Highlights
- The NICD has tested 4250 serum samples for measles since epidemiological week 40, 2022, of which 665 (15.6%) were confirmed positive. In outbreak-affected provinces, 641 cases have been reported since week 40, 2022. In the past weeks (week 07 up until mid-week 08, 2023), 72 laboratory-confirmed measles cases were detected across the country, of which 68 are from outbreak-affected provinces.
- The percentage of samples testing positive (PTP) increased slightly from 18% of 298 samples tested in week 06 to 20% of the 284 samples tested in week 07
- Since the declaration of the outbreak in the Western Cape in epidemiological week 7, no new cases have been reported.
- An outbreak has been declared in the Northern Cape Province following the detection of three laboratory-confirmed cases in the Francis Baard district. Three laboratory-confirmed measles cases were reported in a single facility in Kimberley on the 28th of February, taking the total number of cases to 4. The measles campaign began on the 6th of February 2023. These cases are not reflected in this sitrep as they occurred outside this week’s reporting interval.
- In provinces where an outbreak has been declared, the most affected age groups are still the 5–9-year-olds (41%) with a considerable proportion of cases reported among the 1-4 (25%) and 10-14 age groups (20%). Vaccination campaigns should therefore also include children aged 10 to 14
- The majority of cases (72%) were reported from primary healthcare facilities, and the highest proportion of cases reported from hospitals (53%) was reported in children under the age of one.
- 13 specimens from Limpopo and North West Province during this outbreak had measles virus genotype D8 sequences, either identical or very closely related to the Zimbabwe 2022 outbreak strain.
- Members of the public are urged to ensure their children are vaccinated against measles
Outbreak overview
From epidemiological week 40, 2022 (ending 8 October 2022) to mid-week 08, 2023 (ending 25 February 2023) the NICD has tested 4250 serum samples for measles of which 665 (15.6%) were confirmed measles cases. The number of samples submitted and the percentage of laboratory-confirmed measles-positive cases are shown in Figure 1. From epidemiological week 40 of 2022 to week 08 of 2023, 641 laboratory-confirmed cases were reported from six provinces with declared measles outbreaks; Limpopo (232 cases), Mpumalanga (100 cases), North West (185 cases), Gauteng (90 cases), and Free State (24 cases), Western Cape (10) (Table 1). The geographical distribution of cases across South Africa from week 40 of 2022 until week 08 of 2023 is shown in Figure 2he number of measles cases continues to increase with the high number of blood samples and throat swabs submitted to the NICD for measles serology and PCR testing (Figure 3).
Figure 1. The number of serum samples submitted to the NICD for measles, week 40 2022, until week 08, 2023 and the number (dark green) and % tested positive (red line), by epidemiological week using the date the specimen was collected. *Data from week 08 represent partial data and will be updated in next week’s situation report when complete data from samples collected that week becomes available.
Figure 2. Distribution of laboratory-confirmed measles cases by the testing site (red dots – the size of the dot indicates the number of cases from that facility) and district of South Africa (deepening the colour of blue indicates the total number of cases by sub-district), from week 40 to week 08, 2023.
Figure 3. The number of tests conducted from week 40 2022, until week 08, 2023, by province and epidemiological week using the date the specimen was collected. *Data from week 08 represent partial data and will be updated in next week’s situation report when complete data from samples collected that week becomes available.
Table 1. Cases of laboratory-confirmed measles tested by the NICD from all provinces in South Africa from epidemiological week 40, 2022 to week 08, 2023. Outbreak-associated cases are contained within the red bordered cells* (EC=Eastern Cape; FS=Free State; GP=Gauteng; KZN=KwaZulu-Natal; LP=Limpopo; MP=Mpumalanga NW=North West; NC=Northern Cape). * A measles outbreak is classified as three or more confirmed laboratory measles cases reported within 30 days of the onset of disease, in a district. *Data from week 08 represent partial data and will be updated in next week’s situation report when complete data from samples collected that week becomes available.
