Highlights:

• Since the last situational report (week 32, 2026), the following updates are included in this report:
  o One new laboratory-confirmed case of toxigenic cutaneous diphtheria from Gauteng.
  o No new asymptomatic carriers of toxigenic C. diphtheriae.
• Appropriate public health responses were initiated for all suspected and confirmed cases.

Information for clinicians

Clinical presentation of respiratory diphtheria

Respiratory diphtheria is a vaccine-preventable illness caused by toxigenic C. diphtheriae (and more rarely C. ulcerans or C. pseudotuberculosis), and can occur in persons of all ages.

The clinical presentation includes the following signs and symptoms:

• sore throat
• low-grade fever
• AND an adherent membrane of the nose, pharynx, tonsils, or larynx – the membrane is greyish-white and firmly adherent to the tissue
• AND/OR enlarged glands in the neck (bull neck)
• toxin-mediated systemic signs including myocarditis, polyneuropathy and renal damage

Patient management
Treatment includes antibiotics (azithromycin or penicillin) to clear the organism from the throat and prevent onward transmission, and diphtheria anti-toxin (DAT) to neutralise unbound toxin. The dosage of DAT is determined by the duration and severity of illness. Treatment, contact tracing and chemoprophylaxis should be started prior to laboratory confirmation. Early administration of DAT may be life-saving and should not be delayed in cases with a high index of suspicion. Supportive care is primarily aimed at airway management and includes providing oxygen, monitoring with electrocardiogram and intubation or performance of a tracheostomy if necessary.

To access previous diphtheria situational reports, click here.

READ THE FULL UPDATE HERE

Highlights:

• Since the last situational report (week 31, 2026), the following updates are included in this report:
  o No new laboratory-confirmed cases of toxigenic diphtheria.
  o No new asymptomatic carriers of toxigenic C. diphtheriae.
• Appropriate public health responses were initiated for all suspected and confirmed cases

Information for clinicians

Clinical presentation of respiratory diphtheria

Respiratory diphtheria is a vaccine-preventable illness caused by toxigenic C. diphtheriae (and more rarely C. ulcerans or C. pseudotuberculosis), and can occur in persons of all ages.

The clinical presentation includes the following signs and symptoms:

• sore throat
• low-grade fever
• AND an adherent membrane of the nose, pharynx, tonsils, or larynx – the membrane is greyish-white and firmly adherent to the tissue
• AND/OR enlarged glands in the neck (bull neck)
• toxin-mediated systemic signs including myocarditis, polyneuropathy and renal damage

Patient management
Treatment includes antibiotics (azithromycin or penicillin) to clear the organism from the throat and prevent onward transmission, and diphtheria anti-toxin (DAT) to neutralise unbound toxin. The dosage of DAT is determined by the duration and severity of illness. Treatment, contact tracing and chemoprophylaxis should be started prior to laboratory confirmation. Early administration of DAT may be life-saving and should not be delayed in cases with a high index of suspicion. Supportive care is primarily aimed at airway management and includes providing oxygen, monitoring with electrocardiogram and intubation or performance of a tracheostomy if necessary.

To access previous diphtheria situational reports, click here.

READ THE FULL UPDATE HERE

Measles surveillance

National measles surveillance has detected an increase in measles cases nationwide. Data available (accessed 13 August 2026) from 29 December 2025 to 09 August 2026 (ISO Weeks 1-32) indicated that 3747 laboratory-confirmed measles cases were reported nationally. Since the previous report (ISO week 31), 111 additional cases were detected. The Western Cape reported the highest number of new cases (27), followed by Gauteng (26), Northern Cape (16), Free State (14), Mpumalanga (11), Limpopo (8), Eastern Cape (7) and North West (2).

Public health interventions

For health professionals

Clinicians and public health officials are urged to strengthen measles and rubella surveillance nationally to improve case reporting, laboratory confirmation, and contact tracing, to support national measles elimination goals. All suspected measles and rubella cases should be investigated promptly, with blood specimens collected for laboratory confirmation, and notification should be completed through the Notifiable Medical Conditions Surveillance System (NMCSS ).

