South African Measles Outbreak Update 2023 ( 10 FEBRUARY )


  • The NICD has tested 3279 serum samples for measles since epidemiological week 40, 2022, of which 506 (15.4%) were confirmed positive. In outbreak-affected provinces, 484 cases have been reported since week 40, 2022. In the past weeks (week 04 up until mid-week 05, 2023), there have been 58 laboratory-confirmed measles cases detected across the country of which 56 are from outbreak-affected provinces.
  • In week 04, the percentage of samples testing positive (PTP) increased to 25% of the 330 samples tested, compared with a lower PTP (under 10%) in week 03, 2023. Whilst the PTP for week 05 looks lower, the data for epidemiological week 05 will be reviewed in the next situation report when all samples collected during week 05 have been tested.
  • All Gauteng cases, except two, originate from Ekurhuleni (Daveyton and Germiston). The two cases not from Ekurhuleni are from Tshwane (Hammanskraal) and Johannesburg (Olievenhoutbosch).
  • In provinces where an outbreak has been declared, the most affected age groups are still the 5–9-year-olds (40%) with a considerable proportion of cases reported among the 1-4 (28%) and 10-14 age groups (17%). Vaccination campaigns should therefore also include children aged 10 to 14
  • The majority of cases (73%) were reported from primary healthcare facilities, and the highest proportion of cases reported from hospitals (52%) was reported in children under the age of one.
  • Members of the public are urged to ensure their children are vaccinated against measles

 Outbreak overview

From epidemiological week 40, 2022 (ending 8 October 2022) to week 05, 2023 (ending 4 February 2023) the NICD has tested 3289 serum samples for measles of which 506 (15.4%) were confirmed measles cases. The number of samples submitted and the percentage of Laboratory confirmed measles positive cases are shown in Figure 1.  From epidemiological week 40 of 2022 to week 05 of 2023, 484 laboratory-confirmed cases were reported from five provinces with declared measles outbreaks; Limpopo (167 cases), Mpumalanga (91 cases), North West (157 cases), Gauteng (46 cases), and Free State (23 cases) (Table 2). The geographical distribution of cases across South Africa from week 40 of 2022 until week 05 of 2023 is shown in Figure 2he number of measles cases continues to increase daily as blood and throat swabs are submitted to the NICD for measles serology and PCR testing.

Figure 1. The number of serum samples submitted to the NICD for measles, week 40 2022, until week 05, 2023 and the number (dark green) and % tested positive (red line), by epidemiological week using the date the specimen was collected. *Data from week 05 represent partial data and will be updated in next week’s situation report when complete data from samples collected that week becomes available.

Table 2. Age distribution of laboratory-confirmed measles cases from epidemiological week 40, 2022 to week 05, 2023, in provinces with a declared measles outbreak with age-specific attack rates.

Figure 2. Distribution of laboratory-confirmed measles cases by the testing site (red dots – the size of the dot indicates the number of cases from that facility) and district of South Africa (deepening colour of blue indicates the total number of cases by sub-district), from week 40 to week 05, 2023.


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