From epidemiological week 1 to week 52 of 2024, 931 laboratory-confirmed cases of measles and 15 100 cases of rubella were reported by the Measles Reference Laboratory at the National Institute for Communicable Diseases in South Africa. From epidemiological week 1 to week 5 of 2025, 40 laboratory-confirmed cases of measles and 117 cases of rubella were reported by the Measles Reference Laboratory.
Of the 40 laboratory-confirmed measles cases since the beginning of the year, Gauteng had 30 cases, with 19 cases in the City of Johannesburg. In 2024, with the increased circulation of rubella, the laboratory had seen a number of cases positive for measles IgM and rubella IgM antibodies which suggested that these were false-positive measles IgM results. With the decrease in rubella infections, in the past month, there has been a marked decrease in dual positive results.
Rubella virus infections have decreased significantly in all provinces in South Africa with 117 cases reported in January 2025, with 67 being in North West Province. The back-log of measles and rubella samples has been cleared and results are being sent out in real time as of the beginning of 2025.
Highlights
Measles Surveillance
- A total of 931 laboratory-confirmed measles cases were reported between epidemiological week 1 and week 52 of 2024 in South Africa. From epidemiological week 1 to week 52, the majority of laboratory-confirmed measles cases (372) were reported in Gauteng province.
- A total of 40 laboratory-confirmed measles cases were reported between epidemiological week 1 and week 5 of 2025 in South Africa. with the majority of laboratory-confirmed measles cases (19) reported in Gauteng province, with 19 cases in City of Johannesburg, 6 in Tshwane and 5 in Ekurhuleni.
Rubella Surveillance
- From week 1 to week 52 of 2024, 15 100 laboratory-confirmed rubella cases were reported in South Africa through measles and rubella surveillance. Rubella cases continue to be detected in Gauteng, Kwazulu-Natal, North West, Mpumalanga, Northern Cape and Eastern Cape, but at much lower levels than 2024.
- From week 1 to week 5 of 2025, 117 laboratory-confirmed rubella cases were reported in South Africa through measles and rubella surveillance.
There were 15 100 rubella cases across South Africa in 2024. This number exceeds the typical annual number of rubella cases observed since 2015. A seasonal increase is expected each year, usually between September to December, however the number of cases in 2024 is notably higher than in previous years. There has been a marked decrease in cases in the first 5 weeks of 2025 with 117 reported cases in South Africa, with 67 in North West Province.
Health awareness is recommended in the areas where rubella cases are circulating to inform the population how to prevent rubella infection risk. Although rubella infections cause mild disease in adults and children, pregnant women in their first trimester of pregnancy who acquire rubella for the first time are at risk of passing rubella onto their foetus, with consequential congenital rubella syndrome.
Routine measles vaccination should be strengthened and measles catch-up doses continue in healthcare facilities for the children who missed their scheduled doses. Vaccinating children with the measles vaccine protects them from severe illness caused by measles virus infection, including severe pneumonia, encephalitis, blindness, deafness, and death. For all measles-positive cases, the public health response should be done as per the EPI(SA) immunisation guideline.
