Cases of Malaria increasing in Gauteng due to late detection

The National Institute for Communicable Diseases (NICD) says it is currently seeing a significant increase in malaria cases in the endemic provinces and Gauteng, with many cases of severe malaria due to late presentation or late detection.

“Undiagnosed and untreated malaria rapidly progresses to severe illness, with a potentially fatal outcome,” the NICD warned this week.

The public health institute has since issued an alert to people with fever or “flu-like” illness, who reside in a malaria-risk area in Limpopo, KwaZulu-Natal and Mpumalanga, or have travelled to a malaria-risk area, in the past six weeks, to test using a blood smear microscopy or malaria rapid diagnostic test.

“If they test positive for malaria, the patient must be started on malaria treatment immediately,” the NICD urged.

Taxi Malaria

According to the statement, patients must inform their healthcare provider of their recent travel, particularly to neighbouring countries and malaria-risk areas in South Africa.

The NICD said “taxi malaria” transmitted by hitch-hiking mosquitoes, should be considered in a patient with unexplained fever who has not travelled to a malaria-endemic area but is getting progressively sicker, with a low platelet count.

“Seek medical attention early; both malaria and Covid have similar nonspecific early symptoms including fever, chills, headaches, fatigue and muscle pain.”

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Measles

Meanwhile, eight new laboratory-confirmed cases of measles were recently detected in Limpopo. The measles strain detected in Limpopo and North West is genotype D8 – similar to the strain in Zimbabwe in the 2022 outbreak.

In the provinces where an outbreak has been declared, the most affected age groups are still the five to nine year olds (43%) with a considerable proportion of cases reported among the one to four (26%) and 10-14 age groups (20%).

From epidemiological week 40 of 2022 to week 17 of 2023, 970 laboratory-confirmed cases were reported from eight provinces with declared measles outbreaks: Limpopo (410 cases), Mpumalanga (108 cases), North West (216 cases), Gauteng (166 cases), Free State (29 cases), Western Cape (14), KwaZulu-Natal (20) and Northern Cape (7).

The Eastern Cape has not recorded any cases to date. The NICD says it has also recorded an unexpected, sudden increase in mumps, which constitutes an outbreak.

According to the public health institute, mumps is an acute viral infection caused by the rubulavirus. “It is sometimes called ‘infectious parotitis’, as it causes painful swelling of the parotid and or salivary glands.”

Mumps, the NICD said, is generally a mild childhood disease, mostly affecting children between the ages of five and nine.

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 do rarely occur.”

According to the World Health Organisation (WHO) vaccine-preventable diseases monitoring system’s 2019 global summary, only two Southern African countries – eSwatini and Zambia – frequently reported cases of the mumps between 1999 and 2018, whereas South Africa only reported 24 cases in 2002.

“Mumps reporting has been inconsistent and limited reports on mumps epidemiology in South Africa.

Mumps is not a notifiable medical condition and is not included in any formal surveillance programme,” the NICD noted However, since February 2023, the NICD said it has received many inquiries related to possible clusters or outbreaks of mumps in different provinces.

To limit transmission during an outbreak, the NICD said, public health authorities might recommend an additional dose of the combination measles, mumps and rubella (MMR) vaccine for people at increased risk.

“These are usually those who are likely to have close contact, such as sharing sports equipment or drinks, kissing, or living together, with a person who has mumps.

“As the MMR vaccine is not universally available in SA, it is best to seek the advice of a local healthcare provider.”

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