From week 1 to week 33 of 2025, national measles surveillance has detected an increase in the measles cases. As of 21 August 2025, a total of 701 laboratory-confirmed cases were reported, 481 cases in Gauteng province, 110 in the Free State province, and 31 in Mpumalanga province. Since our last update in epidemiological week 32, 35 new cases recorded were in Gauteng, 2 in Free State, 7 in Limpopo, 1 in Western Cape, and 2 in Mpumalanga Province. 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 481 laboratory-confirmed cases reported from epi-week 1 to 33 of 2025. The majority of the laboratory-confirmed cases were reported in the metropolitan areas with the distribution of cases as follows: City of Johannesburg (129), City of Tshwane (232), Ekurhuleni (105), Sedibeng (12), and West Rand (3).
Free State province measles outbreak update
Free State province continues to report laboratory-confirmed measles cases reported with 104 cases from epi-week 1 to 33 of 2025. The majority of the laboratory-confirmed cases were reported in the Lejweleputswa district (107 reported cases), and 9 cases were reported from epi-weeks 31 to 33.
Limpopo province and Mpumalanga measles outbreaks
Limpopo province reported an increase in the number of laboratory-confirmed case in Vhembe district, which shares the border with the Republic of Zimbabwe. Limpopo Province reported 21 laboratory-confirmed measles cases whose specimens were taken between epi-week 28 and week 33. Nineteen laboratory-confirmed cases were reported from Vhembe district. In Mpumalanga province, 31 laboratory confirmed measles were reported from epi-week 1 to week 33. From epi-week 24 to week 33 there was an increase in laboratory confirmed cases in Gert Sibande and Nkangala districts, with 5 and 17 laboratory-confirmed cases reported respectively.
Recommendations
- Measles surveillance should be strengthened nationally, with the provinces urged to do measles risk assessment and continue to do targeted or supplementary measles immunisation activities or campaigns in areas with low measles coverage and high number of children who never received vaccines (Zero dose areas).
- High-incidence districts such as Vhembe, Nala, Tshwane and Johannesburg should be prioritised.
- Measles awareness should be done in endemic areas and areas with localised outbreaks to alert the communities about the ongoing measles outbreak.
- Public awareness efforts must be intensified to address vaccine hesitancy and improve case reporting.
- Parents should be encouraged to vaccinate their children to protect them against measles infections.
- 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.
- Measles infections can lead to complications such as pneumonia, ear infections, diarrhoea, encephalitis (swelling of the brain) and death.
- Clinicians should collect blood specimens together with a throat swab or urine sample for laboratory confirmation, and also report patients who develop measles signs and symptoms using the NMC Surveillance System.
Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.
