Yellow fever outbreak in W.E.S South Sudan

South Sudan: MSF calls for urgent vaccination campaign to halt deadly measles outbreak in Western Equatoria state

A measles crisis is mounting in South Sudan’s Western Equatoria state, just as health authorities struggle to overcome an outbreak of yellow fever. Since February, 7 deaths among children under-five and 460 cases have been recorded as of March 24th in three health facilities in Yambio and Nzara counties; 90 per cent of these children had never been vaccinated against the disease.

With measles cases on the rise and vaccination coverage alarmingly low, international medical organisation Médecins Sans Frontières/Doctors Without Borders (MSF) urges health authorities and the World Health Organization (WHO) to launch an immediate vaccination campaign to prevent the disease from spreading further.

“When my child fell sick, he was having high fever, diarrhoea and cough. While at home, I gave him Paracetamol but there was no improvement. We then brought him to the MSF facility where he received treatment for three days. If I didn’t come to the facility, I know my child was going to die,’’ said Victoria John, mother of one and half year-old Mark Emmanuel suffering from measles.

Yellow fever outbreak in W.E.S South Sudan
Excitement fills the air as children proudly exhibit their vaccination cards in Yambio, having taken a proactive step against yellow fever during the targeted campaign in Western Equatoria State.
Isaac Buay

Measles has become a persistent emergency in South Sudan, with recurring outbreaks challenging healthcare systems and endangering communities. To respond to this emergency, MSF teams are treating measles in Nzara and Yambio Counties via Gangura and Sakure health centres and at Yambio State Hospital. Our team intends to increase the number of beds for measles patients from 32 to 40 due to the rapidly increasing number of measles cases. MSF is also intervening in the community to look for children with potential measles symptoms and refer them to health facilities.

Twenty per cent of children treated for measles at MSF-supported facilities are over the age of five, highlighting the need for a reactive vaccination campaign to reach this group of older children who did not receive measles vaccinations as part of the existing expanded immunization programme (EPI).

The measles outbreak is a double blow for a region still struggling to deal with yellow fever after the most recent outbreak – the fourth in just six years – was declared by health authorities in December 2023. As of mid-March, 81 cases of yellow fever, including three confirmed ones, and six deaths have been recorded. The Ministry of Health, in collaboration with WHO, launched a yellow fever vaccination campaign, immunising around 357,000 people across three counties of Western Equatoria state. The campaign resulted in a reduction in the number of suspected and confirmed cases – a testament to the efficacy of mass vaccination campaigns.

An MSF nurse attends to a patient suffering from measles at Gangura PHCC, a facility supported by MSF.
An MSF nurse attends to a patient suffering from measles at Gangura PHCC, a facility supported by MSF. 
Isaac Buay
Large-scale vaccination campaigns are vital, both in Western Equatoria state and Northern Bahr el Ghazal state where the current measles outbreaks are ongoing, to halt further spread of the disease and prevent any more outbreaks. South Sudan’s fragile health system cannot bear the burden of recurrent outbreaks MSF head of mission Zakaria Mwatia.

Low vaccination coverage in South Sudan has a significant impact on the population, particularly children, who are highly vulnerable to diseases such as measles which can lead to serious health complications and deaths. Given the gravity of the health threats posed by both measles and yellow fever, MSF calls for increased efforts to raise community awareness about the diseases and to adopt best practices to stop them from spreading.

“It is imperative that the Ministry of Health and other health organisations, including WHO, intensify their efforts to expand vaccination coverage across the country and especially those areas most prone to disease outbreaks,” urges MSF head of mission Zakaria Mwatia.

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Article 15 March 2024