The National Institute for Communicable Diseases(NICD) has confirmed measles cases in all nine provinces. However, only Limpopo, Mpumalanga and the North West are experiencing actual outbreaks. Health Minister Joe Phaala and his nine provincial health MECs will update the country on the situation later on Thursday.
NICD Epidemiologist Jack Manamela said Limpopo recorded 81 laboratory-confirmed cases between 1 September and this Tuesday. He said this figure included two measles cases reported in the Vhembe district, which did not meet the measles outbreak criteria.
Mpumalanga province has reported 28 laboratory-confirmed measles cases. Eighteen in Ehlanzeni district, 9 in Gert Sibande and one in Nkangala district. Mahikeng in the North-West recorded three cases.
Measles is a highly contagious disease caused by a virus. Patients with measles present with fever and with a rash. The rash looks like small, red, flat spots over the body. The rash does not form blisters, nor is it itchy or painful. Other signs include cough, conjunctivitis (red eyes) and coryza (running nose). Complications of measles can include diarrhea, dehydration, brain infection (encephalitis), blindness and death. Complications are more serious in those who catch measles as young infants (under 2 years of age) and in children who are malnourished.
The World Health Organisation defines a measles outbreak as five or more epidemiologically linked. measles cases with dates of rash occurring 7-21 days apart.
“Measles was reported in six other provinces of South Africa without meeting the measles outbreak criteria. Measles virus circulation is endemic in South Africa,” said Manamela.
Consequence of COVID-19
He said the risks of an outbreak increase when there is low measles vaccination coverage. The COVID-19 pandemic negatively impacted South Africa’s immunisation programmes. The required coverage for the measles vaccine to ensure community-level immunity is 95%
Professor Hannelie Meyer, Head of the South African Vaccination and Immunisation centre at Sefako Makgatho Health Sciences, said fewer South Africans went to public health facilities for vaccines during COVID-19.
He said COVID-19 vaccines were not prioritised over routine immunisation but people avoided healthcare facilities due to lockdown restrictions and fear of contracting Covid-19
“We have observed a decline in facility utilisation during the Covid-19 pandemic. Which resulted in missed doses or children not being vaccinated at all. So, yes, low vaccination rates contribute to outbreaks of measles and other vaccine-preventable diseases,” said Meyer.
WHO reported that in 2021, nearly 61 million measles vaccine doses were postponed or missed due to Covid-19-related delays in immunisation campaigns in 18 countries.
Measles cases expected to rise
Manamela said measles cases are likely to increase, especially as South Africa enters its main holiday period, with large numbers of people travelling between provinces.
“There will be more susceptible children in the communities who have never received a measles vaccine dose, and those who received only a single one, and so are not fully vaccinated,” Manamela told Health-e News.
To be fully vaccinated a child must have two measles vaccine doses. In the public healthcare system, this is given at six months and 12 months. In the private sector, a combination of the measles and rubella vaccines is administered from 12 months old. The NICD does not have the verified number of measles vaccine catchup doses administered so far.
Vaccination offers the best protection
National Department of Health (NDoH) spokesperson Foster Mohale, said parents and caregivers must vaccinate their children to increase community immunity. He said the implementation of catch-up plans is going smoothly.
“The fact is that vaccine refusal endangers everyone, not just the unvaccinated children. Hence, we plead with parents to prioritise the health and well-being of their kids by taking them to the nearest clinic or healthcare provider to ensure that they are up to date with immunisation,” said Mohale.
Measles is extremely contagious, as one person with measles can infect 12 to 18 other people. Complications of measles are serious, especially in malnourished children and babies under two years old. – Health-e News.