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

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

Highlights:

• Since the last situational report (week 24, 2026), the following updates are included in this report:
  o Two new laboratory-confirmed cases of toxigenic diphtheria from Limpopo.
  o Five new probable cases of toxigenic diphtheria of whom two died from Limpopo.
  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 17 June 2026) from 29 December 2025 to 14 June 2026 (ISO Weeks 1-24) indicated that 2102 laboratory-confirmed measles cases were reported nationally. Since the previous report several additional cases were identified. The Western Cape reported the highest number of new cases (17) followed by Free State (14), Mpumalanga (11), Gauteng (9), Limpopo (8), Northern Cape (3), Eastern Cape (3), KwaZulu-Natal (3), and North West (3).

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 23, 2026), the following updates are included in this report:
  o Three new laboratory-confirmed cases of toxigenic diphtheria from the Western Cape.
  o No new asymptomatic carriers of toxigenic C. diphtheriae.
  o One additional diphtheria-related death from Gauteng.
• 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

On 15 May 2026, health authorities in the Democratic Republic of the Congo (DRC) and Uganda declared outbreaks of Ebola disease caused by the Bundibugyo virus, following reports of laboratory-confirmed cases in their respective countries. On 16 May 2026, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC) in accordance with the provisions of the International Health Regulations (IHR). On 18 May 2026, the Africa Centres for Disease Control and Prevention (Africa CDC) declared the outbreak a Public Health Emergency of Continental Security (PHECS). Since then, additional cases have continued to be reported.

Bundibugyo virus disease (BVD) is a severe and fatal viral zoonotic disease caused by Bundibugyo virus, one of the four Orthoebolavirus species known to cause disease in humans. In previous BVD outbreaks in 2007 (Uganda) and 2012 (DRC), the case fatality rate (CFR) ranged from 30 to 50%. The incubation period ranges from two to 21 days. Infected persons are considered non-infectious during the asymptomatic phase (during the incubation period); however, they become infectious from the time of symptom onset. Initially, symptoms may be non-specific, with common early symptoms including fever, headache, muscle pain, sore throat, and fatigue. The disease may progress to organ dysfunction, gastrointestinal symptoms, and haemorrhage in some cases. Differential diagnoses may include malaria and other endemic febrile illnesses. Since there are currently no approved or licensed vaccines or specific treatment for BVD, control measures rely on rapid case identification, isolation and care, prompt contact tracing, safe and dignified burials, and effective community engagement. However, early symptomatic treatment and supportive care are lifesaving.

Situation in the Democratic Republic of the Congo (DRC) and Uganda

As of 09 June 2026, 635 confirmed cases, including 127 deaths (CFR: 20%) and 119 suspected cases, were reported in the DRC. In addition, 260 patients are in hospital isolation, with 30 cumulative recoveries and 61.1% of contact follow-up rates reported. Cases have been reported in 26 out of 104 health zones in three provinces (Ituri, North Kivu, and South Kivu). Ituri accounts for the largest number of cases and deaths (600 cases, 104 deaths, CFR: 17.3%) amongst confirmed cases, followed by North Kivu (32 cases, 22 deaths, CFR: 68.8%) and South Kivu (3 cases, 1 death, CFR: 33.3%). Though contact-tracing challenges persist, 5 814 contacts have been identified, and 2 847 are under follow-up and monitoring.

In Uganda, as of 08 June 2026, 19 confirmed cases, including two deaths (CFR: 10.5%), have been reported from Kampala and Wakiso districts. Of the confirmed cases, 14 were imported cases, and five were secondary infections linked to the imported cases. All the cases are epidemiologically linked to the DRC outbreak. One probable case and one probable death were reported. Approximately 792 contacts were identified, of which 388 completed follow-up and symptom monitoring, and 404 remained active and are being monitored.

Public health response, risk assessment, and travel advice

With support from partners and the WHO, both 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, and cross-border coordination between the high-risk countries. 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 risk of spread has been assessed as very high at the national level in the DRC and as high in Uganda. The risk in the neighbouring countries that share a land border with DRC and Uganda is considered high due to high cross-border population movements, trade, and mining activities. However, the risk is low at the Africa region level, and globally. Based on existing information, WHO does not recommend any travel or trade restrictions with the countries currently reporting BVD outbreaks.

Situation in South Africa

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

As of 11 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 (NMCs) in South Africa and require immediate reporting to the relevant authorities and notification within 24 hours of clinical suspicion to the NMC surveillance system. For more information on NMCs and how to notify cases, visit here.

READ THE FULL UPDATE HERE