South African Measles Outbreak 2022 | Measles Outbreak in four provinces (8 Dec 2022)

In total, 137 cases of laboratory-confirmed measles have been reported from the declaration of the outbreak in Limpopo province from the 11^th of October up until the 6^th of December 2022. Figure 1 displays an epidemiological curve from week 30, 2022 for South Africa, by province. Limpopo and Mpumalanga have reported 89 and 40 cases, respectively. An outbreak was declared in North West province on the 2^nd of December 2022 after three cases were reported. On the 6^th of December, three cases were reported by Gauteng, and an outbreak in this province has been declared. The WHO defines a measles outbreak as 3 cases reported in a single district in one month.

The age of cases across the country ranges from 2 months to 42 years (Table 1). The dominant age category of laboratory-confirmed cases is the 5-9 year age group. Of the 137 cases, 98 had an unknown vaccination status, 17 were vaccinated and 22 were unvaccinated (Table 2).

Table 1. Age distribution of laboratory-confirmed measles cases in provinces with a declared measles outbreak from weeks 40 to 49, 2022

Table 2. Vaccination status for laboratory-confirmed measles cases in provinces with a declared measles outbreak from weeks 40 to 49, 2022

Limpopo

In total, 89 cases of laboratory-confirmed measles have been reported from the 11^th of October till the 6^th of December 2022, the majority of cases were reported in Greater Sekhukhune and Mopani districts. Figure 2 displays an epidemiological curve from week 40, 2022 for Limpopo province. Greater Sekhukhune and Mopani reported 30 and 32 cases, respectively. Waterberg district has reported 19 cases.

The age of cases across Limpopo range from 4 months to 42 years. The dominant age category of laboratory-confirmed cases is the 5-9 year age group (Table 1). Of the 89 cases, 70 had an unknown vaccination status, 10 were vaccinated and 9 were unvaccinated (Table 2).

Figure 2. Epidemiological curve showing the number of measles cases in Limpopo Province from week 40 to week 49 (2 October – 6 December), 2022 by province (*the outbreak was declared on 11 October 2022, week 41)

Mpumalanga

In total, 40 cases of laboratory-confirmed measles have been reported from the declaration of the outbreak in Mpumalanga province from the 11^th of November up until the 6^th of December 2022. Figure 3 displays an epidemiological curve from week 40, 2022 for Mpumalanga province. Ehlanzeni and Gert Sibande have reported 25 and 14 cases, respectively.

The age of cases across Mpumalanga ranges from 4 months to 18 years. The dominant age category of laboratory-confirmed cases is the 5-9 year age group (Table 1).  Of the 40 cases, 23 had an unknown vaccination status, 7 were vaccinated and 10 were unvaccinated.

Figure 3. Epidemiological curve showing the number of measles cases in Mpumalanga Province from week 41 to week 49 (2 October – 6 December), 2022

North West
An outbreak was declared in North West province on the 2^nd of December 2022 after three laboratory-confirmed cases were reported in Ngaka Modiri Molema district. There has since been an additional confirmed case reported in the same district. A total of four cases have now been reported as part of this outbreak. Laboratory-confirmed cases fall into the 1-4 and 5-9 year age groups (Table 1). Three cases were not vaccinated and one had an unknown vaccination status (Table 2).

Gauteng
An outbreak was declared in Gauteng province on the 6^th of December 2022 after three laboratory-confirmed cases were reported at a single health facility in Ekurhuleni district. These three cases fell into the 5-9 year age group (Table 1). All three cases had an unknown vaccination status (Table 2). A case was reported in early October in Ekurhuleni district in a different area that was not epidemiologically linked to the other three cases.

 Conclusion

The number of measles cases in the country is rising. Four of our nine provinces have outbreaks. It is imperative to know the signs and symptoms. Measles patients present with fever, rash, and one or more of these 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 young infants under 2 years of age. Persons of any age who are not vaccinated can be infected and develop the disease. Clinicians and caregivers should be on alert for anyone presenting with the aforementioned signs and symptoms. Road-to-health booklets should be checked to ensure measles vaccinations are up-to-date. Measles vaccines are given routinely at 6 and 12 months of age. It is never too late to vaccinate against measles.

Provinces are currently conducting their own vaccination campaigns, for details please contact individual provinces.