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MEASLES
On 15 March, the National Institute for Communicable Diseases confirmed there had been 36 cases of measles across the country this year. Pippa Naudé explains the risks, and how to protect your family and you
PREVENTION IS BEST
The World Health Organization Africa region aims to eliminate measles in Africa by 2020, with the roll out of the Global Measles & Rubella Strategic Plan 2012–2020. A measles vaccine is available, which prevented an estimated 20.3 million deaths worldwide between 2000 and 2015. In South Africa, the government vaccination schedule provides the measles vaccine at six months and again at 12 months. In private practice, it is given at six months, and MMR (a combination vaccine for measles, mumps and rubella) is given at 15 months and again at age five or six. Dr Melinda Suchard, head of the Centre for Vaccines and Immunology at the National Institute for Communicable Diseases (NICD), says, ‘The vaccine is 95% effective at preventing measles, which means five people in every hundred may not be protected. Immunisation schedules and campaigns ensure each child receives more than one dose of measles vaccine to improve their resistance. Additional vaccines (called boosters) are advised where there is a risk of outbreak, even if all vaccinations are up to date.’ Provincial departments have rolled out vaccination campaigns in the areas affected by measles, and are encouraging everyone to be alert to possible infections.
WHAT CAUSED THE OUTBREAK?
Travel reintroduces measles where it has otherwise been eradicated. ‘About 15% of people worldwide 44
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are not vaccinated,’ explains Dr Van der Watt. ‘They are vulnerable to infection, as are those people whose vaccine has not been effective.’ Most non-vaccinated people are children whose parents refuse their vaccinations due to a belief they are harmful and can cause autism. The American Academy of Paediatrics, among others, have confirmed there is no scientific evidence that vaccines are harmful or cause autism, yet unfortunately the misconception has persisted. Medical Director of Cape Medical Response in Cape Town, Dr Alan Walters, says, ‘If a child develops measles, there is a real chance they could die from complications. So, however risky a parent feels the vaccine is, it’s a no-brainer’.
SEEING SPOTS ‘Symptoms include a fever, sore throat, cough, runny nose, painful eyes and small white spots inside the mouth, followed by a rash of red spots on the body,’ says Dr Van der Watt. If you suspect you have measles, contact your doctor to confirm the diagnosis, which can only be done conclusively with blood tests. If you’ve had possible contact with measles, your doctor can check whether you are immune and, if not, administer a vaccination. Until you’re in the clear, avoid contact with others.
MEET OUR EXPERT
Dr Hedi van der Watt is a paediatrician at Life Kingsbury Hospital. She is a member of the Paediatric Management Group, is on the Independent Paediatric Association committee, and joined Operation Smile to repair cleft lips in third world countries.
IMAGES GETTY/GALLO IMAGES, SUPPLIED
T
he recent measles outbreak has been worrying. ‘According to literature, measles is the most serious viral childhood illness. It can cause diarrhoea, dehydration, pneumonia (with a risk of long-term lung damage), blindness, encephalitis (which can lead to brain damage) and death. And because it spreads via droplets, through coughing, sneezing, sharing utensils and touch, it is highly contagious,’ says Dr Hedi van der Watt, paediatrician at Life Kingsbury Hospital. Anyone can catch measles, although malnourished and immune-compromised children, and infants between six months and five years are most at risk of complications.