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

Recent social media posts claiming that the NICD has confirmed a Typhoid fever outbreak in Tshwane are misleading. Please refer to https://www.nicd.ac.za/typhoid-fever-updates/ for an accurate report of the number of cases identified within the country.

We urge the public to verify health information before sharing it and to rely on the NICD website and official social media platforms for accurate, up-to-date public health information.

TAP-WES is a regional initiative that positions the NICD as a technical and training hub for wastewater and environmental surveillance in Africa. The programme supports countries to design, implement, and scale sustainable WES systems by providing technical assistance, training, mentoring, and opportunities for peer learning. It adopts a pathogen-agnostic approach while supporting surveillance of priority pathogens identified by the World Health Organization (WHO).

The programme also shares South Africa’s experience in integrating wastewater surveillance into routine public health surveillance. Through this work, the NICD supports countries in developing policies, designing surveillance systems, strengthening laboratory capacity, improving data analysis, and integrating wastewater surveillance with clinical surveillance and pandemic preparedness.

The two-week training combines classroom learning with practical, hands-on experience. During the first week, participants undertook a field sampling exercise and received laboratory training in sample concentration, nucleic acid extraction, and pathogen detection using both digital and real-time PCR platforms. The second week focuses on data management, epidemiological analysis, reporting, and introductory bioinformatics, with specialised bioinformatics sessions delivered in collaboration with the Scripps Research Institute in the United States.

By building technical expertise and fostering collaboration between African public health institutions, TAP-WES aims to strengthen regional capacity to detect and respond to infectious disease threats through wastewater surveillance. The programme contributes to a more coordinated and resilient public health surveillance network across the continent.

The TAP-WES programme is funded by the Gates Foundation and is implemented in partnership with WHO-AFRO, with technical collaboration from the Scripps Research Institute.

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