For the public

Public awareness campaigns should be intensified to build trust in vaccines and address hesitancy by engaging with community leaders, healthcare workers, and other stakeholders to promote vaccine acceptance and participation in immunisation activities.

Update on the rubella outbreak in South Africa

Between 29 December 2025 and 9 August 2026 (ISO Weeks 1–32), a total of 443 laboratory-confirmed rubella cases were reported in South Africa through the national fever-rash surveillance system (data accessed 13 August 2026). Since the previous report, 15 new rubella cases were reported. During the reporting period, most cases occurred among children aged 1–14 years (332/443; 75.0%).

Public health interventions

For health professionals

Rubella is a contagious viral infection that is usually mild but can cause serious complications in pregnancy, resulting in Congenital Rubella Syndrome (CRS) in infants. Health professionals should strengthen surveillance and laboratory confirmation of suspected cases to support national elimination goals.

For the community

Rubella, also known as German measles, spreads easily through coughs and sneezes and can be dangerous for unborn babies if a pregnant woman becomes infected. The best way to prevent rubella is through vaccination with the MR vaccine. This vaccine is given as part of the routine childhood immunisation schedule.

Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.

READ THE FULL UPDATE HERE

Measles surveillance

National measles surveillance has detected an increase in measles cases nationwide. Data available (accessed 30 July 2026) from 29 December 2025 to 26 July 2026 (ISO Weeks 1-30) indicated that 3462 laboratory-confirmed measles cases were reported nationally. Since the previous report (ISO week 29), 49 additional cases were identified. The Western Cape reported the highest number of new cases (18), followed by Free State (12), Mpumalanga (9), Eastern Cape (4), Gauteng (3) and Northern Cape (3). There were no new cases in Limpopo, KwaZulu-Natal, and North West.

Public health interventions

For health professionals

Clinicians and public health officials are urged to strengthen measles and rubella surveillance nationally to improve case reporting, laboratory confirmation, and contact tracing, to support national measles elimination goals. All suspected measles and rubella cases should be investigated promptly, with blood specimens collected for laboratory confirmation, and notification should be completed through the Notifiable Medical Conditions Surveillance System (NMCSS ).

For the public

Public awareness campaigns should be intensified to build trust in vaccines and address hesitancy by engaging with community leaders, healthcare workers, and other stakeholders to promote vaccine acceptance and participation in immunisation activities.

Update on the rubella outbreak in South Africa

Between 29 December 2025 and 26 July 2026 (ISO Weeks 1–30), a total of 398 laboratory-confirmed rubella cases were reported in South Africa through the national fever-rash surveillance system (data accessed 30 July 2026). Since the previous report on 22 July 2026, no new rubella cases were reported. During the reporting period, most cases occurred among children aged 1–14 years (313/398; 78.6%).

Public health interventions

For health professionals

Rubella is a contagious viral infection that is usually mild but can cause serious complications in pregnancy, resulting in Congenital Rubella Syndrome (CRS) in infants. Health professionals should strengthen surveillance and laboratory confirmation of suspected cases to support national elimination goals.

For the community

Rubella, also known as German measles, spreads easily through coughs and sneezes and can be dangerous for unborn babies if a pregnant woman becomes infected. The best way to prevent rubella is through vaccination with the MR vaccine. This vaccine is given as part of the routine childhood immunisation schedule.

Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.

READ THE FULL UPDATE HERE

Highlights:

• Since the last situational report (week 29, 2026), the following updates are included in this report
  o No new laboratory-confirmed cases of toxigenic diphtheria.
  o No new asymptomatic carriers of toxigenic C. diphtheriae.
• Appropriate public health responses were initiated for all suspected and confirmed cases.

Information for clinicians

Clinical presentation of respiratory diphtheria

Respiratory diphtheria is a vaccine-preventable illness caused by toxigenic C. diphtheriae (and more rarely C. ulcerans or C. pseudotuberculosis), and can occur in persons of all ages.

