From week 1 to week 31 of 2025, national measles surveillance has detected 590 laboratory-confirmed measles cases. In the past five weeks, epi-week 27 to epi-week 31, 190 laboratory-confirmed cases were reported, 121 cases in Gauteng province, 35 in the Free State province, and 9 in Mpumalanga province. Whereas, the other measles cases were reported in the remaining provinces, except the Eastern Cape province, which reported zero laboratory-confirmed measles cases. Measles cases are increasing in Mpumalanga province, where nine cases were detected between epidemiological weeks 27 and 31, 8 in the Nkangala district and 1 in the Gert Sibande district. The reported measles infections were mainly in children aged 1-14 years, which was similar across the provinces.
Update on the measles outbreak in South Africa
Gauteng province measles outbreak update
Gauteng province continues to report a high number, with 409 laboratory-confirmed cases reported from epi-week 1 to 31 of 2025. The majority of the laboratory-confirmed cases were reported in the metropolitan areas with the distribution of cases as follow: City of Johannesburg (116), City of Tshwane (198), Ekurhuleni (83), Sedibeng (10), and West Rand (2).
Free State province measles outbreak update
Free State province continues to report laboratory-confirmed measles cases reported with 97 cases from epi-week 1 to 31 of 2025. The majority of the laboratory-confirmed cases were reported in the Lejweleputswa district, which reported 95 cases, and 35 cases were reported from epidemiological weeks 27 to 31.
Recommendations
Measles awareness should be done in endemic areas and areas with localised outbreaks to alert the communities about the ongoing measles outbreak, and parents should be encouraged to vaccinate their children to protect them against measles infections. Measles infections can lead to complications such as pneumonia, ear infections, diarrhoea, encephalitis (swelling of the brain) and death. Parents whose children have missed their scheduled routine measles immunisation vaccine doses are encouraged to take their children for a measles vaccination catch-up dose.
Clinicians should report the suspected measles cases and collect blood specimens for laboratory confirmation, and also report patients who develop measles signs and symptoms using the NMC surveillance system.These include strengthening routine immunisation services and launching a mass vaccination campaign targeting children up to 15 years of age. High-incidence districts such as Tshwane and Johannesburg should be prioritised. Public awareness efforts must be intensified to address vaccine hesitancy and improve case reporting. Continued environmental surveillance through wastewater testing should be maintained to monitor trends and guide response activities.
Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.
