Measles Outbreak update in South Africa, 17 November 2022

From 01 September to 16 November 2022, 57 measles outbreak cases were reported in Limpopo province and Mpumalanga province. Capricorn and Waterberg districts in Limpopo province and Ehlanzeni in Mpumalanga province reported three or more laboratory-confirmed measles cases within 30 days in the district that meets the criteria for declaring a measles outbreak.

Laboratory-confirmed measles cases in Limpopo province have increased to 52 measles cases since the beginning of the measles outbreak, and laboratory-confirmed measles cases are increasing in Capricorn, Greater Sekhukhune, Mopani, and Waterberg districts. Vhembe district reported two laboratory-confirmed measles cases; one measles case epidemiologically linked to the measles circulation in Zimbabwe. In the past seven days, four laboratory-confirmed measles cases were reported in the Bushbuckridge area of Ehlanzeni district in Mpumalanga province. Ehlanzeni district shares the border with Greater Sekhukhune and Mopani districts which were the first districts to declare measles outbreaks. The spread of measles cases in Limpopo province and Ehlanzeni district, Mpumalanga province, poses the risk of measles spread. The sporadic laboratory-confirmed measles cases were reported in Northern Cape, Free State, Gauteng, Free State, and the Western Cape Provinces.

Figure 1. The epidemiological curve of measles outbreak cases, Limpopo province, September to November 2022(n=57)

The laboratory-confirmed measles cases were identified aged from 6 months to 24 years in the Greater Sekhukhune district, and 2 to 42 years in the Mopani district. The measles in Ehlanzeni district in Mpumalanga province aged between 18 months and 10 years.  The measles incidence is high in age groups 13 months-4 years and 5-9 years (Table 2). No deaths or other complications have been reported after two children were discharged from the hospital.

Affected districts continue with the public health response tracing laboratory-confirmed measles cases and vaccinating 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. Vaccination of measles case contacts is necessary in Ehlanzeni district for laboratory-confirmed measles cases to prevent the spread of the measles virus. To prevent the spread of the measles virus in other provinces, the sporadic measles case contacts should be traced and given measles vaccine doses per the National Measles Surveillance Guidelines.

Table 2. Laboratory confirmed measles outbreak cases by age in measles outbreak district, South Africa, 2022

The laboratory–confirmed measles cases with unknown measles vaccination history was 86% (49/57) impacting the evaluation of the measles coverage in affected areas (Table3). The affected districts in Limpopo province are continuing with the investigation of measles cases and vaccination of measles contacts. Measles catchup vaccination continues at healthcare facilities for the children who missed the routine measles vaccination doses.

Table 3 Number of measles outbreaks cases and vaccination status in Limpopo province, September to November 2022

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

Source; NICD and Limpopo province Department of Health

Diseases A-Z Index



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