71 cases of measles with laboratory confirmation have been recorded in South Africa between September 1 and November 22, 2022, as a result of outbreaks in the provinces of Mpumalanga and Limpopo (see Table 1). Limpopo province now has 60 measles cases, affecting four districts: Capricorn, Greater Sekhukhune, Mopani, and Waterberg, which have all been declared measles outbreak areas. Vhembe district with two laboratory–confirmed measles cases did not meet the measles outbreak criteria.
On 28 October 2022, the Ehlanzeni district in Mpumalanga province, which shares a border with Greater Sekhune and Mopani districts in Limpopo province, was declared a measles outbreak area (Figure 1). Eleven laboratory-confirmed measles cases have been reported in Mpumalanga province, with nine from the Ehlanzeni district, one from the Gert Sibande district, and one from the Nkangala district.
The ages of measles cases in the Limpopo province ranged from 4 months to 42 years, while in the Ehlanzeni district in Mpumalanga province, measles cases ranged from 18 months to 10 years. The most affected age group is the school-going children,1-4 years age group (n=23, 32%) in Mpumalanga province and 5-9 years old (n=24;34%) in Limpopo. Three laboratory-confirmed measles cases were hospitalized and no measles deaths have been reported in Limpopo province and Mpumalanga province (Table1).
In Limpopo province, 38 laboratory-confirmed measles cases had unknown vaccination histories, 11 did not receive any measles vaccine doses, nine were fully immunised with two doses, and two were partially immunised with one dose. In Mpumalanga province, in three laboratory-confirmed measles cases vaccination histories were unknown, five did not receive any measles vaccine dose, and three were fully immunised (Table 2).
In response to the measles outbreak, affected districts follow up on laboratory-confirmed measles cases and vaccinate the contacts. In healthcare facilities, catch-up measles vaccine doses are given to children who missed their measles vaccinations to increase immunity in the community. The public health response to the measles outbreak in Limpopo province should target improving measles immunity in all five districts. Vaccination of measles case contacts is recommended in Ehlanzeni district to prevent the spread of the measles virus.
Measles patients present with fever, rash, and one or more of the following symptoms cough, red eyes, and runny nose. Complications of measles include pneumonia, diarrhoea, dehydration, encephalitis, blindness, and death. Measles complications are severe in malnourished children and those young infants under 2 years of age. Persons of any age who are not vaccinated can catch measles and develop the disease. Clinicians and caregivers should be on alert for anyone presenting with the above symptoms and signs and check children’s road-to-health booklets to ensure measles vaccinations are up to date. Measles vaccine doses are given routinely at 6 and 12 months of age. It is never too late to vaccinate against measles.
Suspected measles cases should be notified on the NMC system; click here to access the notification form