South Sudan intensifies efforts to control an ongoing measles outbreak

Independent finger marking verification of the immunized children

29 April 2019, Juba – To interrupt the transmission of the measles virus, the Ministry of Health for South Sudan, with support from the World Health Organization, UNICEF and other partners, have launched reactive measles campaigns to immunize children in affected locations and provide them with vitamin A supplementation.

To date, more than 310 582 children aged 6 months – 15 years have been vaccinated.

South Sudan is among the countries experiencing an upsurge of measles cases. Since the beginning of 2019, measles outbreaks have been confirmed in 11 counties and three Protection of Civilian sites (POCs) housing displaced populations, affecting over 908 children and claiming at least seven lives. 

Measles is a major concern for global health. It is the leading killer among vaccine-preventable diseases. The outbreaks in South Sudan are partly attributed to low routine immunization coverage (estimated at 58% as of 2018), rampant protracted insecurity, limited access to health care services (estimated at less than 50%), a shortage of health workers to deliver timely vaccinations and an inconsistent compliance in implementing of the basic package for nutrition and health services by public and partner supported health facilities due to funding gaps.

The last measles follow-up campaign was conducted in May 2017 and reached 1 950 955 (84%) of the 2 312 659 targeted children aged 9-59 months. Consequently, a significant number of children were missed by the routine immunization and the last measles follow-up campaign, leading to an accumulation of unvaccinated children and thus increased risk for measles outbreaks.

South Sudan is also experiencing severe food insecurity with 6.54 million (57%) of the population being affected. This has increased the risk of malnutrition in children, thus increasing the risk of severe measles and adverse outcomes, especially those with vitamin A deficiency or whose immune systems have been weakened by HIV or other chronic diseases.  This urgent response is therefore paramount to prevent and/or mitigate the consequences of the current humanitarian situation.

The reactive measles campaigns have been conducted in Abyei, Juba, Pibor, Gogrial West, Gogrial East, Mayom, Melut and Aweil South and are planned for Tonj North, Aweil West and Aweil Center.

A countrywide follow-up mass measles campaign targeting children aged 9–59 months is planned for November to “mop up” the unvaccinated cohorts of children who have accumulated since the 2017 campaign.

“It is important to strengthen routine immunization to ensure that all children, no matter where they live, receive life-saving measles vaccines, despite the challenges, said Dr Olu Olushayo, WHO Representative for South Sudan. Measles is a highly contagious disease currently causing a global crisis, and concerted efforts are needed to improve routine immunization delivery so that all children are protected from vaccine preventable diseases”, Dr Olu stressed.

WHO has deployed emergency medical mobile teams to different areas of South Sudan to support the response. UNICEF continues to support social mobilization and community engagement in addition to ensuring the availability of the vaccines and cold chain.

Given the current transmission rates and the need to meet the emergency needs, an estimated 1.38 million doses of measles vaccine will be required to respond to the measles outbreaks in 2019, said Dr Guracha Guyo, Emergency Coordinator, WHO South Sudan.

Addressing the barriers to routine immunization coverage and improving the overall function of the health system should lead to a significant reduction in measles incidence and mortality in South Sudan. WHO commend Gavi vaccine Alliance and the United States Agency for International Development (USAID) for their continued support to the Ministry of Health to strengthen routine and supplementary immunization, and we welcome the efforts of the implementing partners who have reached out with the much-needed immunization services.

The measles vaccine is safe and effective and reduces the risk of children suffering from severe forms of measles. Every child should receive two doses of the measles vaccination.