From week 1 to week 39 of 2025, national measles surveillance has detected an increase in measles cases. As of 19 September 2025, a total of 1,175 laboratory-confirmed measles cases have been reported nationally, representing an increase of 75 cases since the previous report in week 38. Gauteng reported 19 additional cases, bringing the total to 629. Limpopo reported 14 new cases with a total of 169. The Free State reported two new cases with a total of 142. Mpumalanga reported 14 new cases with a total of 96. The Western Cape reported 10 new cases with a total of 61.
Update on the measles outbreak in South Africa
Gauteng province measles outbreak updates
Gauteng province continues to report a high number of cases, with 629 laboratory-confirmed cases reported from epi-week 1 to 39 of 2025 (Figure 2). The majority of laboratory-confirmed cases were reported in metropolitan areas, with the distribution of cases as follows: City of Johannesburg (147), City of Tshwane (324), Ekurhuleni (134), Sedibeng (21), and West Rand (3).
Free State province measles outbreak update
Two new cases were reported in week 39 in the Free State province. There were 142 cases reported from epi-week 1 to 39 of 2025, with 107/142 (75.4%) cases being children aged 1-14 years. Measles surveillance should be strengthened and supplementary immunisation activities for measles immunisation should be extended to areas previously not included in the measles vaccination campaign to prevent transmission of the infection to new areas.
Limpopo province measles outbreak update
In Limpopo province, 169 laboratory-confirmed measles cases have been reported from epi-week 1 to epi-week 39, with children aged 1-14 years (130/169; 76.9%) being the most affected. From epi-week 27, Limpopo province reported an increase in the number of laboratory-confirmed cases in the Vhembe District Municipality, with 140 cases reported as of the end of epi-week 39. The measles outbreak is currently affecting the Musina Local Municipality in the northern part of Limpopo province.
Mpumalanga province measles outbreak update
In Mpumalanga province, 96 laboratory-confirmed measles cases have been reported from epi-week 1 to week 39, with 75/96 (78.1%) cases being children aged 1-14 years. From epi-week 26 to week 39, there was an increase in laboratory-confirmed cases in Nkangala District Municipality, with 76 laboratory-confirmed cases reported. Additionally, 14 new laboratory–confirmed measles cases were reported in epi-weeks 38 and 39 in Gert Sibande District Municipality.
Western Cape province measles outbreak update
Ten new cases of measles were reported in the Western Cape, bringing the total to 61 in epi week 39. The majority of laboratory-confirmed cases were reported in the City of Cape Town Metropolitan Municipality, which reported 60 cases. The measles cases were mostly detected in the Khayelitsha area.
Recommendations for public health interventions
- Measles awareness should be intensified in areas with localised outbreaks in order to alert the communities about the outbreaks and the prevention of the disease.
- 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 vaccine catch-up dose.
- Measles surveillance should be strengthened nationally to improve case reporting and contact tracing.
- Provinces are urged to conduct measles risk assessment and continue with targeted or supplementary measles immunisation activities or campaigns in areas with low measles coverage and high numbers of children who have either never received vaccines (zero dose areas) or are under vaccinated (children who received one instead of the recommended two measles vaccine doses)
- Public awareness efforts must be intensified to address vaccine hesitancy by engaging with all relevant stakeholders in the affected communities
- 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.
