From epidemiological week 1 to week 33 of 2024, 178 laboratory-confirmed cases of measles and 2059 cases of rubella were reported in South Africa. Measles transmission has decreased in the Sedibeng district with the last measles case reported in week 30 of 2024. Twenty-one(21) laboratory-confirmed measles cases were reported from epidemiological week 30 (21 July 2024) to week 33 from seven provinces, Eastern Cape 3 cases, Free State 1, Gauteng 8 cases, KwaZulu-Natal 2 cases, Limpopo 1 case, Northern Cape 2 cases and Western Cape 4 cases.
Rubella virus infections increased in the Gauteng province in West Rand, City of Johannesburg and Ekurhuleni districts and continued to circulate in Eastern Cape, KwaZulu-Natal in Uthugela district, Northern Cape in Francis Baart and circulation remain sustained in Western Cape province.
Overall, increasing numbers of suspected measles and rubella cases are being submitted to the National Institute for Communicable Diseases for laboratory confirmation. In parallel, clinical cases with fever and rash are being reported mostly in areas where laboratory-confirmed rubella cases have been detected.
Highlights
Measles Surveillance
- A total of 178 laboratory-confirmed measles cases were reported between epidemiological week 1 and week 33 of 2024 in South Africa. From epidemiological week 1 to week 33 majority of laboratory-confirmed measles cases were reported in Gauteng provinces. The last measles case in Sedibeng district was reported in week 30 after laboratory-confirmed measles cases contacts were vaccinated and vaccination campaigns done in schools. Sporadic measles cases have been reported in the City of Johannesburg, City of Tshwane, Ekurhuleni and West Rand districts from week 14 to week 33. Measles cases increased in the City of Johannesburg and Ekurhuleni in epidemiological weeks 26 and 27.
Rubella Surveillance
- Rubella serology testing is conducted at several NHLS laboratories and the NICD. Rubella testing at the NICD is done to differentiate the infection of rubella and measles from fever-rash surveillance samples from patients who meet the suspected measles/rubella case definition. Data reported in the situation report is for samples tested at NICD from measles and rubella rash surveillance.
- From week 1 to week 33 of 2024, 2059 laboratory-confirmed rubella cases have been reported in South Africa. The Western Cape reported 763 cases, the Eastern Cape reported 513 cases, while the Northern Cape and Gauteng reported 214 and 371 cases, respectively.
- Rubella circulation had increased in Eastern Cape, Gauteng, Kwazulu-Natal and Northern Cape provinces in recent epidemiological weeks, with sustained circulation in Western Cape, Northern Cape and Eastern Cape provinces. In Gauteng, Western Cape, and Eastern Cape provinces all districts are affected, in Northern Cape province, four districts are affected which are Pixley Ka Seeme, Namakwa, Frances Baard and ZF Mgcawu. In Kwazulu-Natal, one district is mostly affected, namely Uthukela, while sporadic cases have been reported among other districts.
Health awareness is recommended in the areas where rubella cases are circulating to inform the population how to prevent rubella infection risk. Although rubella infections cause mild disease in adults and children, pregnant women in their first trimester of pregnancy who acquire rubella for the first time are at risk of passing rubella onto their foetus, with consequential congenital rubella syndrome.
Healthcare workers should collect urine, throat swabs, and blood sample specimens for diagnostic testing (serology and PCR detection) on infants with suspected CRS. A good clinical history should be obtained from their mothers regarding fever/rash illness during pregnancy. A completed case investigation form for congenital rubella syndrome should be completed along with the submission of clinical samples to the NICD for testing.
