Measles cases soar by 400% in Africa, but no outbreak in SA yet, says expert

The World Health Organization said last week that Africa is facing an explosion of preventable diseases due to delays in vaccinating children, highlighting that measles cases have jumped by 400%.

According to the health body, 20 African countries reported measles outbreaks in the first quarter of this year, eight more than in the first three months of 2021.

In a statement, the WHO and Humanitarian aid organization UNICEF said measles cases increased by 79% worldwide this year, warning that the rise of the “canary in a coal mine” illness indicates that outbreaks of other diseases are likely on the way.

They added that the risk for large outbreaks has increased as communities relax social distancing practices and other preventative measures for Covid-19 implemented during the height of the pandemic.

UNICEF Executive Director Catherine Russell said while it is encouraging that people in many communities are beginning to feel protected enough from COVID-19 to return to more social activities, doing so in places where children are not receiving routine vaccination creates the perfect storm for the spread of a disease like measles.

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The WHO added that pandemic-related disruptions, increasing inequalities in access to vaccines, and the diversion of resources from routine immunisation are leaving too many children without protection against measles and other vaccine-preventable diseases.

Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization said the impact of these disruptions to immunisation services will be felt for decades to come.

According to the WHO, as of 1 April 2022, 57 vaccine-preventable disease campaigns in 43 countries that were scheduled to take place since the start of the pandemic are still postponed, impacting 203 million people, most of whom are children.

Of these, 19 are measles campaigns, which put 73 million children at risk of measles due to missed vaccinations.

Measles in South Africa

Speaking to Africa Melane on CapeTalk, Dr Lesley Bamford, the Chief Director for the Child Health Programme at the National Department of Health said while measles outbreaks have been reported in several African countries, to date we have not seen a similar picture in South Africa.

Countries with the largest measles outbreaks in the past year include Somalia, Yemen, Nigeria, Afghanistan, and Ethiopia.

She did, however, caution that vaccination rates, particularly for the measles vaccine in South Africa are sub-optimal.

Bamford said in order to ensure that there will not be any outbreaks [in South Africa], we need to achieve a vaccination coverage of 95%.

“Our coverage rates are lower than that and because of this there is always an unknown risk of rising measles cases and outbreaks.”

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Various reasons for low measles vaccination rate

Bamford explained that they think of their vaccination coverage in terms of supply and demand, adding that stock shortages also sometimes play a role in low vaccination rates.

She says they see very good demand for vaccination in very young children – 6 weeks, 10 weeks and 14 weeks, but that there is a drop off as children become older.

“We saw a decline in vaccinations during the hard lockdown, but following catch-up campaigns, the numbers are back to were they where before the Covid-19 pandemic across the country,” Bamford reassured.

She said there are, however, still some pockets around the country where the numbers [measles vaccine rates] have still not returned to the pre-pandemic level.

While measles vaccines are given at 6 months and 12 months, children older than this who might have missed a dose can still get ‘catch-up doses’ up until the age of 5 years.

The WHO warned that measles is very contagious, and cases tend to show up quickly when vaccination levels decline.

They warn that apart from its direct effect on the body, which can be lethal, the measles virus also weakens the immune system and makes a child more vulnerable to other infectious diseases like pneumonia and diarrhoea, including for months after the measles infection itself among those who survive. 

The WHO and UNICEF said in 2020, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.