By Siyabonga Gema – HST Communications Officer
The COVID-19 pandemic disrupted health programmes and caused delays in surveillance and immunisation programmes across the globe. School health activities, routine check-ups and other programmes took a backseat as the scramble for a COVID-19 vaccine took centre stage. The global suspension of immunisation programmes, as well as decreases in immunisation rates and surveillance, have exposed millions of children to preventable diseases such as measles. Measles is a highly contagious disease caused by a virus. It spreads easily when an infected person breathes, coughs or sneezes, it can cause severe disease, complications, and even death.
Symptoms of measles usually begin 10–14 days after exposure to the virus. A prominent rash is the most visible symptom. Early symptoms usually last 4–7 days. They include:
- runny nose
- cough
- red and watery eyes
- small white spots inside the cheeks.
In December 2023, the National Institute for Communicable Diseases (NICD) reported that a total of 1 317 laboratory-confirmed measles cases were reported between epidemiological week 40 2022 to week 47 2023 in South Africa. Limpopo had reported the most number of cases (532), followed by Gauteng (256) and then North West (226). Due to intensified measles immunisation efforts, measles mortality has decreased substantially worldwide, particularly in sub-Saharan Africa (SSA). However, the recent measles outbreak has caused concern and highlighted the ongoing challenges that hinder the successful implementation of vaccination programmes and effective control efforts in South Africa.
The role of primary healthcare in controlling outbreaks of diseases such as measles is indisputable, however, the challenge of access to primary healthcare services, especially in rural areas, calls for a concerted approach and collaboration amongst various stakeholders. Recognising this, the Departments of Basic Education and Health jointly implemented the Integrated School Health Programme (ISHP) that will extend, over time, the coverage of school health services to all learners in primary and secondary schools. Its strategic objectives are to:
- increase knowledge and awareness of health-promoting behaviours
- develop systems for the mainstreaming of care and support for teaching and learning
- facilitate early identification and treatment of health barriers to learning
- increase knowledge and awareness of health
- promote health-seeking behaviours.
Although measles is highly contagious, an effective and safe vaccine is available for prevention and control. A nation-wide measles response strategy has been put into place by the National Department of Health (NDoH) in co-ordination with the World Health Organization (WHO), and a mass vaccination campaign is being carried out in every province for children between the ages of six months to 15 years. WHO staff have been deployed to support all aspects of the response: co-ordination; information management and surveillance; case management; supplies and logistics; and risk communication and community engagement.
Other response activities include:
- active case search, investigation and line listing of fever and rash cases;
- support team meetings and situation reports conducted with all provinces;
- weekly interim reports based on the results of laboratory tests being issued by the NDoH and NICD;
- deployment of provincial and district rapid response teams (RRTs) to affected neighbourhoods; and
- training in preparation for the national immunisation campaign, completed in all provinces.
WHO advises that the MCV1 vaccine is given at the age of 9 months in countries with both ongoing transmission and a high risk of measles mortality among infants. These countries should administer the routine MCV2 at the age of 15-18 months. In South Africa, MCV1 is given at 6 months and MCV2 at 12 months. A 95% population coverage of MCV1 and MCV2 is required to stop measles circulation. Reaching all children with two doses of the measles vaccine is recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose.
Although there is no cure for measles, parents need to ensure that children get vaccinated as part of their regular immunisation schedule. If a child has not been immunised, measles can still be prevented by getting the vaccination within three days of being exposed to the virus. If you are an adult and are not sure whether you have been vaccinated against measles, speak with your healthcare provider about receiving the vaccine. Current evidence suggests that immunity after the disease is life-long, whereas the response after two doses of measles-containing vaccine declines within 10–15 years.
To learn more about immunisation, visit https://www.health.gov.za/immunization/