JOHANNESBURG - South Africa is confronting a considerable outbreak of rubella, commonly known as German measles, which predominantly impacts children under ten years old and pregnant women. The National Institute for Communicable Diseases (NICD) reported over 10,000 cases of rubella this year alone, marking the highest number of German measles and rubella cases since 2015.
According to NICD data compiled from January to November 2024, there have been 626 confirmed cases of German measles and a staggering 10,137 rubella cases across the country. Children between the ages of five and nine account for more than half of these infections. While there has been some reduction of rubella cases within the Western Cape Province, the North West Province has experienced a sharp increase.
Pivotal findings from the NICD indicate the overwhelming majority of rubella cases are affecting younger populations, with the highest incidence reported from Gauteng, where 2,603 rubella infections and 285 German measles cases have occurred. NICD spokesperson Vuyo Sabani reported, "Over 8,700 IgM-positive cases have been identified. Notably, 98% of these cases have affected children under 15, with many occurring within the 5-9 age group." This has raised alarms among health officials, as cases of measles have surged alongside those of rubella.
The NICD attributes the outbreak to several compounding factors: children have entered 2024 without the requisite immunity due to insufficient vaccination campaigns and limited natural exposure to the rubella virus. "The natural transmission of rubella was interrupted by the non-pharmaceutical interventions implemented during the SARS-CoV-2 pandemic," Sabani explained. "These measures led to reduced exposure to rubella, which has increased susceptibility among children as they return to school and social interactions."
To combat the outbreak, the South African Department of Health has launched a rubella vaccination initiative aimed at children aged six and nine months. Dr. Kerrigan McCarthy from NICD urged prompt medical attention for pregnant women who come in contact with individuals showing rubella symptoms. "If a mom is diagnosed with rubella during her pregnancy, she should be referred to specialist obstetric services where she will be advised on the health of her little one," McCarthy emphasized.
Pregnant women are particularly vulnerable to rubella infection as exposure during the first trimester can result in Congenital Rubella Syndrome (CRS). CRS can lead to severe developmental issues, including heart defects, blindness, and hearing impairment. "The concern is substantial because rubella infection during pregnancy can have dire consequences,” warned Dr. McCarthy.
Despite the alarming rise, the NICD is optimistic about the outbreak subsiding by early January 2025, pending vaccination efforts. "We expect the rubella outbreak to be over by the end of the year or early January," stated Dr. McCarthy, reinforcing the urgency of vaccination campaigns. The challenges posed by the increased rubella cases are compounded by the observations made by the NICD, which indicate there were significant lapses among the youth who were unable to be vaccinated during campaigns held previously due to various constraints.
Health authorities noted, "Most children reported with measles infection were among age groups who should have been vaccinated during the measles vaccination campaign in 2023." There remains substantial discourse on fortifying public health initiatives to prevent similar outbreaks moving forward.
Health officials are calling for parents and caregivers to prioritize vaccinations for their children. The NICD's role extends beyond just reporting the outbreak; it actively seeks the cooperation of communities to normalize health discussions centered around vaccinations. Their campaigns aim to raise awareness of the importance of immunization, particularly as schools resume and children become increasingly social and less isolated.
The situation serves as a reminder of the broader implications of public health measures, underscoring the necessity of maintaining vaccination coverage for diseases like rubella. This current health crisis showcases the interconnected nature of individual and community health, as well as the pivotal role vaccines play in safeguarding public wellbeing. South Africa’s health department is taking proactive steps to secure these vaccines and implement community engagement strategies to reintegrate vaccinations as routine preventative measures.
