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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Measles Outbreak in South Africa: Epidemiology of Laboratory-Confirmed Measles Cases and Assessment of Intervention, 2009-2011
PLoS ONE, Volume 8, No. 2, Article e55682, Year 2013
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Description
Background: 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. Methods: 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. Results: 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. Conclusion: 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. © 2013 Ntshoe et al.
Authors & Co-Authors
Ntshoe, Genevie M.
South Africa, Johannesburg
National Institute for Communicable Diseases
McAnerney, Johanna M.
South Africa, Johannesburg
National Institute for Communicable Diseases
Archer, Brett Nicholas
South Africa, Johannesburg
National Institute for Communicable Diseases
Smit, Sheilagh Brigitte
South Africa, Johannesburg
National Institute for Communicable Diseases
Harris, Bernice N.
South Africa, Pretoria
University of Pretoria
Tempia, Stefano
United States, Atlanta
Centers for Disease Control and Prevention
Mashele, Mirriam
South Africa, Johannesburg
National Institute for Communicable Diseases
Singh, Beverley
South Africa, Johannesburg
National Institute for Communicable Diseases
Thomas, Juno
South Africa, Johannesburg
National Institute for Communicable Diseases
Cengimbo, Ayanda
South Africa, Johannesburg
National Institute for Communicable Diseases
Blumberg, Lucille Hellen
South Africa, Johannesburg
National Institute for Communicable Diseases
Puren, Adrian
South Africa, Johannesburg
National Institute for Communicable Diseases
Moyes, Jocelyn A.
South Africa, Johannesburg
National Institute for Communicable Diseases
van den Heever, Johann
South Africa, Pretoria
Department of Health, Pretoria
Schoub, Barry David
South Africa, Johannesburg
National Institute for Communicable Diseases
Cohen, Cheryl D.
South Africa, Johannesburg
National Institute for Communicable Diseases
Statistics
Citations: 55
Authors: 16
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0055682
e-ISSN:
19326203
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
South Africa