Measles outbreak in South Africa, 2003-2005.
- 1 May 2009
- journal article
- Vol. 99 (5), 314-9
Abstract
Measles was virtually eliminated in South Africa following control activities in 1996/7. However, from July 2003 to November 2005, 1676 laboratory-confirmed measles cases were reported in South Africa. We investigated the outbreak's cause and the role of HIV. We traced laboratory-confirmed case-patients residing in the Johannesburg metropolitan (JBM) and O. R. Tambo districts. We interviewed laboratory--or epidemiologically confirmed case-patients or their caregivers to determine vaccination status and, in JBM, HIV status. We calculated vaccine effectiveness using the screening method. Household survey in JBM and O. R. Tambo districts. Outcome measures. Vaccine effectiveness, case-fatality rate, and hospitalisations. In JBM, 109 case-patients were investigated. Of the 57 case-patients eligible for immunisation, 27 (47.4%) were vaccinated. Fourteen (12.8%) case-patients were HIV infected, 46 (42.2%) were HIV uninfected, and 49 (45.0%) had unknown HIV status. Among children aged 12-59 months, vaccine effectiveness was 85% (95% confidence interval (CI): 63, 94) for all children, 63% for HIV infected, 75% for HIV uninfected, and 96% for children with unknown HIV status. (Confidence intervals were not calculated for sub-groups owing to small sample size.) In O. R. Tambo district, 157 case-patients were investigated. Among the 138 case-patients eligible for immunisation, 41 (29.7%) were vaccinated. Vaccine effectiveness was 89% (95% CI 77, 95). The outbreak's primary cause was failure to vaccinate enough of the population to prevent endemic measles transmission. Although vaccine effectiveness might have been lower in HIV-infected than in uninfected children, population vaccine effectiveness remained high.This publication has 17 references indexed in Scilit:
- Case-Fatality Rate during a Measles Outbreak in Eastern Niger in 2003Clinical Infectious Diseases, 2006
- Measles: the need for 2 opportunities for prevention.Clinical Infectious Diseases, 2006
- Public-health impact of accelerated measles control in the WHO African Region 2000–03The Lancet, 2005
- Neonatal Measles Immunity in Rural Kenya: The Influence of HIV and Placental Malaria Infections on Placental Transfer of Antibodies and Levels of Antibody in Maternal and Cord Serum SamplesThe Journal of Infectious Diseases, 2005
- Interruption of Indigenous Measles Transmission in Bolivia since October 2000The Journal of Infectious Diseases, 2003
- Vitamin A for the Treatment of Children with Measles--A Systematic ReviewJournal of Tropical Pediatrics, 2002
- First 5 years of measles elimination in southern Africa: 1996–2000The Lancet, 2002
- Measles elimination in the Americas. Evolving strategiesPublished by American Medical Association (AMA) ,1996
- Estimation of Vaccine Effectiveness Using the Screening MethodInternational Journal of Epidemiology, 1993
- Population-based study of measles and measles immunization in human immunodeficiency virusinfected childrenThe Pediatric Infectious Disease Journal, 1992