The clinical presentation includes the following signs and symptoms:

• sore throat
• low-grade fever
• AND an adherent membrane of the nose, pharynx, tonsils, or larynx – the membrane is greyish-white and firmly adherent to the tissue
• AND/OR enlarged glands in the neck (bull neck)
• toxin-mediated systemic signs including myocarditis, polyneuropathy and renal damage

Patient management
Treatment includes antibiotics (azithromycin or penicillin) to clear the organism from the throat and prevent onward transmission, and diphtheria anti-toxin (DAT) to neutralise unbound toxin. The dosage of DAT is determined by the duration and severity of illness. Treatment, contact tracing and chemoprophylaxis should be started prior to laboratory confirmation. Early administration of DAT may be life-saving and should not be delayed in cases with a high index of suspicion. Supportive care is primarily aimed at airway management and includes providing oxygen, monitoring with electrocardiogram and intubation or performance of a tracheostomy if necessary.

To access previous diphtheria situational reports, click here.

READ THE FULL UPDATE HERE

Measles surveillance

National measles surveillance has detected an increase in measles cases nationwide. Data available (accessed 16 July 2026) from 29 December 2025 to 12 July 2026 (ISO Weeks 1-28) indicated that 3209 laboratory-confirmed measles cases were reported nationally. Since the previous report (ISO week 26), 590 additional cases were identified. The Western Cape reported the highest number of new cases (171), followed by Free State (155), Gauteng (65), Mpumalanga (48), Northern Cape (44), Limpopo (43), Eastern Cape (34), KwaZulu-Natal (19) and North West (11).

Public health interventions

For health professionals

Clinicians and public health officials are urged to strengthen measles and rubella surveillance nationally to improve case reporting, laboratory confirmation, and contact tracing, to support national measles elimination goals. All suspected measles and rubella cases should be investigated promptly, with blood specimens collected for laboratory confirmation, and notification should be completed through the Notifiable Medical Conditions Surveillance System (NMCSS ).

For the public

Public awareness campaigns should be intensified to build trust in vaccines and address hesitancy by engaging with community leaders, healthcare workers, and other stakeholders to promote vaccine acceptance and participation in immunisation activities.

Update on the rubella outbreak in South Africa

Between 29 December 2025 and 14 June 2026  (ISO Weeks 1–24), a total of 312 laboratory-confirmed rubella cases were reported in South Africa through the national fever-rash surveillance system (data accessed 17 June 2026). In the previous week, 5 new rubella cases were reported. During the reporting period, the majority of cases occurred among children aged 1–14 years (252/312; 80.8%).

Public health interventions

For health professionals

Rubella is a contagious viral infection that is usually mild but can cause serious complications in pregnancy, resulting in Congenital Rubella Syndrome (CRS) in infants. Health professionals should strengthen surveillance and laboratory confirmation of suspected cases to support national elimination goals.

For the community

Rubella, also known as German measles, spreads easily through coughs and sneezes and can be dangerous for unborn babies if a pregnant woman becomes infected. The best way to prevent rubella is through vaccination with the MR vaccine. This vaccine is given as part of the routine childhood immunisation schedule.

Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.

READ THE FULL UPDATE HERE

Highlights:

• Since the last situational report (week 27, 2026), the following updates are included in this report:
  o One new laboratory-confirmed case of toxigenic respiratory diphtheria from the Western Cape.
  o Three new asymptomatic carriers of toxigenic C. diphtheriae: two from Limpopo and one from the Western Cape.
• Appropriate public health responses were initiated for all suspected and confirmed cases.

Clinical presentation of respiratory diphtheria

Respiratory diphtheria is a vaccine-preventable illness caused by toxigenic C. diphtheriae (and more rarely C. ulcerans or C. pseudotuberculosis), and can occur in persons of all ages.

