Highlights:

• Since the last situational report (week 34, 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

South African stakeholders have once again come together through the National Rabies Advisory Group, joining forces in the fight against rabies. We aim to create awareness around rabies and the animal and public health impact this deadly disease has, using multiple platforms. Be on the lookout for the national social media campaign in September 2026.

Rabies remains one of the world’s deadliest yet most preventable diseases. This year’s World Rabies Day theme, ‘Stronger Together’, reminds us that eliminating rabies requires partnership at every level. Communities, pet owners, veterinary and para-veterinary professionals, healthcare workers, government departments, policymakers and partner organisations each have a critical role in rabies elimination.

Rabies prevention depends on coordinated human, animal and environmental health systems working together in support of each other.

Core rabies messages

Rabies is nearly always fatal once symptoms appear, but it is preventable through vaccination and prompt post-exposure treatment.

• Although Rabies is 99.9% fatal once a person or animal shows clinical signs, it is also 100% preventable through vaccination of our pets and timely and correct treatment of exposed humans.
• Rabies is a deadly disease with no cure once symptoms appear. It can be transmitted to people by an infected animal’s bite, scratch, or lick. If a person is bitten, scratched, or licked by an animal suspected to have rabies (an animal showing odd behaviour or neurological symptoms), the person needs to wash the wound thoroughly with soap and running water for at least 10 minutes and seek medical attention immediately. Post-exposure prophylaxis treatment will involve a series of rabies vaccinations and rabies immunoglobulin being injected into the wound (if the skin has been broken).
• If your dogs and cats are vaccinated annually against rabies, they form a protective barrier for your family and protect you. The same is true if everyone in your community ensures that their dogs and cats are vaccinated annually.
• Rabies vaccines that are registered for use in South Africa are safe to use in your dogs and cats and should be administered through a registered veterinary professional.
• Legally, every pet owner must have their dogs and cats vaccinated to protect both humans and animals against rabies. The first rabies vaccine is given at 12 weeks (three months) of age, followed by a booster vaccination one month later. A booster can be given up to 12 months later, but one month later is the recommended option. Thereafter, a booster is legally required every three years. In high-risk areas, annual vaccination is strongly advised!
• Remember that any mammal can become infected with rabies – this includes pets, wildlife, livestock, and humans. Typical wildlife species that can host rabies include jackals, foxes, mongooses, aardwolf and cape fur seals, amongst others.
• Dogs and cats are often moved between provinces by travellers, workers, or holiday-goers, which can easily cause the spread of rabies to any area if these animals are not vaccinated against rabies and are incubating the disease.

Enquire with your local state or private veterinarian, animal health technician or welfare organisation. State veterinary office contact details are available at: https://www.nda.gov.za/index.php/component/content/article/451-provincial-veterinary-services-contacts

A list of all registered veterinary facilities is available at: https://savc.org.za/wp-content/uploads/2026/07/FacilityRegisterPublish_July-2026.pdf

Vaccinate your dogs and cats, support campaigns, share accurate information, educate others and strengthen community protection. For more information about rabies, visit here.

READ THE FULL MEDIA STATEMENT HERE

Rotavirus is a common childhood diarrhoeal infection that has a seasonal pattern, peaking during the cooler, drier months of the year. Most children have at least one infection by two years of age.  The virus is transmitted via the faecal-oral route. “Clinical symptoms include the sudden onset of vomiting followed by non-bloody watery diarrhoea, which may result in severe life-threatening dehydration. Fever may occur in approximately 30-50% of patients. Associated symptoms include loss of appetite (anorexia), lethargy, and mild abdominal discomfort,” said Prof. Nicola Page, head of the Centre for Enteric Diseases at the National Institute for Communicable Diseases.

Since the rotavirus vaccine was introduced into the expanded programme of immunisation in August 2009, the annual rotavirus season in South Africa typically occurs from July to August and may extend into September.

Diarrhoeal syndromic surveillance is conducted at five sites as part of the GERMS-SA platform (Pelonomi Hospital, Free State; Klerksdorp/Tshepong hospitals, North West; Red Cross Children’s Hospital, Western Cape; Kabokweni Clinic, Mpumalanga and Kalafong Hospital, Gauteng). The surveillance targets all patients presenting for the treatment of diarrhoea at participating sites.

