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EPIDEMIC

Deadly measles outbreak in Zimbabwe kills 750 children, SA at risk

Deadly measles outbreak in Zimbabwe kills 750 children, SA at risk
Since April this year a deadly measles outbreak in Zimbabwe has killed more than 750 young children. (Photo: File, Getty Images)

Although it has not garnered much attention from politicians in the southern African region, a measles outbreak in Zimbabwe, that has killed 750 children, has raised alarm bells internationally, with organisations like Unicef and the WHO expressing concern and activating an emergency response strategy to provide support and resources to the government. South Africa too should be concerned, says Shabir Madhi.

Since April this year, a deadly measles outbreak in Zimbabwe has killed more than 750 young children according to the Ministry of Health in Zimbabwe. Measles is a disease caused by a virus that can easily be prevented with a vaccination that, according to the WHO, “has been in use for nearly 60 years” and which “is safe, effective and inexpensive”. 

It costs approximately one US dollar to immunise a child against measles. Nonetheless, records the WHO, “in 2018, there were more than 140,000 measles deaths globally, mostly among children under the age of five.” 

Most of these deaths were in developing countries.  

Although it has not garnered much attention in the region, SADC for example has been silent, the measles outbreak in Zimbabwe has raised alarm bells internationally, with organisations like Unicef and the WHO expressing concern and activating an emergency response strategy to provide support and resources to the government.

According to a report in the respected international publication, Deutsche Welle (DW), Dr Fiona Braka, the WHO head of emergency operations in Africa, told reporters in September that “the case fatality is relatively higher when compared to other recent outbreaks” across the continent. Braka said the outbreak is “the first in many years at this scale and it’s been progressing quickly.”

According to activists in Zimbabwe, the causes of the outbreak, and the reasons why it has spread so rapidly are not hard to discern. According to Tony Reeler, a senior researcher at the Research and Advocacy Unit (RAU): “One aspect is the reluctance of the Vapostori (Apostolics) to vaccinate their children, another is the downstream effects of Covid and then there’s the near-collapse of the state health service.”

Frances Lovemore, the director of the Counselling Services Unit (CSU) confirmed there have been 7,300 cases and about 744 deaths since April. This week there have been 194 more cases and one suspected death.


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Lovemore explains that there have been a number of determinants driving the outbreak: 

“The April outbreak in Manicaland was related to the Apostolic Church refusal to get vaccinations for anything. They are always a challenge. 

“That outbreak was related also in part to schools returning to normal. There was a big response from the Ministry of Health and a mass vaccination drive. But the disease was already ripping through the kids, many of whom had missed vaccination due to Covid. The poverty-induced malnutrition contributes to the high mortality.”

Prof Shabir Madhi, Dean of the Faculty of Health Sciences and Professor of Vaccinology, described the outbreak as “highly disconcerting and likely an underestimate of the number of deaths, as well as number of cases.” 

Madhi says it is “Likely a culmination of an increase in immunity gap due to disruptions of routine childhood immunisation programmes over the last two years (2020-2021) related to diverting resources to deal with Covid-19.” 

He says the threat of further outbreaks is “compounded by the modest vaccine coverage of at least two doses, even before further disruption of measles and general childhood immunisation programmes before the onset of Covid. To avoid outbreaks of measles requires at least 95% of the population to have immunity; hence the target to get more than 90% of children immunised with at least two doses of measles vaccine.” 

According to Madhi, several other African countries, as well as Pakistan and Afghanistan are also reporting higher numbers.

He says there are “a handful of cases in SA” but is concerned about the potential for an outbreak “as we have modest measles vaccine coverage as well”. 

“Measles is the canary in the mine: it is more transmissible than many other diseases against which we vaccinate and also easier to diagnose and recognise. It therefore often unmasks patterns of under immunisation.” 

Describing it as “collateral damage following the deviation of scarce resources to deal with Covid, which would otherwise have been used in the immunisation programmes. It should be a wake-up call that warrants immediate planning of mitigation strategies, and also a more balanced approach on a ranking with Covid vaccines and avoiding further undermining childhood immunisation programmes.” DM/MC

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