Published Date: 2010-02-02 22:00:03
Subject: PRO/EDR> Measles - Africa (05): South Africa (Cape) alert
Archive Number: 20100202.0358
MEASLES - AFRICA (05): SOUTH AFRICA (CAPE) ALERT
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
 Cape Provinces
 Cape Town
 Cape Provinces
Date: Mon 1 Feb 2010
Source: IOL (Independent Online, South Africa), Cape Argus (South
Africa) report [edited]
Cape measles outbreak
Western Cape health authorities say they are on high alert after
receiving reports that nearly 250 people around the province have
contracted measles in the past 5 months. The provincial department of
health on Monday [1 Feb 2010] confirmed that the 236 laboratory
confirmed cases of the highly contagious disease reported around the
Western Cape since September  warranted describing it as "an
The department has already started implementing measures to address
the unusually high number of cases. It has announced that a national
mass immunisation programme, which was due to start in April ,
has been pushed forward and will now begin in February . Measles
is characterised by a high fever and skin rash. It mainly affects
young children. In some cases, it can cause brain damage. Flu-like
symptoms precede the first appearance of a rash.
Western Cape Health Department spokeswoman Faiza Steyn said that by
Friday [29 Jan 2010], 236 laboratory confirmed cases of measles had
been reported in the province since September . No deaths have
yet been reported in the Western Cape [province] as a result of the
disease. Out of these confirmed cases, only 10 involved people over
the age of 40. Steyn was unable to quantify how many adults had been
diagnosed with measles. The new cases, however, have been confirmed in
cases involving patients as young as 6 months old.
Both Gauteng and KwaZulu-Natal [provinces] were hit by measles
outbreaks late last year . More than 1000 children in Gauteng
contracted measles in the space of 3 months. The Gauteng outbreak also
saw one Joburg [Johannesburg] prison being quarantined because 51
inmates there had been diagnosed with measles. More than 3000 cases at
27 courts had to be postponed in Joburg as a result of the quarantine.
The Eastern Cape [province] has also experienced a surge in measles
cases during the past month. A 25-year-old man from Tshezi village
outside Mthatha died on 3 Jan 2010 after contracting the virus from a
two-year-old who came to visit during Christmas holidays from Gauteng.
By mid-January , there were 50 suspected measles infections
reported from villages of Mathojanini, Thwalikulu, Mpaku, Zidindi,
Ngcwanguba, Kwaiman and Tshezi.
A team from the Eastern Cape Health Department travelled around the
province to vaccinate people against measles. And north of the [South
African] border, 22 people died in Zimbabwe during the month of
December  because of a measles outbreak there.
Steyn said Khayelitsha, Mitchells Plain, Gugulethu, Athlone, and the
Cape Winelands region were hotspots for the current outbreak.
"The department can officially confirm an outbreak of measles in the
province. All health facilities have been notified to be on alert,"
She said the department had first noticed an increase in recorded
measles cases in September last year . The numbers had started
climbing after the festive season, when many people were travelling
back into Western Cape province after spending time in other parts of
the country. Damaries Fritz, the chairwoman of the Cape Metro Health
Forum, has meanwhile criticised the department for "downplaying" the
outbreak. She said even though the forum was at the coalface of health
care, and was supposed to be informed of such outbreaks, it had only
learnt about the surge in measles cases on [Fri 29 Jan 2010], during a
meeting with an official from the health department. Fritz said the
forum was told by a health department official that there was an
"outbreak" in some parts of the province, particularly in Mitchells
Plain and Khayelitsha.
Steyn denied a cover-up, and said the provincial department had fed
the information to the national department for dissemination. Steyn
said a multi-phased national department of health immunisation
project, designed to tackle measles and polio, had been planned to
start in April . The project would now start this month
[February 2010], she said, and this was a direct consequence of the
Western Cape measles outbreak.
[Byline: Sipokazi Maposa]
 Cape Town
Date: Mon 1 Feb 2010
Source: IOL (Independent Online, South Africa), South African Press
Association (Sapa) report [edited]
Measles alert issued in Cape Town
The city of Cape Town on Monday [1 Feb 2010] issued a warning about a
measles outbreak. "A measles outbreak which started in Gauteng
[province] last year  has spread to all provinces in the
country, including the Western Cape," said the city's health
department spokesperson Ivan Bromfield. He said more than 100 cases of
measles had been reported in Cape Town since October .
Measles is a viral infection and is characterised by a cough, runny
nose, fever, and a blotchy red rash that appears several days after
the initial symptoms. A person who contracts measles is infectious the
day before the symptoms occur, and for about 4 days before and after
the rash appears.
"The rash first develops in the facial area, with swelling of the
eyes, conjunctiva, and a redness of the mouth. The rash then spreads
over the body within 3 to 7 days," said Bromfield. After the 2nd day
of the rash, there is minimal risk for infecting others.
Measles was most severe in children who are malnourished and under the
age of one. Measles was also more severe in adults than in children
over 2 years old, with potential complications including ear
infections, diarrhoea, pneumonia, croup, and convulsions. Health
officials recommend that all children routinely receive a measles
vaccination at 9 months and a booster injection at 18 months.
"Measles immunisations are available free of charge from all city
health clinics," said Bromfield. "Measles is a preventable disease,
and the city urges residents to be aware of the symptoms and to ensure
that their children's vaccinations are up to date," he said.
HealthMap Alerts via ProMED-mail
[Measles appears now to be prevalent throughout South Africa with both
adults and children at risk, indicating incomplete vaccine coverage.
Visitors to South Africa should ensure that they have adequate
protection. Measles infection, although usually mild, can have serious
consequences for non-immunised or partially immunised children and
A map of the provinces of South Africa, showing Western Cape in the
south and Gauteng in the north, can be accessed at
<http://www.sa-venues.com/maps/south-africa-provinces.htm>; and the
HealthMap/ProMED-mail interactive map of South Africa is available at
[Photo of measles rash (harder to see on dark skin)