“Parents should also watch for signs of early to moderate dehydration, including no tears, dry mouth, sunken soft spot or eyes, fewer wet nappies (no wet nappy for previous 6-8 hours), and behaviour changes like unusual fussiness, listlessness and lethargy or refusal to eat or drink. In these children, parents could increase fluid intake or, if concerned, proceed to the nearest clinic or health facility,” warned Prof. Page.

Children with severe dehydration may become excessively sleepy or limp, produce dark urine, have cold or discoloured skin, exhibit fast breathing or heartbeat and their skin will form a tent when pinched and be slow to return to normal. Severe dehydration is a medical emergency, and these children should be taken to the nearest medical facility or clinic immediately, administering oral rehydration solution on the way, if possible. Prompt recognition of dehydration and rapid treatment will prevent prolonged hospitalisation, complications and even death.

For more information about rotavirus, visit the NICD website here.

READ THE FULL MEDIA STATEMENT HERE

The workshop, which brings together around 25 scientists, industry developers, regulators, and international partners, builds on progress that South Africa has made in developing the sterile insect technique (SIT), in which male mosquitoes are reared in the laboratory, sterilised and released by the thousands to mate with wild females, whose eggs then will never hatch. Since the first sterile male releases in Jozini, KwaZulu-Natal, in 2021, the South African SIT programme has advanced the technology. The lessons learned along the way, from mass-rearing to long-distance transportation to community engagement, are proving to be the foundation for adaptation to other new innovative tools such as gene drive technology.

The gene drive technology – in contrast to SIT, which makes male mosquitoes unable to father offspring – provides a genetic change a head start: instead of being inherited by only half of a mosquito’s offspring as normal genes are, a gene drive is passed on to nearly all of them. Released in small numbers, it can spread through a wild population over generations, offering a self-sustaining tool that needs far fewer repeat releases than SIT. “The two technologies share the same starting point,” explains Dr Givemore Munhenga, Principal Medical Scientist in the Vector Control Reference Laboratory at NICD’s Centre for Emerging Zoonotic and Parasitic Diseases. “Before any genetically modified mosquito can help fight malaria, someone still has to rear it by the hundreds of thousands, package it safely, transport it, and release it in the field. That is exactly where our SIT experience becomes so valuable.”

The workshop, jointly convened with the USA Foundation for the National Institutes of Health (FNIH) and supported by the Bill & Melinda Gates Foundation, focuses on three practical questions: What are the biggest technical challenges in mass-rearing, handling, transporting and releasing genetically modified mosquitoes? Which of these steps can realistically be automated? And should production happen locally, country by country, or regionally, with mosquitoes shipped across borders to where they are needed? Delegates included gene drive researchers, companies developing mosquito-rearing automation, and oversight bodies such as the International Atomic Energy Agency and New Partnership for Africa’s Development. “Gene drives have shown enormous promise in caged trials, but very few groups have grappled with what it actually takes to move from the laboratory to the field,” emphasised Dr Munhenga. “That is our expertise. This workshop lets us share it, learn from others working on the same problem, and make sure that when these tools are ready, Africa is ready to deploy them.”

By the end of the week, the workshop aims to produce an understanding of technical needs and knowledge gaps, new collaborations between NICD and gene drive developers and implementers, and a refined roadmap for the Institute’s own upscaling of the SIT project, another step towards putting a self-sustaining tool in the hands of malaria control programmes in South Africa and across the continent.

The workshop launches alongside a new three-year NICD project to upscale the deployment of genetic control approaches against Anopheles, South Africa’s primary malaria-carrying mosquito. The project will refine mass-rearing and sexing automation, test long-distance chilled transport, trial both ground and drone-based releases, and strengthen the regulatory pathways needed before any gene-drive mosquito can be released in the field.

Measles surveillance

National measles surveillance has detected an increase in measles cases nationwide. Data available (accessed 20 August 2026) from 29 December 2025 to 16 August 2026 (ISO Weeks 1-33) indicated that 3,891 laboratory-confirmed measles cases were reported nationally. Since the previous report (ISO week 32), 144 additional cases were detected. The Western Cape reported the highest number of new cases (38), followed by Limpopo (30), Northern Cape (20), Gauteng (16), Free State (14), Mpumalanga (12), North West (7), KwaZulu-Natal (5), and Eastern Cape (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 16 August 2026 (ISO Weeks 1–33), a total of 480 laboratory-confirmed rubella cases were reported in South Africa through the national fever-rash surveillance system (data accessed 20 August 2026). Since the previous report, 37 new rubella cases have been reported. During the reporting period, most cases occurred among children aged 1–14 years (384/480; 79.0%).

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

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