National Measles alert - everything you need to know

For the first time in years a nationwide measles alert has been issued by the Department of Health (DOH) to caution members of the public, health professionals and health workers following an outbreak of the viral disease in Gauteng.

According to the DOH there have been 131 cases in the country in the last five months.  About 109 cases were from Gauteng with 97 of these from the Tshwane (Pretoria) health district.  The health department said there was a possibility that the disease could spread to other provinces. Parents are urged to vaccinate their children. 

The movement of people across municipal borders and provinces and between different levels of health service provision (public and private service providers) has made the containment and prevention of spread of measles particularly difficult. As a result the entire country has been placed on the alert.

However, just how serious a disease is measles exactly?  According to the World Health Organisation (WHO), measles is a leading cause of death among young children even though a safe and cost-effective vaccine is available to prevent the disease. At the end of 2008 the WHO reported that there were 197 000 measles deaths globally in 2007 - nearly 540 deaths every day or 22 deaths every hour.  These deaths were mostly children under the age of five.

Measles is an acute, highly contagious viral disease affecting more than 20 million individuals annually, mainly in developing countries.  The most serious of the common childhood viral illnesses, measles can affect those not properly vaccinated against the disease.

In South Africa the prevalence of measles has substantially decreased in the last decade or two through concerted efforts to vaccinate all children throughout the country.

Parents and caregivers of children are urged to ensure that children have received all their vaccines for the age of the child, by checking their Road to Health/Immunisation cards. If unsure, have these checked at your local clinic. Two doses of measles vaccine should be administered - at 9 and 18 months of age. Measles immunisations are available free of charge from all public and municipal health clinics.

With measles not being a hot topic in the news in first world countries, some people are under the misunderstanding that measles has been eradicated, and stop immunising their children against the disease, leading to renewed outbreaks.

What are the signs and symptoms of measles?
Measles typically presents with fever, coughing, a runny nose and a red rash over the body.  Complications can include middle ear infection, pneumonia and brain infection (encephalitis) and can lead to brain damage.  Although there is no rash at the onset, the patient is highly contagious during this time. Older children usually complain of sensitivity to light and joint pains. Koplik's spots (small spots with white or bluish-white centres, resembling "grains of salt sprinkled on a red background") may be seen on the insides of the cheeks in over 80% of cases before the onset of the rash. The blotchy red rash usually appears behind the ears and on the face within 2 to 4 days after the pre-rash feverish period. The rash peaks in 2 to 3 days and becomes most concentrated on the trunk and upper extremities. It lasts from 3 to 7 days. Malnourished or vitamin deficient children may develop severe skin exfoliation.

Severe complications from measles can be avoided through supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration.  Antibiotics should only be prescribed to treat eye and ear infections.

What about vaccination?
In South Africa, children are generally immunised against measles at 9 months and again at 18 months, or at 15 months in combination with mumps and rubella (MMR) with a booster at 5 years," says Vincent. "Adults who are not sure if they were ever immunised can have a laboratory test to check their immunity, or receive a dose of MMR.