PLoS ONE (Jan 2013)

Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011.

  • Genevie M Ntshoe,
  • Johanna M McAnerney,
  • Brett N Archer,
  • Sheilagh B Smit,
  • Bernice N Harris,
  • Stefano Tempia,
  • Mirriam Mashele,
  • Beverley Singh,
  • Juno Thomas,
  • Ayanda Cengimbo,
  • Lucille H Blumberg,
  • Adrian Puren,
  • Jocelyn Moyes,
  • Johann van den Heever,
  • Barry D Schoub,
  • Cheryl Cohen

DOI
https://doi.org/10.1371/journal.pone.0055682
Journal volume & issue
Vol. 8, no. 2
p. e55682

Abstract

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BackgroundSince 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.MethodsSerum 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.ResultsA 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 ConclusionWe 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.