Measles Outbreak in South Africa: Epidemiology of Laboratory-Confirmed Measles Cases and Assessment of Intervention, 2009–2011Report as inadecuate




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Background

Since 1995, measles vaccination at nine and 18 months has been routine in South Africa; however, coverage seldom reached >95%. We describe the epidemiology of laboratory-confirmed measles case-patients and assess the impact of the nationwide mass vaccination campaign during the 2009 to 2011 measles outbreak in South Africa.

Methods

Serum specimens collected from patients with suspected-measles were tested for measles-specific IgM antibodies using an enzyme-linked immunosorbent assay and genotypes of a subset were determined. To estimate the impact of the nationwide mass vaccination campaign, we compared incidence in the seven months pre- 1 September 2009–11 April 2010 and seven months post-vaccination campaign 24 May 2010–31 December 2010 periods in seven provinces of South Africa.

Results

A total of 18,431 laboratory-confirmed measles case-patients were reported from all nine provinces of South Africa cumulative incidence 37 per 100,000 population. The highest cumulative incidence per 100,000 population was in children aged <1 year 603, distributed as follows: <6 months 302-100,000, 6 to 8 months 1083-100,000 and 9 to 11 months 724-100,000. Forty eight percent of case-patients were ≥5 years cumulative incidence 54-100,000. Cumulative incidence decreased with increasing age to 2-100,000 in persons ≥40 years. A single strain of measles virus genotype B3 circulated throughout the outbreak. Prior to the vaccination campaign, cumulative incidence in the targeted vs. non-targeted age group was 5.9-fold higher, decreasing to 1.7 fold following the campaign P<0.001 and an estimated 1,380 laboratory-confirmed measles case-patients were prevented.

Conclusion

We observed a reduction in measles incidence following the nationwide mass vaccination campaign even though it was conducted approximately one year after the outbreak started. A booster dose at school entry may be of value given the high incidence in persons >5 years.



Author: Genevie M. Ntshoe , Johanna M. McAnerney, Brett N. Archer, Sheilagh B. Smit, Bernice N. Harris, Stefano Tempia, Mirriam Mashele,

Source: http://plos.srce.hr/



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