Three laboratory-confirmed measles cases have been detected between the 30th of October to the 5th of November in two provinces (Eastern Cape and KwaZulu-Natal) by the National Institute for Communicable Diseases (NICD). These cases do not yet comprise a cluster or outbreak (defined as 3 cases within one health district within one month) but warrant heightened attention.
There have been changes in health-seeking behaviour since the start of the COVID-19 pandemic with declining vaccine coverage rates. Health care professionals should remain vigilant when faced with a suspected measles case. Due to complications and mortality associated with measles, it is important for individuals to be aware of symptoms, seek help early and have a blood test to differentiate measles from other rash illnesses such as rubella (German measles).
Measles is a contagious disease caused by the measles virus and is spread by droplets from respiratory secretions of infected persons when coughing or sneezing. People at high risk for severe illness and complications from measles include infants and children aged <5 years, pregnant women and persons with compromised immune systems, such as from certain cancers and HIV infection.
Measles starts with respiratory tract symptoms similar to the common cold or ‘flu’, with ‘the three C’s’: conjunctivitis (red, watery eyes), cough and coryza (runny nose), fever, tiredness and muscle pain. The rash of measles usually appears 3 – 5 days after the start of symptoms, beginning on the face and spreading down the body. It is important for individuals with these signs and symptoms to visit a clinic/doctor to confirm the diagnosis and make sure complications of measles do not occur.
Measles is a notifiable medical condition (NMC) and any doctor in the public or private sector can send blood specimens to the NICD for testing at no cost to the patient. Throat swabs or urine samples should be sent in addition to blood samples during an outbreak, provided they are collected within 7 days of the date of onset of rash. Any patient with suspected measles should be notified to the Notifiable Medical Conditions (NMC) system and a case investigation form (CIF) should be filled.
Vaccination is the most important way of preventing measles. The Department of Health provides measles vaccine free of charge at local clinics. After two doses of vaccine 95% of persons will be protected from measles. The measles vaccine is safe and effective. The MeasBio® (Biovac) vaccine is administered at 6 months of age with a booster at 12 months of age according to the South African Expanded Programme on Immunization. Public and private providers in South Africa use the MeasBio® (Biovac) vaccine. In the private health sector, there are additional vaccines (Priorix® and Omzyta®) that each offer protection against measles, mumps and rubella (MMR).