From epidemiological week 1 to week 14 of 2025, 108 laboratory-confirmed measles cases and 238 rubella cases were reported by the Measles Reference Laboratory at the National Institute for Communicable Diseases in South Africa. Of the 108 laboratory-confirmed measles cases reported since the beginning of 2025, 72 (67%) cases were in Gauteng province. Meanwhile, of the 238 laboratory-confirmed rubella cases reported, 91 (38%) were reported in North West province. Both measles and rubella affected mostly children aged 1-15 years with an increase in measles and rubella cases seen in the age group 15-49 years the fever rash surveillance used to monitor measles and rubella virus circulation.
Highlights
Measles Surveillance
- From epidemiological week 1 to week 14 of 2025, the National Measles laboratory surveillance detected 108 laboratory-confirmed measles cases from eight provinces. Gauteng province reported 72 (67%) of the measles cases. Most measles cases were detected in the City of Johannesburg (42/72, 58%) and the City of Tshwane (21/72, 29%), with seven cases from Ekurhuleni Metro and two from Sedibeng District.
- Measles cases were also reported in Free State province, Mpumalanga province, North West province (7 cases each, respectively); whereas six cases were reported in the Northern Cape province, five in the Western Cape province, three in Limpopo province and one in KwaZulu Natal.
Rubella Surveillance
- From week 1 to week 14 of 2025, 238 laboratory-confirmed rubella cases were reported in South Africa through measles and rubella surveillance. Rubella virus circulation is highest in the Ngaka Modiri Molema District in North West province.
Since the beginning of 2025, most fever-rash samples submitted to the National Measles Reference Centre at NICD for measles and rubella surveillance have tested positive for rubella rather than measles. The rubella virus transmission has decreased nationally with sustained rubella transmission seen in Ngaka Modiri Molema District in North West province and Thabo Mofutsanyana District in Free State province from week 1 to week 14 of 2025.
Health awareness is recommended in the areas where rubella cases are circulating. Although rubella infections cause mild disease in adults and children, 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 (CRS). Healthcare workers should collect urine, throat swabs, and blood sample specimens for diagnostic testing (serology and PCR detection) on infants with suspected CRS and pregnant women in their first trimester of pregnancy, whom either exposed to a case/s of confirmed or suspected rubella. A good clinical history should be obtained from their mothers regarding fever/rash illness during pregnancy. A completed case investigation form for congenital rubella syndrome should be completed along with the submission of clinical samples to the NICD for testing.
