An outbreak of measles has been declared in KwaZulu-Natal, many of the cases withing communities within communities hesitant to accept vaccination, the SA National Institute for Communicable Diseases has announced.
An increase in number of laboratory-confirmed measles cases was observed in Ethekwini and Umgungundlovu districts from July 2017. As of 5 September 2017, a total of 23 laboratory-confirmed measles cases has been reported in four of the 11 districts in KwaZulu-Natal: Ethekwini (n=14), Umgungundlovu (n=6), ILembe (n=2) and Uthukela (n=1).
Many of the cases are among persons aged more than five years, outside the age groups that were targeted by the national measles vaccination campaign conducted recently in 2017. Furthermore, the majority of the cases are from the private sector and within communities that are hesitant to accept vaccination for religious reasons.
Outbreak response activities are ongoing. Provincial and district outbreak response teams have met, and interventions are being planned, including targeted vaccination campaigns. Community engagement meetings are being held, and information, education and communication material are being disseminated. The public are urged to ensure that all children are up to date with vaccinations.
Healthcare workers are advised to be on the alert for persons presenting with fever and maculopapular rash (non-vesicular) and any one of the 3 Cs – cough, coryza (runny nose) or conjunctivitis (red eyes)’ OR any person in whom a clinician suspects measles infection.
Health care workers should notify all suspected cases to district and provincial authorities, and should confirm each measles case through submission of a blood specimen and a completed case investigation form to the NICD, which provides testing free of charge. Private laboratories have agreed to courier blood specimens for measles testing to the NICD, when the specimen request form clearly indicates ‘Measles serology for NICD-JHB – no charge’.
Prior to the measles outbreak in KwaZulu-Natal Province, there have been two measles outbreaks in 2017: the first in Western Cape Province in January and the second in Gauteng Province in June.
There have been concerns by some religious communities about the presence of porcine gelatin in the measles vaccine. Currently, public and private providers in South Africa use the MeasBio® (Biovac) vaccine. The MeasBio® (Biovac) vaccine contains porcine gelatine but it is currently the ONLY option available in South Africa. The previous vaccine for measles called Rouvax (Sanofi Pasteur) did not contain porcine gelatine but it is no longer manufactured.
In the private sector, some providers may offer a vaccine called Priorix® which contains measles, mumps and rubella virus (MMR) but this vaccine is not currently available in South Africa.
Health care workers should inform persons who hesitate to receive vaccination of the risks of illness, the benefits of vaccination, and religious authorities’ official responses. Material on vaccination, including statements from the Jaimatul Ulama, and the Islamic Medical Association in support of vaccination may be found on the NICD website.NICD material