The National Institute for Communicable Diseases (NICD) has reported a significant rise in rubella cases across the country.
By the end of September, the NICD identified over 8,700 IgM-positive cases.
Data indicates that 98% (8, 543 out of 8, 723) of these cases have affected children under 15 years old. With the majority occurring in the age group of five to nine years.
The Centre for Vaccines and Immunology (CVI) at the NICD has recorded a rise in rubella cases in 2024. This is exceeding the numbers from fever-rash surveillance since 2015.
Children under 15 years old mostly affected
“This surge is attributed to a large number of children entering 2024 without prior rubella exposure or vaccination,” said the NICD in a statement.
The NICD said that the seasonal increase in cases is due to transmission through droplets containing the virus.
Additionally, non-pharmaceutical interventions disrupted the natural seasonal transmission patterns of rubella. These include lockdowns, social distancing, and mask-wearing implemented during the Covid-19 pandemic.
The NICD noted that between 2020 and 2022, almost no rubella cases were identified from the fever-rash surveillance.
“Children who would have been infected with rubella over the past three years are now becoming infected.”
Symptoms
Rubella is a mild, self-limiting infection that presents with fever and a maculopapular rash. Also with myalgia, enlarged lymph nodes, headache and conjunctivitis.
Occasionally, the NICD said people may develop joint pain or arthralgia, low platelets and mild encephalitis.
Meanwhile, certain pregnant are at risk of passing rubella infection to their unborn child. This may result in “congenital rubella infection”. These are women who are susceptible to rubella. Those who have not been vaccinated against rubella nor had natural rubella infection at some point in their lives.
“Fortunately, this is uncommon. Studies have shown that up to 98% of women of childbearing age are immune to rubella.”
The NICD explained that the congenital rubella syndrome may lead to foetal death. Or congenital abnormalities such as congenital heart disease, blindness and deafness.
Pregnant women
Any pregnant woman who has been exposed to a case of rubella, or a person with fever and rash, should report this urgently to their health practitioner for tests.
“A pregnant woman who is diagnosed with rubella should undergo specialist obstetric evaluation.”
Rubella is a notifiable medical condition and people meeting the case definition for rubella should be notified. A blood specimen for rubella antibody testing should be sent to the NICD.
“Specimens are routinely tested for measles and rubella,” the institute explained.
Due to the backlog of tests at the NICD, priority rubella testing should be requested under three conditions, it said.
A pregnant woman in her first trimester may need testing if she is exposed to someone with rubella. Or a person exhibiting fever and rash.
Severely ill patients
In addition, testing is necessary for severely ill patients admitted to the hospital to rule out rubella or measles.
Furthermore, testing is warranted if a new-born is suspected of having congenital rubella syndrome.
The specimen should be marked “Priority sample, urgently required”.
Health practitioners are advised to email Busisiwe Masengemi at BusisiweM@nicd.ac.za (NICD receiving office). Jayendrie Thaver at jayendriet@nicd.ac.za, and Lillian Makhathini at LillianM@nicd.ac.za. The latter are both from the CVI laboratory, and will help with urgent testing.
- SAnews.gov.za
