Measles on the rise in South Africa: What health measures are in place? - IOL

South Africa is seeing a sharp increase in cases of measles.

South Africa faces a public health challenge rising measles cases reported nationally prompting urgent vaccination efforts across the country.

The National Institute for Communicable Diseases (NICD) revealed that data available from December 29, 2025, and June 21, 2026 (ISO Weeks 1-25) indicated that 2,476 laboratory-confirmed measles cases were reported nationally. 

The NICD said that since the previous report, several additional cases were identified. 

“The Free State reported the highest number of new cases (132), followed by Western Cape (58), Gauteng (46), Northern Cape (44), Limpopo (36), Mpumalanga (28), Eastern Cape (20), KwaZulu-Natal (6), and North West (4),” the NICD said. 

Laboratory-confirmed measles detected for ISO Weeks 1-25 of 2026, December 29, 2025, to June 21, 2026, by province in South Africa.

It said that most of the reported measles cases were children aged 1-14 years (1,749/2,476; 70.6%), with an increase in laboratory-confirmed cases among people aged >15 years (437/2,476; 17.7%). 

“This is indicative of continuing measles 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. 

The institute said that 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). Therefore, maintaining high vaccine coverage is important for preventing measles transmission.

“Measles outbreaks are ongoing across South Africa, with the Western Cape being the most affected province, particularly in the City of Cape Town. District and metropolitan municipalities that meet the case definition for a laboratory-confirmed measles outbreak (three or more cases in a health district within four weeks). New outbreaks have been reported in Fezile Dabi and Xhariep Districts in the Free State, eThekwini, King Cetshwayo and uMkhanyakude in KwaZulu-Natal and Pixley Ka Seme in the Northern Cape,” the NICD said. 

Laboratory-confirmed measles outbreaks reported in the last four weeks (May 24, 2026 – June 21, 2026) versus total cases from December 29, 2025 to June 21, 2026, in South Africa.

Meanwhile, responding to a parliamentary question from the DA’s Michéle Clarke, Health Minister Dr Aaron Motsoaledi revealed that nationally and provincially, the department has implemented measures to improve measles vaccine coverage towards the 95% target. 

“These include routine immunisation strengthening, intensified catch-up vaccination, mop-up activities in low-performing districts, use of DHIS (District Health Information System) data to identify missed and under-immunised children, and targeted support to provinces and districts with low coverage,” Motsoaledi said.  

“Provinces are also required to monitor measles first- and second-dose coverage, conduct defaulter tracing, strengthen outreach services, and improve vaccine availability at the facility level.” 

Motsoaledi said the department supports provinces through national coordination and the Big Catch-Up initiative, targeting children who missed vaccinations since 2022. Key efforts include improving cold chain infrastructure and improving district- and facility-level microplanning to reach zero-dose and under-vaccinated children, including in hard-to-reach areas. 

Provincially, the focus is on district micro-plans, outreach services, school and community-based mobilisation, catch-up vaccination, and strengthened supervision of facilities. All provinces have been directed to develop provincial immunisation improvement plans. The lowest-coverage provinces have been prioritised for intensified technical support.

Motsoaledi said Limpopo is receiving prioritised support to address low measles first-dose coverage. The province has to strengthen district-level catch-up plans, improve defaulter tracing, intensify community mobilisation, monitor stock availability, and reach children who missed vaccination through outreach and facility-based services.

The focus is particularly on low-performing districts and facilities where coverage has remained below target. Limpopo has initiated targeted supplemental immunisation activities in under-vaccinated communities; cold chain capacity improvements; and community outreach to address vaccine hesitancy. 

The minister said that while progress has been made in strengthening immunisation services and disease surveillance, current immunisation coverage levels remain below national targets and are not yet sufficient to prevent the accumulation of susceptible individuals and the risk of outbreaks.

“Although immunisation coverage remained relatively stable during the Covid-19 period, a decline has been observed in the years following the pandemic. Contributing factors include increasing vaccine hesitancy and refusals, missed opportunities for vaccination, challenges in reaching under-immunised populations, and persistent health system constraints in some areas,” Motsoaledi said. 

He said that to address these challenges, the department is implementing intensified catch-up activities, defaulter tracing, targeted outreach services, strengthened monitoring of coverage data, enhanced disease surveillance, community engagement and risk communication to increase vaccination coverage and reduce hesitancy.