Update: Measles outbreak in KwaZulu-Natal Province
September 19, 2017
Since the declaration of measles in KwaZulu-Natal Province on 1 September 2017, a total of 80 suspected or laboratory-confirmed cases have been reported to health authorities. As of 15 September 2017, 26 laboratory-confirmed measles cases have been reported and 54 suspected measles cases are awaiting laboratory results. Laboratory-confirmed cases are reported in four of the 11 districts in KwaZulu-Natal: Ethekwini (n=17), Umgungundlovu (n=6), ILembe (n=2) and Uthukela (n=1). Suspected measles cases have been reported from Umgungundlovu (n=14), Umkhanyakude (n=9), Uthukela (n=7), King Cetshwayo (n=7), Amajuba (n=7), Ethekwini (n=6), and Harry Gwala (n=4) districts.
The NICD is working together with the KwaZulu-Natal Department of Health and private laboratory networks to provide diagnostic testing, assist with notification of cases and support outbreak response. Tracing and vaccination of contacts is ongoing. Provincial and district outbreak response teams are preparing for emergency targeted vaccination campaigns in at risk areas, including schools in the affected communities. These preparatory activities include community engagement meetings and dissemination of information, education and communication material.
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 (i.e. non-vesicular) and any one of the 3 Cs – cough, coryza (i.e. runny nose) or conjunctivitis (i.e. 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.
Communicated by: National Institute for Communicable Diseases