WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 30: 18 to 24 July 2022
Data as reported by: 17:00; 24 July 2022
...
Measles Zimbabwe
421 cases
38 Deaths
9.0%CFR
EVENT DESCRIPTION
The measles outbreak, which has been ongoing in Zimbabwe
since 10 April 2022, continues, however with a decrease in new
cases in the past two weeks. The first case was detected after a
village health worker notified Mutasa District health team of a
suspected measles community death in Makabvepi village.
Following the community signal, health workers conducted
preliminary investigation on 11 April that confirmed another
suspected death and several children with similar symptoms of
a body rash. Majority of the suspected cases and the two deaths
belonged to a religious group that does not accept immunisation.
The deaths were reported in Guta area, Chidazembe village and
Marange village, both in Mutasa district. Anecdotal community
reports also confirmed earlier cases of measles in March 2022.
Notably, there was a mass gathering which reportedly occurred
in the first week of April that could have fuelled the spread on
the bug in an already compromised community with suboptimal
immunisation coverage.
A total of 26 blood samples were collected from suspected cases
between 12–13 April from Roli and Makabvepi village and 13
samples (33.3%) from the patients were confirmed Measles IgM
positive and 11 negative for Rubella on 22 April. Subsequently,
more cases have been reported in the communities and at health
facilities in Mutasa district, which borders Mozambique to the
East.
As of 19 July 2022, a total of 421 cases have so far been identified
in Mutasa District. Of these, 55 (13.0%) are vaccinated against
measles, 330 (78.4%) are not vaccinated and 36 (8.6%) have
unknown vaccination status. A total of 38 deaths have so far
been recorded, yielding a case fatality ratio of 9.0%. Of the 38
deaths, 29 were unvaccinated, while the nine had an unknown
vaccination status.
The age-group between 1-4 years (Attack rate=1.2/1 000
population) were the most affected while those above 15 years
were the least affected (Attack rate= 0.01/1 000 population). Of
the reported cases, 56.0% are males and while 44% are females.
The ministry of health is currently conducting a reactive measles
campaign targeting the 6 months to under 15yrs age group with
a projected population of 78 968 children. Vaccinations are being
done at all static facilities with support of six mobile teams.
Vaccine doses were mobilized from provincial vaccine stores and
additional doses were distributed from the central vaccine stores.
PUBLIC HEALTH ACTIONS
All districts in Manicaland Province were notified of the
outbreak and advised to be on high alert and strengthen
measles surveillance. The districts updated their Epidemic
Preparedness plan. Response activities are currently
underway in collaboration with key partners.
Community surveillance has been strengthened through
sensitization of all village health workers, village heads and
community case definitions are being used. Active case
search is being conducted at all health facilities in the district.
In response to the outbreak, National, Province and
District leadership are rolling out a measles vaccination
campaign in Mutasa district. Measles rubella supplementary
immunization activities were commenced on the 25 April in
the northern part of the district where majority of cases were
reported.
The districts have developed their micro-plans and facility
based outreaches are complementing static facility-based
vaccination. District mobile outreach teams and health
facilities have gone further to re-establish outreach points
with the community.
Facilities are offering health education to all individuals
seeking health services simultaneously providing awareness
on measles outbreak.
Community engagement meetings have been conducted,
with community leaders, community/village health
workers (VHW) and the health care workers. Overall, social
mobilization activities are ongoing with VHW conducting
door to door awareness.
Measles case definitions and case management guidelines
have been distributed to all health facilities.
SITUATION INTERPRETATION
Zimbabwe is having a measles outbreak for the first time in twelve years. Because of COVID-19 restrictions at various points since
March 2020, access to immunization services for vaccine preventable diseases have been negatively affected with a significant
drop in measles and other vaccination antigen coverages. According to recently conducted Measles risk assessment, 10 districts
of 62 are in high risk on population immunity and an additional 20 districts are in medium risk. There has also been unusually high
numbers of suspected measles cases reported in districts of Hwedza, Makonde, Zvishavane and Centenary. The Ministry of Health is
currently conducting a mass vaccination in Mutasa district in response to the measles outbreak. Risk communication and community
engagement remains key to prevention and containment of the outbreak and need for continued implementation of response activities.
https://apps.who.int/iris/bitstream/handle/10665/360976/OEW30-1824072022.pdf