The clinical presentation includes the following signs and symptoms:

• sore throat
• low-grade fever
• AND an adherent membrane of the nose, pharynx, tonsils, or larynx – the membrane is greyish-white and firmly adherent to the tissue
• AND/OR enlarged glands in the neck (bull neck)
• toxin-mediated systemic signs including myocarditis, polyneuropathy and renal damage

Patient management
Treatment includes antibiotics (azithromycin or penicillin) to clear the organism from the throat and prevent onward transmission, and diphtheria anti-toxin (DAT) to neutralise unbound toxin. The dosage of DAT is determined by the duration and severity of illness. Treatment, contact tracing and chemoprophylaxis should be started prior to laboratory confirmation. Early administration of DAT may be life-saving and should not be delayed in cases with a high index of suspicion. Supportive care is primarily aimed at airway management and includes providing oxygen, monitoring with electrocardiogram and intubation or performance of a tracheostomy if necessary.

To access previous diphtheria situational reports, click here.

READ THE FULL UPDATE HERE

Highlights:

• Since the last situational report (week 26, 2026), the following updates are included in this report:
  o Four new laboratory-confirmed cases of toxigenic diphtheria: two from Limpopo, one from Gauteng and one from the Western Cape.
  o No new asymptomatic carriers of toxigenic C. diphtheriae.
• Appropriate public health responses were initiated for all suspected and confirmed cases.

Information for clinicians

Clinical presentation of respiratory diphtheria

Respiratory diphtheria is a vaccine-preventable illness caused by toxigenic C. diphtheriae (and more rarely C. ulcerans or C. pseudotuberculosis), and can occur in persons of all ages.

The clinical presentation includes the following signs and symptoms:

• sore throat
• low-grade fever
• AND an adherent membrane of the nose, pharynx, tonsils, or larynx – the membrane is greyish-white and firmly adherent to the tissue
• AND/OR enlarged glands in the neck (bull neck)
• toxin-mediated systemic signs including myocarditis, polyneuropathy and renal damage

Patient management
Treatment includes antibiotics (azithromycin or penicillin) to clear the organism from the throat and prevent onward transmission, and diphtheria anti-toxin (DAT) to neutralise unbound toxin. The dosage of DAT is determined by the duration and severity of illness. Treatment, contact tracing and chemoprophylaxis should be started prior to laboratory confirmation. Early administration of DAT may be life-saving and should not be delayed in cases with a high index of suspicion. Supportive care is primarily aimed at airway management and includes providing oxygen, monitoring with electrocardiogram and intubation or performance of a tracheostomy if necessary.

To access previous diphtheria situational reports, click here.

READ THE FULL UPDATE HERE

Measles surveillance

National measles surveillance has detected an increase in measles cases nationwide. Data available (accessed 24 June 2026) from 29 December 2025 to 21 June 2026 (ISO Weeks 1-25) indicated that 2476 laboratory-confirmed measles cases were reported nationally. Since the previous report, several additional cases were identified. The Free State reported the highest number of new cases (132), followed by Western Cape (58), Gauteng (46), Northern Cape (44), Limpopo (36), Mpumalanga (28), Eastern Cape (20), KwaZulu-Natal (6), and North West (4).

Public health interventions

For health professionals

Clinicians and public health officials are urged to strengthen measles and rubella surveillance nationally to improve case reporting, laboratory confirmation, and contact tracing, to support national measles elimination goals. All suspected measles and rubella cases should be investigated promptly, with blood specimens collected for laboratory confirmation, and notification should be completed through the Notifiable Medical Conditions Surveillance System (NMCSS ).

For the public

Public awareness campaigns should be intensified to build trust in vaccines and address hesitancy by engaging with community leaders, healthcare workers, and other stakeholders to promote vaccine acceptance and participation in immunisation activities.

Update on the rubella outbreak in South Africa

Between 29 December 2025 and 21 June 2026 (ISO Weeks 1–25), a total of 338 laboratory-confirmed rubella cases were reported in South Africa through the national fever-rash surveillance system (data accessed 24 June 2026). In the previous week, 26 new rubella cases were reported. During the reporting period, the majority of cases occurred among children aged 1–14 years (271/338; 80.2%).

