Zimbabwe: Measles Outbreak - Emergency Plan of Action (EPoA), DREF Operation n° MDRZW018


A. Situation analysis

Description of the disaster

Zimbabwe has been hit by a deadly national measles outbreak whose cases have doubled from 1036 to 2056 in four days (as of the 15 August 2022) and has killed 157 children from 2056 cases reported in all the provinces between April and August 20221. The disease was first recorded in Manicaland province on the 10 April 2022 in Mutasa district. The government responded through initiating vaccination of children under 5 years regardless of vaccination status. As of 31 August 2022, cumulative total of 5 735 Cases were recorded by MoH. 4 117 Recoveries and 639 Deaths have been reported since the onset of the outbreak. New cases were reported from Matabeleland North (60), Manicaland (49), Mashonaland East (41), Mashonaland West (23), Chitungwiza (11) and Harare (6). Since Mid-August, it has been an upward trend of new cases and a spread to other provinces since mid-August. Same for the fatality. On 31 August, 639 dead were recorded against 704 in September. Cases from 5735 on 31 August to 5,843 cases in the 01 September SITREP (108 new cases in less than 48 hours) below is the national summary of cases from government’s Sitrep 01 September 2022. On 06 September, total deaths were 704.

From the current situation, the most affected provinces since the start of the outbreak are Manicaland (the main epicentre), Mash East, Mash West and the Midlands which contribute to 80% of the cases.

The outbreak has been attributed to the disruption of routine vaccination activities by the COVID-19 pandemic from 2020 which has increased the risk of the disease. The Government identified some anti-vaccine groups, whose behaviour contributed to slow down the vaccination campaign on measles and even others routine vaccination. From MoH information, most of the exposed families do not bring children for vaccination due to their belief systems. Religious and traditional behaviors are key aspects to manage in this outbreak to ensure the best interests of the child, survival and development principles and rights of children respected.

Since the declaration, cases continue to rise and mass vaccination initiatives need scaling up to enhance coverage and reach. Most of the identified cases have not been vaccinated against measles. Risk for infection among children under 15 years remains high especially among these anti-vaccination apostolic sects. Consequently, it has led to a surge in deaths and other related complications. Measles can be a serious disease, with 30% of reported cases experiencing one or more complications. Most complications occur mostly in children and pregnant women. Measles during pregnancy increases the risk of premature labour, miscarriage, and low-birth-weight infants. Measles is more severe in malnourished children, particularly those with vitamin A deficiency. About 30% of Zimbabweans are projected to be food insecure by the end of 20222. Also, if not treated early, the child may develop complications such as pneumonia and encephalitis. The MOHCC during a meeting on 25 August requested support from the Red Cross to urgently support the response across the country ad especially in Mutare district in Manicaland and Gokwe North district in the Midlands province.