Measles, mumps, chickenpox – what to know

MEASLES, mumps and chicken pox are among a group of infectious diseases that may occur during childhood which, until recent years, have seen outbreaks and/or sporadic incidents reported.

In March, the National Institute for Communicable Disease (NICD) declared a measles outbreak in South Africa.

According to the NICD’s last update (October 9), there were 1,214 cases across the country, barring the Northern Cape, the North West, and the Free State the Northern Cape in week 15, the North West in week 24, and the Free State where the measles outbreak has been declared as being over.

“To declare the measles outbreak over, the following criteria should be achieved: Absence of newly detected measles cases for more than two incubation periods (42 days),” said an NICD update.

Measles is a highly contagious disease caused by the measles virus. Patients with measles present with fever and a rash. The rash looks like small, red, flat spots that start on the face/head and then spread downwards over the body. The rash does not form blisters, nor is it itchy or painful.

Other signs include cough, conjunctivitis (red eyes) and coryza (running nose).

Mumps

In May, the NICD said it had recorded an unexpected, sudden increase in mumps, which constituted an outbreak.

Mumps is an acute viral infection caused by the rubula virus, also known as mumps virus. It is sometimes called “infectious parotitis”, as it causes painful swelling of the parotid or salivary glands.

According to the NICD, mumps are generally a mild childhood disease, mostly affecting children between 5 to 9 years of age. However, younger and older children as well as adults can become infected with mumps.

“People who have had mumps are usually protected for life against another mumps infection. However, second occurrences of mumps rarely occur. To limit transmission during an outbreak, in countries where mumps vaccination is universally available, public health authorities may recommend an additional dose of the combination measles, mumps and rubella (MMR) vaccine for people who belong to groups at increased risk of getting mumps.

“These groups are usually those who are likely to have close contact, such as sharing sport equipment or drinks, kissing, or living together, with a person who has mumps. As the MMR vaccine as an intervention is not universally available in South Africa, it is best to seek the advice of your local healthcare provider,” said the NICD in a follow-up statement later that month.

Cases

While the NICD has not released any alerts regarding chickenpox, in recent weeks a number of cases have been reported locally, with some schools issuing letters alerting parents that some cases had been reported.

Dr Ashmika Gokhul is a Specialist Paediatrician at Life The Crompton Hospital and she has admission rights at Life Westville and Entabeni hospitals; and Netcare St Augustine’s and Parklands hospitals.

Gokhul said at her practice they saw increased cases of all three diseases.

“Some of these children were admitted because of complications from these infections. I have also had a lot general practitioners tell me that they saw an increase in adult cases with these infections in their practices. These numbers have since dropped.”

Gokhul said there had been more cases of measles, mumps and chicken pox in recent years.

“The reasons for this is poor vaccine uptake in general population. People had lack of access or intentionally avoided healthcare facilities during the Covid-19 pandemic and therefore did not get their routine vaccines on time.

“Post the Covid-19 pandemic, children are back at school and there are more larger gatherings. People are not social-distancing, wearing masks and sanitising/washing hands as often as they were during the onset of the pandemic. Therefore, there is an increased risk of picking up infections.”

Gokhul said anti-vaccine communities were also increasing.

“People have varying religious and personal beliefs that vaccines may be harmful and therefore refuse to vaccinate their children. Most important is that the majority of the general public is unaware that the mumps and chicken pox vaccine is not included in the government or standard vaccine schedule given by state/public facilities.

“The mumps and chicken pox vaccine is only given in the private sector. So unless you have medical aid that covers these vaccines, or you pay cash for them in the private sector you and your child would not have received mumps or chickenpox vaccines.”

During the hard lockdown, children were mostly isolated at home and Gokhul said this would have affected their immunities.

“We definitely saw an increase in the severity of viral illness in children and adults post Covid-19 that we did not experience prior to the pandemic but this was mainly because of relaxation of Covid-19 mitigating rules; ie lack of using masks, no social distancing, decreased vaccine uptake.

“Exposure to different microbes from other people, animals and the environment help build a healthy immune system by producing anti-bodies/protective proteins. However, exposure to certain types of germs can weaken the microbiome and cause infections. In addition previous exposure to some viruses, for example, rhinovirus, does not protect you from getting infected with the same virus in the future.”

She said it was important for all parents to ensure their children were vaccinated against MMR and chicken pox.

“These infections are extremely contagious and can cause severe illness in non-vaccinated individuals. As mentioned the government only issues the measles vaccine, so parents should contact the GP, pharmacies or paediatricians for more information on how to catch up on their vaccines if they have been missed.”

Gokhul said the best thing that parents could do to ensure their children were protected against these diseases was to vaccinate.

“If these vaccines were missed, they can be caught up. The government schedule for measles vaccine is 6 months and 1 year of age. Private practice schedule for MMR vaccine is 1 year and 6 years of age. Chicken pox is 15 months of age and 6 years.”

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