Measles and rubella surveillance data and analyses are updated daily and reported weekly. The reported figures may be influenced by the number of specimens from suspected cases that are received by the laboratory at the time of testing.
Measles surveillance
Measles outbreaks are ongoing in different parts of South Africa, with Gauteng being the most affected. Additional outbreaks have been reported in the Lejweleputswa in Free State, Capricorn, Mopani, Sekhukhune, Vhembe and Waterberg District Municipalities in Limpopo, the Gert Sibande and Nkangala District Municipalities in Mpumalanga, the Ngaka Modiri Molema District Municipality in North West, Frances Baard District Municipality in the Northern Cape Town and the Cape Town Metropolitan Municipality in the Western Cape.
From week 1 to week 48 of 2025, the national measles surveillance has detected an increase in measles cases countrywide. As of 28 November 2025, 2148 laboratory-confirmed measles cases have been reported nationally, with an increase of 29 cases since the previous report in epidemiological (epi) week 47. Gauteng reported 14 additional cases in epi week 48, bringing the total to 793.
In week 48, new cases were reported in the following provinces: Free State (2 cases), Limpopo (21 cases), Mpumalanga (18 cases), North West (7 cases), Northern Cape Province (10) and the Western Cape (56 new cases).
Measles is endemic in South Africa, with cases typically increasing during autumn and spring. Although sporadic cases are reported in areas with high measles vaccination coverage throughout the year in South Africa, outbreaks usually occur in areas with low vaccination coverage, where many children are either unvaccinated or under-vaccinated (having received only one instead of the two recommended doses).
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
From epi-week 1 to epi-week 48, 1957 laboratory-confirmed rubella cases were reported in South Africa through measles and rubella surveillance. Rubella cases continue to be detected throughout the country, with an increase of 95 cases since epi-week 47.
North West province rubella outbreak update
The North West province continues to report a high number of cases, with 1159 laboratory-confirmed cases reported from epi week 1 to week 48 of 2025, with an increase of 68 new cases from week 47 . The majority of laboratory-confirmed cases were reported in the Ngaka Modiri Molema District Municipality (977/1159, 84.3%).
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.
