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Speaker 1: As you have probably heard on other shows and certainly

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Speaker 1: in the news bulletins, there has been a resurgence of

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Speaker 1: measles in the Western Cape, nearly one hundred and forty

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Speaker 1: cases reported since November last year, almost half of them

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Speaker 1: coming from Dunon. But the outbreak is not limited to

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Speaker 1: that community, nor is it unique to our province. The

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Speaker 1: National Institute for Communicable Diseases telling us there've been more

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Speaker 1: than two thy seven hundred confirmed measles cases in the

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Speaker 1: past year, and they attribute the surge to a drop

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Speaker 1: in routine childhood immunizations. And I want us to have

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Speaker 1: a conversation about measles today because I know some people

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Speaker 1: are quick to dismiss such news because they think of

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Speaker 1: measles as a mild disease that most people bounce back

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Speaker 1: from easily, and if you're lucky, that is indeed what

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Speaker 1: might play out. But we do want to take a

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Speaker 1: closer look in health and wellness today because that is

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Speaker 1: not the situation for everybody, and to help us understand

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Speaker 1: the condition better. It's a pleasure to welcome another doctor,

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Speaker 1: Darren to the show. Doctor Darren Pedro is a GP

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Speaker 1: who runs his practice in Kale's River and is joining

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Speaker 1: me on the line this afternoon to chat a little

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Speaker 1: bit more about measles.

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Speaker 2: Darren. It's wonderful to have you with us this afternoon.

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Speaker 2: Welcome to the show, Darren.

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Speaker 3: Can you to your listeners, Yes.

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Speaker 1: Great to have you with us, Darren. We often hear

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Speaker 1: people sort of brush measles aside, saying it's just a

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Speaker 1: childhood illness. All of us had it and got over it.

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Speaker 1: And yes, that is true for many people. It's not

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Speaker 1: a too serious illness. But that's not the case for everyone,

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Speaker 1: is it. Can you explain why we shouldn't just dismiss

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Speaker 1: it as being low risk.

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Speaker 3: Yeah, I think that's a true proper. I think everybody

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Speaker 3: sort of thinks as measles as just a mild illness

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Speaker 3: that you know, it's not serious, and but in actual fact,

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Speaker 3: you know, it is something that's completely preventable. It's a

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Speaker 3: highly contagious disease. And for those unvaccinated, you know, those

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Speaker 3: who are im you know, suppressed, and our young children,

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Speaker 3: especially under the age of five, you know, it is

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Speaker 3: quite a serious illness. You know that leads to many

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Speaker 3: complications and you know, could even lead to death for

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Speaker 3: those that are that are unvaccinated.

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Speaker 2: Okay, I mean.

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Speaker 1: The National Institute for Communical Diseases obviously concerned about the

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Speaker 1: rise in cases, and they are drawing a direct line

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Speaker 1: to a dip in childhood sort of routine vaccination compliance.

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Speaker 1: So they're obviously concerned about outbreaks occurring. Can you elaborate

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Speaker 1: a little bit more on on how oartbreaks occur. I

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Speaker 1: mean you've just mentioned the key thing there that this

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Speaker 1: is a very contagious illness, perhaps more so than some

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Speaker 1: of the other childhood diseases.

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Speaker 3: Not so yeah, yeah, one hundred percent correct. I think

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Speaker 3: very interesting. I mean again with it, because it is

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Speaker 3: a preventable disease. You know, we've seen that that you know,

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Speaker 3: measles doesn't come in seasons. Really, it's one of those

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Speaker 3: we can have a direct correlation when vaccination rate, you know,

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Speaker 3: starts dropping, and I think post COVID there has been

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Speaker 3: a used you know, disruption in vaccination and vaccination uptake,

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Speaker 3: and so even post COVID now we've seen where many

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Speaker 3: just never went for their catch up vaccinations and there's

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Speaker 3: been quite a drop in vaccination rates, both in public

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Speaker 3: and private sector. And you can almost draw a direct

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Speaker 3: correoration between you know, the uptake of a measles outbreak

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Speaker 3: and what happens with our vaccination schedules within communities.

