Investigation of measles outbreak in Emalahleni sub-district, Nkangala district, Mpumalanga province, August—December 2025
1
1 Nkangala Sub-district, Mpumalanga Department of Health, Mbobela, South Africa
2
2 South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, Division of the National Health Laboratory Services, Johannesburg, South Africa
3
3 Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Services, Johannesburg, South Africa
4
4 Faculty of Health Science, University of Witwatersrand, School of Public Health, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3945
ABSTRACT
BACKGROUND:
Measles is a highly contagious viral disease of public health concern despite the availability of a safe and effective vaccine. Gaps in immune coverage drive recurrent measles outbreaks. On the 26th August 2025, a measles outbreak was confirmed in Emalahleni sub-district of Nkangala District, Mpumalanga province. We described the magnitude and epidemiological characteristics of the cases, vaccination coverage, and factors contributing to the outbreak.
METHODS:
We conducted a descriptive cross-sectional outbreak investigation in Emalahleni sub-district from August to December 2025. Cases were identified through the Notifiable Medical Conditions Surveillance System, and contact tracing was conducted in households and schools. Laboratory confirmation was done using measles IgM antibody testing. We collected data through a case investigation form, review of clinical records, immunisation cards, vaccination coverage reports, and household environmental assessments. Data were analysed using Microsoft Excel and summarised in frequencies, proportions, medians, and epidemic curve. Age-specific attack rates were calculated using District Health Information System population estimates.
RESULTS:
Of the 46 suspected cases investigated, 27 (59%) were laboratory confirmed. Females accounted for 51.9% of cases, and the most affected age group was 5–9 years (55.6%) with attack rate of 4 per 10,000 populations. The median age was 10 years. One primary health care clinic accounted for most cases (74.1%, 20/27). Vaccination status was unknown for 74.1% of cases. Immunisation coverage decreased from 74.4% in quarter one to 72.1% in quarter two of 2025. Household overcrowding and poor infection prevention and control (IPC) practices were identified as contributing factors.
CONCLUSIONS:
This outbreak was driven by low routine immunisation coverage and poor IPC practices. Health talks were aired through radio and informed communities of the catch-up campaigns that were conducted within the study period. We recommend continued health education, strengthened facility-based vaccination activities and regular catch-up campaigns to prevent future outbreaks.
Measles is a highly contagious viral disease of public health concern despite the availability of a safe and effective vaccine. Gaps in immune coverage drive recurrent measles outbreaks. On the 26th August 2025, a measles outbreak was confirmed in Emalahleni sub-district of Nkangala District, Mpumalanga province. We described the magnitude and epidemiological characteristics of the cases, vaccination coverage, and factors contributing to the outbreak.
METHODS:
We conducted a descriptive cross-sectional outbreak investigation in Emalahleni sub-district from August to December 2025. Cases were identified through the Notifiable Medical Conditions Surveillance System, and contact tracing was conducted in households and schools. Laboratory confirmation was done using measles IgM antibody testing. We collected data through a case investigation form, review of clinical records, immunisation cards, vaccination coverage reports, and household environmental assessments. Data were analysed using Microsoft Excel and summarised in frequencies, proportions, medians, and epidemic curve. Age-specific attack rates were calculated using District Health Information System population estimates.
RESULTS:
Of the 46 suspected cases investigated, 27 (59%) were laboratory confirmed. Females accounted for 51.9% of cases, and the most affected age group was 5–9 years (55.6%) with attack rate of 4 per 10,000 populations. The median age was 10 years. One primary health care clinic accounted for most cases (74.1%, 20/27). Vaccination status was unknown for 74.1% of cases. Immunisation coverage decreased from 74.4% in quarter one to 72.1% in quarter two of 2025. Household overcrowding and poor infection prevention and control (IPC) practices were identified as contributing factors.
CONCLUSIONS:
This outbreak was driven by low routine immunisation coverage and poor IPC practices. Health talks were aired through radio and informed communities of the catch-up campaigns that were conducted within the study period. We recommend continued health education, strengthened facility-based vaccination activities and regular catch-up campaigns to prevent future outbreaks.
| eISSN: | 2654-1459 |
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