the Paramyxoviridae family.

"Humans are the only natural hosts of measles virus."