Public health interventions

For health professionals

Rubella is a contagious viral infection that is usually mild but can cause serious complications in pregnancy, resulting in Congenital Rubella Syndrome (CRS) in infants. Health professionals should strengthen surveillance and laboratory confirmation of suspected cases to support national elimination goals.

For the community

Rubella, also known as German measles, spreads easily through coughs and sneezes and can be dangerous for unborn babies if a pregnant woman becomes infected. The best way to prevent rubella is through vaccination with the MR vaccine. This vaccine is given as part of the routine childhood immunisation schedule.

Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.

READ THE FULL UPDATE HERE

Table 1: Number of Bundibugyo virus disease cases and deaths in DRC, Uganda and France as at 25 June 2026

Democratic Republic of the Congo

As of 25 June 2026, 1 155 confirmed cases, including 304 deaths (CFR 26.3%), 385 admissions and 138 recoveries have been reported. Cases have been reported across 34 health zones in three provinces (Ituri, North Kivu and South Kivu). Ituri accounts for the largest proportion of cases and deaths (1 054 cases, 250 deaths), followed by North Kivu (98 cases, 53 deaths) and South Kivu (3 cases, 1 death). About 9 305 contacts have been identified, with a contact follow-up rate of 79.2%.

Uganda

As of 25 June 2026, 20 confirmed cases, including two deaths (CFR 10%, 2/20), 15 recoveries, and three hospitalisations, have been reported. Of the 20 confirmed cases, 15 were imported, and five were linked to the imported cases. Where geographical information was available, cases were reported in Kampala and Wakiso. Cumulatively, about 831 contacts have been identified, of which 814 have completed their 21-day monitoring period, and nine are under monitoring.

France

As of 24 June 2026, one imported case linked to the current outbreak in the DRC has been reported. The case involves a healthcare worker who was deployed to the DRC. The case is reported to be in a stable condition, and contacts are being identified.

Public health response, current risk assessment and travel advice

With support from partners and the World Health Organization (WHO), both affected countries have instituted various public health response measures to contain and prevent further spread. The public health response activities include, but are not limited to, the deployment of rapid response teams, strengthening of surveillance and laboratory confirmation, contact tracing, isolation and treatment of cases, cross-border coordination between high-risk countries, engaging donors and resource mobilization. Response efforts in the eastern DRC are largely affected by insecurity, population movement, weak contact follow-up, and challenges associated with extensive mining in the areas.

The WHO assess the risk of spread as very high in the DRC, high in Uganda, high in neighbouring countries sharing land borders with DRC and Uganda, low at the regional level, and low globally. WHO does not recommend any travel or trade restrictions with the affected countries due to these outbreaks.

Situation in South Africa

The National Institute for Communicable Disease (NICD), in collaboration with the National Department of Health (NDOH), issued preparedness guidance for BVD following outbreaks declared by health authorities in DRC and Uganda on 15 May 2026.

As of 25 June 2026, there have been no laboratory-confirmed cases of BVD in South Africa linked to the current outbreaks in the DRC and Uganda. However, healthcare workers should remain vigilant and maintain a high index of suspicion for individuals presenting with febrile illness and a recent travel history to affected areas in the DRC and Uganda. Additionally, malaria should be considered in the differential diagnosis of febrile illness in returning travellers. If a suspected BVD case is identified (as per the case definition), testing should be requested via the NICD Hotline at 0800 212 552 (a 24-hour service for healthcare professionals only), with a detailed clinical, travel, and exposure history. Testing for viral haemorrhagic fevers (VHFs) in South Africa is available only at the NICD. VHFs, including BVD, are Category 1 Notifiable Medical Conditions in South Africa and require immediate reporting to the relevant authorities and notification within 24 hours of clinical suspicion to the Notifiable Medical Condition surveillance system. For more information on notifiable medical conditions and how to notify cases, visit here.

READ THE FULL UPDATE HERE