A research paper released by the Public Health Bulletin South Africa has highlighted possible answers to the measles outbreak in Mpumalanga in 2022 and 2023, due to gaps in immunity caused by missed opportunities to vaccinate against the highly contagious disease.
Measles is a highly infectious and potentially fatal acute, viral disease that predominantly affects young children. It is characterised by fever and a maculopapular rash that typically appears three to five days after the onset of respiratory-like symptoms.
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The researchers’ eyes were drawn to the topic following the large number of reported measles cases from November 11 2022 to December 31 2023, along with the official declaration of a measles outbreak that impacted five out of the nine provinces.
According to one of the lead investigators, Naume Dibuile Tebeila, when outbreaks occur, it is crucial that they come under investigation for future prevention.
“In public health, outbreak investigations are crucial, as they help identify the source and implement measures to control and prevent future outbreaks. This was a large measles outbreak, with over 100 cases reported,” Tebeila said.
As a result, it offered an opportunity to identify immunity gaps in the community and the development of strategies to improve vaccination coverage. Documenting these findings and recommendations is important in the control and prevention of future outbreaks.
The measles outbreak in Mpumalanga resulted in 118 confirmed laboratory cases.
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The research paper boiled down to one aspect that led to this number of reports, in which 60% of measles-infected individuals were, on average, nine years old, with the majority being aged between one and four years old, as gaps in immunity.
Additionally, children in the age group of one to nine years of age may have been missed during the routine immunisation schedule, resulting in the high attack rates observed in this age group.
According to the paper, optimal vaccination coverage, around 95%, was not achieved during the nationwide measles vaccination campaign in Mpumalanga. This potentially indicated that the province remains at continued risk of future outbreaks.
The outbreak mainly impacted the Bushbuckridge and Chief Albert Luthuli sub-districts located in the Ehlanzeni and Gert Sibande districts, respectively. Although Ehlanzeni district achieved optimal vaccine coverage of the first dose during October and December, the second dose was suboptimal.
The Gert Sibande district did not achieve optimal vaccination coverage for either dose during the same period. Vaccine hesitancy influenced by religious beliefs was identified as one of the key drivers of transmission in the Bushbuckridge and Chief Albert Luthuli sub-districts.
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In its recommendation, the researchers suggested that the Department of Health should draft a health promotion plan to raise community awareness about the disease and strengthen commitment to routine vaccination.
Where measles vaccination coverage is low in some areas, efforts need to be made to find unimmunised children and vaccinate them actively.
Health facilities must continue to administer catch-up doses to eligible children who were missed during vaccination.
Lastly, the Department of Health must maintain surveillance for measles to detect and respond to suspected cases, and limit transmission.
Kayla Shaw
witness.co.za
