Measles Outbreak Alert Western Cape province, City of Cape Town (20 February 2023)

The National Institute for Communicable Disease alerts the National Department of Health and the Western Cape province about the increase in laboratory-confirmed measles cases.  Four laboratory-confirmed measles have been reported in the City of Cape Town from 24 January 2023 to 17 February 2023.  Even though all the lab-confirmed measles were investigated, no epidemiological link could be established.  The cases meet the South African measles outbreak criteria based on the 2015 EPI Surveillance Manual. A confirmed measles outbreak, according to WHO-AFRO, is defined as the occurrence of three or more confirmed measles cases (at least two of which should be laboratory-confirmed; IgM positive) in a health facility/district / sub-district (approximate catchment population of 100 000) in a month.

The missing information of the laboratory-confirmed measles cases should be followed up, and all the contacts should be vaccinated against measles. Clinicians and caregivers should check children’s road-to-health booklets to ensure measles vaccinations are up to date.

It is noted that the country started with the National Measles Supplementary Immunization campaign on 06 February 2023, including the Western Cape province, and the vaccination of the measles-confirmed contacts in daycare centres and schools might coincide with the campaign vaccination. It should be documented and taken as public health response to the measles cases and the data for vaccination recorded in the measles campaign.

Enhanced measles surveillance should be done in healthcare facilities in the affected area to assess if some measles cases were not reported. Suspected measles cases should be screened using the measles case investigation form to check if they meet the suspected measles case definition before the measles samples are collected for laboratory confirmation.

Measles disease is a notifiable medical condition, and healthcare workers should notify the suspected measles cases on the NMC system;

Measles presents with fever, malaise, cough, conjunctivitis, and a runny nose. A maculopapular non-itchy, the non-vesicular rash appears on the face, neck, trunk, and limbs, usually on day four of the illness.  Other measles complications are pneumonia, scarring of the cornea (kerato-conjunctivitis), and rarely encephalitis. Measles is highly infectious and spreads rapidly from person to person. Persons of any age who are not vaccinated can catch measles. Measles vaccines are given routinely at 6 and 12 months of age. It is never too late to vaccinate against measles.

 Source: Centre for Vaccine and Immunology, National Institute for Communicable Diseases

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