From week 1 to week 34 of 2025, national measles surveillance has detected an increase in the measles cases. As of 22 August 2025, a total of 741 laboratory-confirmed cases were reported, 503 cases in Gauteng province, 110 in the Free State province, and 35 in Mpumalanga province. Since our last update in epidemiological week 33, 22 new cases recorded were in Gauteng, 7 in Free State, 10 in Limpopo, 1 in Western Cape, and 4 in Mpumalanga Province. The reported measles infections were mainly in children aged 1-14 years, with an increase seen in persons 15 years and older in Gauteng province.
Update on the measles outbreak in South Africa
Gauteng province measles outbreak update
Gauteng province continues to report a high number, with 503 laboratory-confirmed cases reported from epi-week 1 to 34 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 (132), City of Tshwane (244), Ekurhuleni (108), Sedibeng (16), and West Rand (3).
Free State province measles outbreak update
Free State province continues to report laboratory-confirmed measles cases, with 110 cases reported from epi-week 1 to 34 of 2025. The majority of the laboratory-confirmed cases were reported in the Lejweleputswa district, which reported 107 cases, and 9 cases were reported from epi-weeks 31 to 34. The measles cases in Lejweleputswa district are decreasing after the measles outbreak was declared and the public health interventions were implemented.
Limpopo province and Mpumalanga province measles outbreaks
From epi-week week 28, 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 32 laboratory-confirmed measles cases whose specimens were taken between epi-week 28 and week 34. Thirty laboratory-confirmed cases were reported from Vhembe district.
In Mpumalanga province, 35 laboratory confirmed measles were reported from epi-week 1 to week 34. From epi-week 24 to week 34, there was an increase in laboratory confirmed cases in Gert Sibande and Nkangala districts, with 5 and 21 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).
- Measles awareness should be conducted in areas with localised outbreaks in order to alert the communities about the ongoing measles outbreak and prevention of the disease.
- Public awareness efforts to address vaccine hesitancy with relevant stakeholders in the communities must be intensified.
- Case reporting and contact tracing should be improved.
- 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 ensure that their children receive a measles vaccination catch-up dose.
- Awareness about complications of measles infection such as pneumonia, ear infections, diarrhoea, encephalitis (swelling of the brain) and death should be intensified.
- 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.
- Strengthening routine immunisation services and launching a mass vaccination campaign targeting children up to 15 years of age is also recommended.
Relevant resources, including the case definition, investigation form, and surveillance results, are available on the NICD measles page and the measles-rubella dashboard.