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Speaker 1: Okay, Darren, As you've pointed out, there are some people

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Speaker 1: who can't be vaccinated, either because they're still too young

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Speaker 1: or because they have a suppressed immune system and cannot

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Speaker 1: safely take the vaccine for that reason. But what sort

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Speaker 1: of level of population vaccination is needed to keep it

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Speaker 1: at a fairly stable rate. Is there a particular percentage

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Speaker 1: at which you start getting worried if the vaccination rate

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Speaker 1: drops below that?

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Speaker 3: Yeah, so very interesting. I mean, I mean many of

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Speaker 3: the listeners have heard of heard immunity that they talk about,

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Speaker 3: and really for us to achieve herd immunity where most

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Speaker 3: people are vaccinated, and because most people are vaccinated, you

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Speaker 3: know those unvaccinated, you know, there's no chance of a

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Speaker 3: really really spreading. But we need for immunity, we'd probably

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Speaker 3: need a population of that's vaccinator of ninety five percent

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Speaker 3: plus anything below that, I think we really failed with

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Speaker 3: the immunity as such, So it's quite a high updick.

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Speaker 1: Margaret writing in to say her experience of measles in

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Speaker 1: childhood was not a simple illness. She said, I had

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Speaker 1: a decades ago. I landed up in hospital with encephalitis

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Speaker 1: and also had damage to my eyes as a result.

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Speaker 1: She was eight or nine years old at the time.

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Speaker 1: She writes, So just emphasizing, Margaret, I'm sorry that was

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Speaker 1: your experience, but thank you very much for sending that through,

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Speaker 1: because it does make the point we're trying to make

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Speaker 1: that it's not simple and bounce back from it quickly

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Speaker 1: for everybody, even if it is for many people.

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Speaker 2: Okay, Keith is asking, what is.

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Speaker 1: The difference between measles and German measles, completely separate diseases.

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Speaker 2: Darren, would you want to just give us a couple

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Speaker 2: of pointers there?

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Speaker 3: Yeah, yeah, I think, I mean it is completely to

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Speaker 3: the separate disease. You know, Measles is caused by the

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Speaker 3: measles virus, which is part of the if I remember correctly,

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Speaker 3: and I'm trying to remember our paramix so very day

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Speaker 3: family and rubella is sort of a milder illness. It's

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Speaker 3: more important for you know, the pregnant mothers with the

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Speaker 3: children that can cause congenital diseases. But measles definitely, it's

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Speaker 3: it's it's a more serious illness with with way more

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Speaker 3: complications and and and very very highly contagious.

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Speaker 1: Okay, thanks for asking, Keith, because I'm sure you're not

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Speaker 1: the only one who gets them mixed up for one thing.

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Speaker 2: Yeah, yeah, Darren.

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Speaker 1: I mean, let's talk about, pardon the pun, spotting the

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Speaker 1: signs of measles. Everybody associates the first thing they think

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Speaker 1: of when they think of measles is a rash. But

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Speaker 1: actually the rash cunt comes quite late in the progression

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Speaker 1: of the disease, doesn't it one.

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Speaker 3: Hundred percent correct? And I think that that's probably also

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Speaker 3: what causes you know, this outbreak, because often people they

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Speaker 3: have this predromal symptoms that starts with severe viral illness

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Speaker 3: or flu like symptom, you know, the high fevers, a

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Speaker 3: little bit of a cough, a little bit of a

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Speaker 3: runny snotty knows that the children has some watery eyes,

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Speaker 3: and then everybody manages that for a while, and then

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Speaker 3: the rash actually only comes a few days later. And

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Speaker 3: I think the important part is that you're actually contagious

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Speaker 3: way before the rash comes. So by the time the

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Speaker 3: rash appears and we now diagnose measles, the contagion has

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Speaker 3: already been sort of around and I think the important

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Speaker 3: thing for especially parents with you know, the kids are

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Speaker 3: at creation at school, when your child is in fever

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Speaker 3: or any flu like illness, it's always important just to

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Speaker 3: have a checked out instead of sending them for a

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Speaker 3: few days. And by the time we see something, you know,

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Speaker 3: the contagion's already there. So yeah, it spreads way before

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Speaker 3: the rash.

