New surveillance data from the National Institute for Communicable Diseases (NICD) reveals that while laboratory-confirmed measles cases are on the rise across South Africa, rubella infections have declined.
In a statement on Monday, the NICD said data available from December 29 2025 to April 12 this year indicated that 1,076 laboratory-confirmed measles cases were reported nationally.
In the past week, the Western Cape reported the highest number of new cases (63), followed by the Eastern Cape (17), Limpopo (13), Mpumalanga (12), Northern Cape (11), Free State (10), Gauteng (7), KwaZulu-Natal (1) and North West (1).
Most of the reported measles cases were children aged one to 14 years (731 of 1,076) with an increase in laboratory-confirmed cases among people aged 15 years and older (213 of 1,076).
“This is indicative of continuing transmission within communities and possibly an immunity gap in older age groups. This shift in the epidemiology of measles among adults warrants further investigation to inform and improve public health interventions,” the NICD said.
It said measles remained endemic in South Africa, with seasonal increases in reported cases typically observed during autumn (March to May) and spring (September to November).
“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).”
Wastewater detection continues to provide evidence of ongoing excretion and, therefore, transmission in these same districts. Updated wastewater results are pending.
— NICD
The NICD said maintaining high vaccine coverage was important.
The NICD also said measles-positive wastewater samples were detected in Gauteng, specifically in the Ekurhuleni, City of Tshwane and City of Johannesburg districts, KwaZulu-Natal, North West and Western Cape provinces.
“Wastewater detection continues to provide evidence of ongoing excretion and, therefore, transmission in these same districts. Updated wastewater results are pending.”
The NICD said 217 laboratory-confirmed rubella cases were reported in the period in South Africa through the national fever-rash surveillance system.
“This represents a decline compared with the same period in 2025.”
During the reporting period, most cases occurred among children aged 1–14 years (171 out of 217 cases).
The NICD said rubella remained endemic in South Africa, with seasonal increases in transmission typically observed during autumn and spring.
The infection primarily affects children under 15 years of age and is generally self-limiting.
The NICD said 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. It said 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.
TimesLIVE
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