South Sudan: Measles vaccination campaign urgently needed in flood-affected Pibor area

A woman carries tree branches to construct a new house in Pibor town.
South Sudan 2020 © MSF/Tetiana Gaviuk
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NEW YORK/JUBA, South Sudan, November 4, 2020—Measles is rapidly spreading in the flooded town of Pibor and surrounding areas, severely affecting young children, Doctors Without Borders/Médecins Sans Frontières (MSF) warned today, calling for health organizations to urgently carry out a measles vaccination campaign.

MSF treated the first children with suspected measles in central Pibor town in August, and the outbreak has grown significantly since then. From August to October, MSF treated more than 250 children and is currently treating 30 children with severe measles in its Pibor health facility. Patients are increasingly coming from farther away in the surrounding Greater Pibor Administrative Area, as people walk and paddle through stagnant and moving floodwaters, sometimes for up to seven days. 

"We believe measles is now widespread and getting out of control," said Adelard Shyaka, an MSF doctor in Pibor. "It is especially concerning that the Greater Pibor Administrative Area is flooded in a larger emergency. The severity of the situation is magnified by other illnesses including severe malaria, pneumonia and severe malnutrition. Two children have already died of measles and we are deeply concerned that without a prompt reactive vaccination campaign, more children will die."

Measles is a highly contagious disease that is transmitted through the air. Malnourished children under the age of five are more likely to develop severe measles, with serious and even fatal complications, including severe diarrhea, pneumonia, blindness or encephalitis.

There is no specific treatment for measles, but a well-conducted vaccination campaign is extremely effective in preventing new cases. In areas like Pibor with large-scale movement of people and low immunization rates due to insecurity and logistical challenges, vaccination can reduce infant mortality by 50 percent.

Pibor and the surrounding area experienced intercommunal conflicts earlier this year, and many people were displaced by the violence before being displaced again by flooding. Children in Pibor are now living in close contact to each other, increasing the risks of transmission.

"With the floods, many communities are clustered on small islands of dry land," said Josh Rosenstein, MSF coordinator in Pibor. "This is the moment to vaccinate as many children as possible through small mobile teams visiting these small islands. If it does not happen now, the water levels will start to decrease and people will start to return to their homes elsewhere. This is the best chance that we have at controlling the disease outbreak."

MSF has been calling on health organizations in South Sudan to urgently implement a widescale reactive vaccination campaign since August 31, when six measles cases were confirmed by laboratory testing. It is the third measles outbreak in Pibor in the last 12 months, and MSF is struggling to control it while simultaneously responding to multiple health emergencies in the area.

MSF is not able to do more. In the last 11 weeks, MSF has treated more than 15,624 patients in and around Pibor, including 6,290 children under the age of five. More than half of these patients have been treated for malaria: a number far above normal for this time of year. MSF has also treated 1,700 children under five for respiratory tract infections and 699 for watery diarrhea and is responding to rapidly increasing numbers of patients with malnutrition.

MSF teams are delivering health care through six mobile clinics in villages on the periphery of Pibor and a health facility in the town. MSF is also supporting water and sanitation activities, distributing about 60,000 liters of water daily.

As a medical humanitarian organization, MSF has been working in the region that is now South Sudan since 1983 and currently works in 14 locations throughout the country.