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Speaker 1: Okay, we are in conversation with doctor Darren Pedro, who

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Speaker 1: is a local GP who practices in Kale's River. If

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Speaker 1: you've got questions around measles, whether it's around its presentation,

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Speaker 1: it's treatment and management, anything of the sort, you very

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Speaker 1: welcome to ask away on the WhatsApp line O seven

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Speaker 1: to five six seven one five six seven. Before we

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Speaker 1: get to talking about management of symptoms and treatment of measles,

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Speaker 1: let's just circle back to the issue of vaccination, Darren.

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Speaker 1: I mean, we've had a vaccine available for measles since

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Speaker 1: the early sixties. That's now sixty years worth of history

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Speaker 1: to look at. Obviously, it has been refined, I assume

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Speaker 1: over the years, but sixty years is more than enough

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Speaker 1: data to look at effectiveness and to look at the

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Speaker 1: issue of potential side effects, which is one of the

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Speaker 1: things that those who are vaccine hesitant tend to be

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Speaker 1: concerned about. Do you want to make any comment about

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Speaker 1: what you've seen in your career or what you know

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Speaker 1: from the medical literature that you read around both effectiveness

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Speaker 1: and safety of the vaccine.

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Speaker 3: Yeah, yeah, Look, I think there's been a lot of

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Speaker 3: controversy around the virus and it all stems out of

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Speaker 3: an article that was published, you know, I think in

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Speaker 3: the eighties in the Lancet way, a gentleman by the

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Speaker 3: name of Wakefield published an article which it was disproven

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Speaker 3: that it was it was concocted sort of evidence and

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Speaker 3: data that he that he published. He was actually stripped

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Speaker 3: of his license. But you know, it started with saying

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Speaker 3: that the vaccine causes autism. I think that was the

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Speaker 3: big one, and it's still something that we here quite

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Speaker 3: often and creates the sort of resistance against vaccination, especially

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Speaker 3: against measles with the measles vaccine. But we've got numerous,

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Speaker 3: numerous studies and like you say, I mean since nineteen

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Speaker 3: sixty three, loads of data that disproves the fact that

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Speaker 3: you know, there's serious sort of effects from the vaccine.

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Speaker 3: In fact, we've got more data to prove just the

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Speaker 3: effect of prevention through the measles vaccine. And I think

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Speaker 3: if you look at world the ARP organization they speak about,

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Speaker 3: you know, just since the two thousands, over fifty nine

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Speaker 3: million lives that were saved and tats prevented just by

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Speaker 3: proper vaccination schedules.

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Speaker 1: Is availability of the vaccine an issue, Darren? Somebody's saying

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Speaker 1: they have previously heard about shortages of this particular vaccine.

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Speaker 1: Is that something that is currently a concern or has

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Speaker 1: been historically?

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Speaker 3: Sorry, proply I just missed you there for a moment.

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Speaker 1: Question and listener asking whether availability of the vaccine is

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Speaker 1: an issue because she has heard that there have been

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Speaker 1: shortages in the past of the measles vaccine. Is that

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Speaker 1: currently a problem or has it been historically?

