South Africa is currently experiencing a nationwide increase in laboratory-confirmed measles cases, with 2,476 cases reported nationally between December 29, 2025, and June 21, 2026. Measles outbreaks are ongoing across the country, particularly affecting the Western Cape, especially the City of Cape Town, according to the NICD. The NICD stated, "Measles outbreaks are ongoing across South Africa, with the Western Cape being the most affected province, particularly in the City of Cape Town." To counter this, the department has implemented measures aimed at improving measles vaccine coverage towards the 95% target. He confirmed, "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."
Nationwide Outbreak Details
The Free State recorded the highest number of new measles cases, with 132 infections, according to the National Institute for Communicable Diseases (NICD). The NICD stated that the Western Cape followed with 58 new cases, Gauteng with 46, Limpopo with 36, and Mpumalanga with 28. The Eastern Cape reported 20 new cases, KwaZulu-Natal recorded 6, and the North West registered 4. The NICD added, "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)."
New outbreaks have been identified in the Fezile Dabi and Xhariep Districts within the Free State. The majority of reported measles cases, totaling 1,749 out of 2,476 (70.6%), were among children aged 1-14 years. An increase in laboratory-confirmed cases was also observed among individuals aged over 15 years, accounting for 437 out of 2,476 cases (17.7%). To address the outbreak, 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. He confirmed, "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."
Response and Vaccination Efforts
Measures to combat the rising measles cases include strengthening routine immunization, implementing intensified catch-up vaccination campaigns, and conducting mop-up activities in districts with low performance. The Department of Health is utilizing District Health Information System (DHIS) data to identify children who have missed vaccinations or are under-immunized, providing targeted support to provinces and districts that exhibit low coverage rates. Provinces are mandated to monitor measles first and second dose coverage, conduct defaulter tracing, enhance outreach services, and ensure improved vaccine availability at the facility level.
The department supports provinces through national coordination and the "Big Catch-Up" initiative, which specifically targets children who have missed their vaccinations since 2022. Limpopo province is receiving prioritized support to address its low measles first-dose coverage. New outbreaks of measles have been reported in eThekwini, King Cetshwayo, and uMkhanyakude districts in KwaZulu-Natal, as well as in Pixley Ka Seme in the Northern Cape. 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.
Challenges and Coverage Gaps
The Northern Cape reported 44 new measles cases, contributing to the ongoing national outbreak. Current immunisation coverage levels across South Africa remain below national targets, which health officials state are insufficient to prevent the accumulation of susceptible individuals and the risk of further outbreaks. Contributing factors to this declining coverage include increasing vaccine hesitancy and refusals, missed opportunities for vaccination, difficulties in reaching under-immunised populations, and persistent health system constraints. 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.
