Over the last two weeks of May 2022, four laboratory-confirmed cases of measles from persons resident in Gauteng have been notified and confirmed through laboratory testing by the National Institute for Communicable Diseases (NICD). Three cases are known to be epidemiologically linked, and are resident in south-western Tshwane. The fourth case is resident on the West Rand of Gauteng Province. All cases are presently isolated and are recovering. Health authorities in the affected districts and communities are working together to identify contacts, promote/offer vaccination, and/or conduct vaccination of contacts. According to the World Health Organization (WHO), two or more cases of measles in a health district within one month is regarded as a measles outbreak.
Measles is a highly contagious disease and it spreads through infectious airborne respiratory droplets from infected persons when coughing or sneezing. Measles commonly presents with respiratory tract symptoms and any of the three C’s: conjunctivitis, cough, and coryza. Other symptoms can include fever, fatigue, and muscle pain, which typically appear before the onset of the disease’s characteristic maculopapular rash. Children under 1 year of age may develop complicated measles including bronchopneumonia, keratoconjunctivitis, and rarely, encephalitis. These complications may lead to irreversible damage and or death, especially in immunocompromised or malnourished children. Furthermore, even healthy children who develop measles develop transient immunosuppression and are more susceptible to common childhood illnesses for at least one year after infection.
The Gauteng Department of Health is working together with City of Tshwane and the West Rand district health teams, the National Department of Health, the NICD, and WHO staff members to investigate and respond to the outbreak. Measles is a notifiable medical condition (NMC) according to the National Health Act. Health care workers should notify all suspected cases via the NMC app (https://www.nicd.ac.za/nmc-overview/overview/ ). Practitioners should submit a blood specimen for antibody testing and a throat swab along with a completed case investigation form available here . Samples should be submitted to the NICD, marked ‘NICD Measles Laboratory– attention CVI’. Testing is done free of charge.
Non-pharmaceutical measures such as social distancing and hand-washing might not be sufficient to prevent transmission of the measles virus. Measles is preventable through a safe and effective vaccine. Caregivers and mothers are urged to ensure that children are up to date with their routine vaccinations. According to the South African Expanded Programme on Immunization (EPI), children are given the MeasBio® (Biovac) vaccine at 6 months old and a booster at 12 months old. These vaccines are available free of charge at public health facilities. The measles-mumps-rubella vaccine (MMR) is also available, at cost, in private sector clinics and is equally effective and safe.
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