Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011.
<h4>Background</h4>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 campaig...
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oai:doaj.org-article:f7c471d015194270b5d8b89b74c468b82021-11-18T07:56:59ZMeasles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011.1932-620310.1371/journal.pone.0055682https://doaj.org/article/f7c471d015194270b5d8b89b74c468b82013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23437059/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Genevie M NtshoeJohanna M McAnerneyBrett N ArcherSheilagh B SmitBernice N HarrisStefano TempiaMirriam MasheleBeverley SinghJuno ThomasAyanda CengimboLucille H BlumbergAdrian PurenJocelyn MoyesJohann van den HeeverBarry D SchoubCheryl CohenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e55682 (2013) |
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Medicine R Science Q 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 Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| description |
<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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. |
| format |
article |
| author |
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 |
| author_facet |
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 |
| author_sort |
Genevie M Ntshoe |
| title |
Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| title_short |
Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| title_full |
Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| title_fullStr |
Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| title_full_unstemmed |
Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| title_sort |
measles outbreak in south africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/f7c471d015194270b5d8b89b74c468b8 |
| work_keys_str_mv |
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| _version_ |
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