Differences in trends of measles notifications by age and race in the western Cape, 1982-1986

Measles remains a major health problem in the Cape Western Region of the Department of National Health and Population Development. During the 5-year period 1982-1986, 5,089 notifications were received and analysed for the Cape Town Metropolitan area and for the rest of the region. Of the 3,682 notifications for Cape Town, 60.6% of the patients were under 2 years old, compared with 15.4% of the 1,407 notifications for the rest of the region. The black population in Cape Town accounted for 58.3% of the notifications, and the coloured population in the rest of the region for 51.5%. White notifications for both areas were low, except in the latter half of 1986, when widespread outbreaks affected mainly the white population. Age-adjusted notification rates varied between the two areas, the highest being for blacks in Cape Town, ranging up to 302.3/100,000, and the lowest being for whites, at 1.6/100,000 in the rest of the region. The implications of these different trends are discussed, and a possible reason for the outbreaks in whites is postulated. The most effective way of dealing with the problem is for every effort and available resource to be put into immunising every child at 9 months of age, and any older children who have not yet been immunised.