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Speaker 3: It had historically been a problem. I know also in

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Speaker 3: the public sector there was a stage where there was

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Speaker 3: a little bit of a stock supply issue, but I

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Speaker 3: think that has been sorted. And even with that, I

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Speaker 3: think the fear, you know, often when you've missed your

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Speaker 3: your routine schedule. So for example, you know, our children

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Speaker 3: would get an mumunization at six months and at twelve months,

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Speaker 3: but often you miss and even in the COVID years

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Speaker 3: there was a little bit of attuction in the schedule,

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Speaker 3: but there's always a catch up vaccination is what we

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Speaker 3: call it. So as much as there was a stock

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Speaker 3: supply issue, I think we back to having supply and

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Speaker 3: I think we can always sort of apply catch up vaccinations.

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Speaker 3: So if you haven't had your two doses, that you

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Speaker 3: can actually go for a catch up vaccination. I think

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Speaker 3: that's important.

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Speaker 1: Okay, thanks for mentioning that. Zenica asking on the WhatsApp

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Speaker 1: line how soon measle symptoms present themselves? So, in other words,

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Speaker 1: from what time after you've come into contact with somebody

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Speaker 1: who had measles should you be mindful of possible symptoms developing?

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Speaker 2: What's the sort of lag, Darren.

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Speaker 3: Look, so there's an incubation period of about you know,

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Speaker 3: seven to eighteen days really from exposure. But somebody that's

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Speaker 3: not been vaccinated that's coming to contact, we often speak about,

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Speaker 3: you know, within the first seventy two hours, if you

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Speaker 3: haven't had a vaccine before that, we try and do

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Speaker 3: you know, if you're older than six months old, there's

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Speaker 3: a kid, often we vaccinate within seventy two hours of exposure.

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Speaker 3: If you're not fully immunized now, so.

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Speaker 2: You can intervene after the factor to.

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Speaker 3: To try and as set correct correct.

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Speaker 2: Thanks for asking, Zeneca.

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Speaker 1: All right, the one thing we haven't spoken about yet

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Speaker 1: is how to help somebody who has got it. So, Darren,

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Speaker 1: obviously you don't want to send a child to school

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Speaker 1: who is presenting symptoms that could be measles, like you've

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Speaker 1: mentioned that.

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Speaker 2: But if you are the patient who has.

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Speaker 1: Already presented with the ration, you have a confirmed diagnosis,

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Speaker 1: how do you actually treat the condition?

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Speaker 3: Yeah, so so so I think firstly important to know

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Speaker 3: it's a vital illness, so antibiotics makes no difference, you know,

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Speaker 3: unless there's a complication with secondary things. But you know,

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Speaker 3: measles does not require an antibiotic to treat it. I

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Speaker 3: think that's the first the first thing that's really very

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Speaker 3: important just to note. But then it's support of k

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Speaker 3: you know, it's it's it's often we give vitam an

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Speaker 3: a because there's a complication with regards to I think

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Speaker 3: one of your listeners mentioned that the damage share to

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Speaker 3: our eyes and so blind blindness is a complication of

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Speaker 3: it as well, and we often vitamin A as of

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Speaker 3: those who treat it. And then whatever symptoms comes with it.

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Speaker 3: So with a fever, we manage the fever. We give

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Speaker 3: antibarexials which which manages that. And then often it's high

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Speaker 3: duration and isolation and then if there's any complications that develops,

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Speaker 3: we sort of manage those symptoms. But often it just

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Speaker 3: needs isolation, you need a little bit of vitamin A.

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Speaker 3: We manage the fever and that Jenny, is it okay?

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Speaker 1: Just once again for anybody who's come in midway to

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Speaker 1: this conversation, you're listening to doctor Darren Pedro, a local

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Speaker 1: GP who practices in Kales River, chatting to us about measles.

