Measles outbreaks confirmed in five provinces, with test positivity rate skyrocketing

The National Institute for Communicable Diseases (NICD) has urged parents to get their children vaccinated after a measles outbreak that has spread to five provinces in fewer than two months, with data revealing dismal vaccination rates.

The first outbreak was confirmed in Limpopo in October 2022.

“It is never too late to vaccinate,” the NICD’s statement reads, adding that major vaccination campaigns have commenced or are being planned countrywide.

Measles is a highly contagious disease caused by a virus. The most common symptoms are fever and a rash that looks like small, flat, red spots all over the body, that do not form blisters.

Other symptoms include a cough, conjunctivitis and a runny nose.  

The virus can cause severe complications like encephalitis (an infection in the brain) as well as blindness, diarrhoea and dehydration. It can be deadly, and infants under two years of age are most at risk.  

Measles vaccines are given routinely at six and 12 months of age. Unvaccinated children who are older than six months can receive free vaccinations at any state clinic.

Between October and December, the NICD tested 2,252 samples for measles antibodies, of which 14% tested positive.

Since the first week of December, however, the positivity rate in measles cases jumped to above 20%, with new cases in Limpopo, Mpumalanga (69 cases), North West (80), Gauteng (14) and the Free State (11).

A single case was reported in the Eastern Cape, five in KwaZulu-Natal, three in the Northern Cape and four in the Western Cape. The World Health Organization (WHO) classifies a measles outbreak as three or more cases reported within 30 days in a defined district. However, the cases in these provinces were confirmed further apart than 30 days. 

Visit Daily Maverick’s home page for more news, analysis and investigations

“The number of cases continues to increase daily as blood samples and throat swabs are submitted to the NICD for [testing],” a statement from the NICD reads. 

The outbreak was first declared in Limpopo on 11 October 2022, with most patients between the ages of five and nine, while some babies and adults were also infected. Of the 131 measles cases confirmed in the province, 80% had an “unknown” vaccination status, 9% were vaccinated and 11% were unvaccinated.

In Mpumalanga, an outbreak of measles was declared in November — 63% of those infected had an unknown vaccination status, 13% were vaccinated and 24% were unvaccinated.

In North West, an outbreak was declared in December. The Lonely Park Clinic in Mafikeng reported 38 cases. Only 10 of the 80 cases confirmed in this province had been vaccinated.

In Gauteng, 14 cases were reported, and an outbreak was declared on 6 December 2022. Three cases were reported at the Ethafeni Clinic in Ekurhuleni. Five of the 14 cases were reported in Tshwane and 13 of these cases had an “unknown” vaccination status.

In the Free State, the Bethlehem Clinic reported five of the province’s 11 cases.

On 23 November, in a joint statement, the WHO and the US Centers for Disease Control and Prevention noted that 40 million children globally had missed a measles vaccine dose in 2021. Of these, an estimated 25 million children missed their first dose.

In 2021, an estimated nine million measles cases were recorded globally and 128,000 deaths. Twenty-two countries experienced large and disruptive outbreaks.

“The paradox of the pandemic is that while vaccines against Covid-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunisation programmes were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said.

“Getting immunisation programmes back on track is absolutely critical. Behind every statistic in this report is a child at risk of preventable disease,” he said. DM/MC