From epidemiological week 1 to week 27 of 2025, 379 laboratory-confirmed measles cases and 409 rubella cases were reported by the Measles Reference Laboratory at the National Institute for Communicable Diseases in South Africa. Of the 379 laboratory-confirmed measles cases reported since the beginning of the year, 279 cases were in Gauteng Province and 59 were reported in Free State Province. In Free State Province, most of the measles cases were reported in the Lejweleputswa District, Matjhabeng Subdistrict, and recently laboratory confirmed cases were detected in other areas. Meanwhile, in Gauteng Province, the majority of the measles cases were reported in City of Johannesburg, City of Tshwane and the Ekurhuleni district. Measles surveillance using wastewater has identified evidence of measles predominanty in Gauteng, with sporadic detections in other provinces.
Meanwhile, 403 laboratory-confirmed rubella cases were reported in the country, with 143 rubella cases reported in North West province from week 1 to 27 of 2025. Both measles and rubella mostly affected children aged 1-15 years, with an increase in several measles and rubella cases in the age group 15-49 years in the fever rash surveillance used to monitor measles and rubella virus circulation.
Highlights
Measles Surveillance
- From epidemiological week 1 to week 27 of 2025, the National Measles Laboratory Surveillance detected 379 laboratory-confirmed measles cases in the country including those tested on 30 June 2025.The majority of cases have been detected in Gauteng Province, followed by Free State.
- Sporadic measles cases have been reported in other provinces, with the Eastern Cape province, KwaZulu-Natal province, and Limpopo province reporting the lowest number of measles cases.
Rubella Surveillance
- From week 1 to week 27 of 2025, 409 laboratory-confirmed rubella cases were reported in South Africa through measles and rubella surveillance, Table 1, Figure 1 and Figure 9. Ngaka Modiri Molema District in the Northwest Province and Namakwa District in the Northern Cape Province reported a high number of rubella cases from week 1 to week 27 of 2025, with 110 cases and 49 cases, respectively. In Free State and Gauteng provinces , the rubella cases are reported in areas where measles outbreaks are detected.
- Rubella infections affected mostly children aged 1 to 14 years, with the highest infections detected in 5 to 9 years. Seventeen (14) rubella cases were reported in persons aged 15-49 years. Rubella infection poses a risk of pregnant women giving birth to a child with congenital rubella syndrome if infected in the first trimester of pregnancy.
Since the beginning of 2025, the number of fever rash samples submitted to the National Measles reference laboratory at NICD for measles and rubella surveillance, the rubella virus has still been detected more than the measles virus nationally. The rubella virus transmission has decreased nationally as compared to the number of rubella cases detected in 2024 , with sustained rubella transmission seen in the Ngaka Modiri Molema District, North West province and Namakwa District in the Northern Cape province from week 1 to week 27 of 2025.
The measles transmission still continues in areas with low measles immunity in the community with measles transmission continuing in Gauteng province and a measles outbreak detected in Lejweleputswa district in the Free State province. Routine measles vaccination should be strengthened, and measles catch-up doses should continue in healthcare facilities for the children who missed their scheduled doses. Vaccinating children with the measles vaccine protects them from severe illness caused by the measles virus infection, including severe pneumonia, encephalitis, blindness, deafness, and death.
Health awareness is recommended in the areas where rubella cases are circulating. Although rubella infections cause mild disease in adults and children, 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 (CRS).