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Speaker 1: The context for the conversation that coming off the back

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Speaker 1: of latest indications from the National Institute for Communicable Diseases

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Speaker 1: that we are seeing a surge in cases of measles

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Speaker 1: around South Africa, including here in the Western Cape. And Darren,

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Speaker 1: you know, I think it's very telling that nearly there

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Speaker 1: said one hundred and forty cases reported in the Western

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Speaker 1: Cape since no last year, and almost half of those

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Speaker 1: have come from DeNoon. Now, if you think about living

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Speaker 1: conditions in Denon, you have a lot of people living

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Speaker 1: very much cheek by agile on top of each other

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Speaker 1: in very tightly cramped spaces. That's obviously going to be

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Speaker 1: a bad worst case scenario for spread up a very

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Speaker 1: contagious disease. So you can understand why that's been a

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Speaker 1: focal point for the upsurge. But that's not to say

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Speaker 1: that somebody who lives in their own standalone house on

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Speaker 1: an acre of ground in ground in Constantia isn't at

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Speaker 1: risk of getting measles. What would you like to say

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Speaker 1: about managing contact? I mean you've said you use the

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Speaker 1: word isolation for a patient who has been confirmed as

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Speaker 1: already diagnosed with measles. But Darren, if a parent has

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Speaker 1: a child who is presenting with those early virus like symptoms,

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Speaker 1: but is it sure that it might be measles, what's

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Speaker 1: the sort of course of action in terms of being

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Speaker 1: mindful of other people as well as your child?

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Speaker 3: Yeah, yeah, I think the great question. I mean, again,

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Speaker 3: once you know, I often say sometimes we all rush

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Speaker 3: to the doctor with a full waiting room sitting with

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Speaker 3: a lot of other patients and children, and I think

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Speaker 3: sometimes just making contact with your clinique, making contact with

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Speaker 3: your doctor and just just sort of saying, look, I'm

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Speaker 3: suspecting this and and often, you know, especially in my practice,

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Speaker 3: we often guide the patients just say, look, come at

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Speaker 3: this time so that we mitigate a little bit of

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Speaker 3: the risk of exposure, because we we sometimes forget that

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Speaker 3: that exposure happens within the our spaces as well, you know.

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Speaker 3: But but it's not you know, we often think of

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Speaker 3: it also as something far away. Oh it's in the

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Speaker 3: noon area, but it's actually in the metropol and so

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Speaker 3: so there's spikes in certain sort of communities. But but

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Speaker 3: it is something that that affects all of us. And

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Speaker 3: so I think when when we understand, you know, I

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Speaker 3: almost want to say, in the spirit of a buntu

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Speaker 3: that we have in South Africa, we know so so well.

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Speaker 3: You know, if i' vaccinate my child, it doesn't only

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Speaker 3: protect my child, but it actually protects the community and

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Speaker 3: and and and and so even if I have symptoms,

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Speaker 3: you know, if I can if I can look and

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Speaker 3: diagnose it early, that I don't put others at the risk.

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Speaker 3: It's always about thinking about can I use this term

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Speaker 3: of buntu that we think about the neighbor to, you know,

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Speaker 3: and think of think about the community at large. But

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Speaker 3: making contact with your doctor, making contact with a local

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Speaker 3: clinic and just saying these are the symptoms my child

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Speaker 3: are experiencing. I've taken them out of school. Do I

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Speaker 3: come in to see you? Do we just manage it,

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Speaker 3: you know, telephonically. But but I think you know, making

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Speaker 3: contact with with with your health provider and and taking

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Speaker 3: them out of the closit community where that school, where

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Speaker 3: it's at home, that that we that we just isolate them.

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Speaker 1: Now, I think that's very wise advice about don't just

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Speaker 1: rush into a packed waiting room where you're going to

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Speaker 1: potentially pass it on to every other person there who's

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Speaker 1: already dealing with whatever sickness brought them to the GP.

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Speaker 1: Doctor Darren Pedro, thank you so much, really appreciate your

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Speaker 1: your advice and input this after need a pleasure to

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Speaker 1: have you with us.

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Speaker 3: Thank you, Papa, and thank you. Thank you to your listeners.

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Speaker 1: Once again, keep well please, Doctor Darren Pedro GP running

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Speaker 1: his practice in Kales Rever