Following an outbreak of measles cases in Limpopo, an expert from the National Institute for Communicable Diseases (NICD) has warned that similar outbreaks are likely to occur in other parts of the country.

A surveillance team from the NICD has already detected cases of the disease in the Greater Sekhukhune District in Limpopo. According to NICD Deputy Director, Dr Nishi Prabdial-Sing, similar outbreaks are on the cards across South Africa where vaccination coverage is low. 

Reasons behind potential outbreaks

“There are several reasons why children may have missed their measles vaccine. One reason is because of the COVID-19 lockdown, but there are others. Sometimes the health facility has a stock-out of the vaccine. Sometimes parents or caregivers forget to take their children for the 6-month and 12-month checkup,” said Prabdial-Sing.

Measles is a viral infection that is serious for small children but is easily preventable by a vaccine. It is highly infectious and spreads rapidly from person to person and persons of any age who are not vaccinated.

The World Health Organisation (WHO) states that even though a safe and cost-effective vaccine is available, in 2018, there were more than 140 000 measles deaths globally, mostly among children under the age of five.

According to WHO, the first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus and lasts four to seven days. This is followed by a runny nose, cough and red and watery eyes. Small white spots can develop inside the cheeks early on.

Low vaccination coverage

Prabdial-Sing said that the main driving force of outbreaks is low vaccination coverage. This leads to an increase in the number of people susceptible to the virus infection.  

“During the COVID-19 outbreak, many children missed the opportunity to be vaccinated. This was due to lockdown restrictions and parents avoiding healthcare facilities. This may have contributed to the outbreak in Limpopo,” said Prabdial-Sing.

On Monday, the Limpopo Provincial Health Department embarked on a catch-up measles vaccine campaign. These vaccine booster shots are important to help combat the spread within the province.

“It is highly unlikely that a child who has had two doses of the measles vaccine will get measles. In the exceedingly rare case that this does happen, the illness will be mild and less likely to spread to other people. The best protection against measles infection is the vaccine. There is no treatment for measles and no other way to protect your child from measles other than vaccination,” said Prabdial-Sing.

MEC @PhophiRamathuba taking notes during a briefing session at Bohlale Creche at Fetakgomo Tubatse where she is leading a measles vaccination campaign. The @nicd_sa has since detected 3 cases of measles in the Sekhukhune District pic.twitter.com/X80uGyonKW

— Limpopo Department of Health (@HealthLimpopo) October 17, 2022

‘There is no treatment for measles’

The measles vaccine is given at six and 12 months in the Expanded Programme on Immunisation in South Africa (EPI-SA) in public healthcare facilities. In private healthcare facilities, a combination of the measles and rubella virus (MR) vaccine or the measles, mumps, and rubella (MMR) vaccine is given at 12-15 months of age and the second dose between the age of four and six.

“If your child has not been vaccinated and gets sick, they should stay at home and isolate from other children. A person with measles is infectious from four days before rash onset until approximately four days after,” said Prabdial-Sing.

‘Bring your children’

Limpopo health MEC Dr Phophi Ramathuba urged parents to ensure their children are vaccinated against measles.

“We encourage parents to bring their children to the nearest clinic for catch-up if they have missed it at six or 12 months. Let’s help prevent the spread of the outbreak,” said Ramathuba.

She added: “If any person experiences a fever, malaise, cough, conjunctivitis or a running nose, they should immediately visit their nearest health care facility.”

Associated risks

According to Prabdial-Sing, measles can cause severe disease in:

• Children under the age of one
• Immunocompromised persons (such as persons who are receiving chemotherapy or who have advanced HIV/AIDS); and
• Children who are malnourished. 

“These individuals may suffer from severe complications such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalised and could die,” added Prabdial-Sing. – Health-e News