Measles outbreak in the Western Cape Province, South Africa January 2025- January 2026
1
Western Cape Department of Health and Wellness, Western Cape Government, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A652
ABSTRACT
BACKGROUND:
Measles is a highly contagious airborne viral infection and remains a significant cause of vaccine‑preventable morbidity and mortality globally. South Africa has experienced an ongoing measles outbreak since June 2025, with cases identified in the Western Cape Province from epidemiological week 43 of 2025. The outbreak originated in the Khayelitsha sub‑district within the City of Cape Town Metropolitan District and subsequently spread to other sub‑districts. A cluster was also identified in the West Coast district. This study describes the epidemiological characteristics of the outbreak and the public health response implemented in the province.
METHODS:
A descriptive epidemiological analysis was conducted using data from the measles case-based surveillance database, the notifiable medical conditions system and laboratory results provided by the Measles National Reference Laboratory. Laboratory confirmed cases from public and private sectors were included. Data from 1 January 2025 to 17 January 2026 were analysed and stratified to identify transmission patterns.
RESULTS:
From 1 January 2025 to 17 January 2026, 908 laboratory‑confirmed measles cases were reported in the Western Cape, with 97% (884) occurring in the City of Cape Town. Khayelitsha sub‑district bore the highest burden (44%), followed by Eastern (15%) and Mitchells Plain (11%); children aged 5–9 years were most affected (46%), followed by individuals aged ≥15 years (152/905; 17%) - and females accounted for 52% of cases. Public health response measures included outbreak coordination, enhanced surveillance, case management, risk communication, booster vaccination to healthcare workers, and supplementary immunisation activities. Approximately 11,590 learners and staff were vaccinated across 52 educational institutions in Khayelitsha by December 2025. Targeted vaccination continues in other affected sub‑districts.
CONCLUSIONS:
Measles transmission persists due to low vaccination coverage and susceptible populations, particularly under-vaccinated and unvaccinated children. Addressing immunity gaps in older age groups and targeted supplementary immunisation is required to interrupt transmission.
Measles is a highly contagious airborne viral infection and remains a significant cause of vaccine‑preventable morbidity and mortality globally. South Africa has experienced an ongoing measles outbreak since June 2025, with cases identified in the Western Cape Province from epidemiological week 43 of 2025. The outbreak originated in the Khayelitsha sub‑district within the City of Cape Town Metropolitan District and subsequently spread to other sub‑districts. A cluster was also identified in the West Coast district. This study describes the epidemiological characteristics of the outbreak and the public health response implemented in the province.
METHODS:
A descriptive epidemiological analysis was conducted using data from the measles case-based surveillance database, the notifiable medical conditions system and laboratory results provided by the Measles National Reference Laboratory. Laboratory confirmed cases from public and private sectors were included. Data from 1 January 2025 to 17 January 2026 were analysed and stratified to identify transmission patterns.
RESULTS:
From 1 January 2025 to 17 January 2026, 908 laboratory‑confirmed measles cases were reported in the Western Cape, with 97% (884) occurring in the City of Cape Town. Khayelitsha sub‑district bore the highest burden (44%), followed by Eastern (15%) and Mitchells Plain (11%); children aged 5–9 years were most affected (46%), followed by individuals aged ≥15 years (152/905; 17%) - and females accounted for 52% of cases. Public health response measures included outbreak coordination, enhanced surveillance, case management, risk communication, booster vaccination to healthcare workers, and supplementary immunisation activities. Approximately 11,590 learners and staff were vaccinated across 52 educational institutions in Khayelitsha by December 2025. Targeted vaccination continues in other affected sub‑districts.
CONCLUSIONS:
Measles transmission persists due to low vaccination coverage and susceptible populations, particularly under-vaccinated and unvaccinated children. Addressing immunity gaps in older age groups and targeted supplementary immunisation is required to interrupt transmission.
| eISSN: | 2654-1459 |
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