The Western Cape is facing a significant increase in measles cases as 2025 comes to a close, with health authorities noting ongoing outbreaks in urban and peri-urban areas. Hotspots include Khayelitsha, Mitchells Plain, Mfuleni, Eerste River, Somerset West, Kraaifontein, Wesbank, and Citrusdal. This outbreak highlights the dangers of declining vaccination rates and the urgent need for community action.
As of mid-December 2025, the province continues to report new cases, according to the National Institute for Communicable Diseases (NICD) and the Western Cape Department of Health and Wellness. Recent weekly reports show dozens of new cases, with 56 reported in epidemiological week 48 alone.
The Current Measles Situation in the Western Cape
By early November 2025, the Western Cape had recorded 282 laboratory-confirmed measles cases, primarily in the Cape Town metropolitan area. The surge has continued into December, with significant weekly increases contributing to the provincial total, now well over 400 cases based on cumulative reports.
This outbreak is part of a national resurgence in 2025, with over 2,100 laboratory-confirmed cases reported countrywide by late November. Provinces such as Gauteng, Limpopo, Mpumalanga, Free State, North West, and Northern Cape have also seen substantial numbers, but the Western Cape’s dense urban clusters pose particular risks for rapid transmission.
Measles is a highly contagious airborne virus that spreads through respiratory droplets and can remain infectious in the air for up to two hours. Symptoms usually emerge 10-12 days after exposure and include high fever, cough, runny nose, red and watery eyes, followed by a rash that starts on the face and spreads across the body. Complications can be severe, particularly in young children, leading to pneumonia, encephalitis, severe diarrhoea, dehydration, blindness, or even death.
Fortunately, no measles-related deaths have been reported in the Western Cape this year, thanks to timely health interventions and management.
Why the Surge? Declining Vaccination Rates
Experts point to falling childhood immunisation rates as the primary driver of this outbreak. Sub-optimal coverage of the two-dose measles vaccine has left pockets of the population vulnerable, allowing the virus to spread in communities with immunity gaps.
Vaccination uptake has declined nationally and provincially in recent years, worsened by COVID-19 disruptions and ongoing hesitancy. In the Western Cape, this has resulted in outbreaks concentrated in high-density areas. Children aged 1-14 years are the most affected, accounting for the majority of cases, consistent with national patterns.
The province is also dealing with diphtheria, another vaccine-preventable disease linked to similar coverage gaps. While diphtheria cases have mainly impacted adults, they add pressure to an already burdened health system responding to measles.
Measles remains endemic in South Africa, with typical seasonal increases, but low vaccination coverage transforms sporadic cases into widespread outbreaks.
Health Department’s Response and Vaccination Efforts
The Western Cape Department of Health and Wellness has activated an early warning and response system, including enhanced surveillance, case management, and community outreach. Targeted vaccination drives are focusing on high-risk areas like Khayelitsha and Mitchells Plain.
A national measles vaccination campaign took place from 3-28 November 2025 to address immunity gaps through mass immunisation. Public clinics remain open during the festive season, providing free childhood vaccines, including catch-up doses for those who missed scheduled immunisations.
Parents should review their child’s Road-to-Health booklet and ensure measles-rubella (MR) doses are current—at 6 months and 12 months. Two doses offer 97% lifelong protection and are available free at public facilities or through private providers.
Healthcare workers are vigilant for symptoms, confirming cases via blood tests and managing contacts to prevent further spread.
Broader Context in South Africa
South Africa’s 2025 measles outbreaks align with global trends where vaccination interruptions have revived the disease in areas once under control. The NICD stresses the importance of maintaining high coverage to prevent such resurgences.
Community measures are vital: isolate anyone showing symptoms, seek prompt medical attention, and prioritise vaccination. Early treatment can mitigate complications, especially in vulnerable groups like infants, malnourished children, or those with weakened immune systems.
With the festive season bringing more travel and gatherings, extra caution is needed to avoid accelerating transmission.
Preventing Future Outbreaks: The Path Forward
To achieve herd immunity and eliminate measles, South Africa needs sustained 95% coverage with both vaccine doses—a goal that requires renewed commitment from families and health systems alike.
The current situation in the Western Cape serves as a powerful reminder of how vaccine-preventable diseases can quickly rebound when coverage slips. By closing gaps through routine immunisations, outreach campaigns, and improved surveillance, the province and country can protect future generations.
Vaccination is safe, effective, and the best defence against measles. Clinics are accessible, and the message from authorities is unequivocal: protect your children and community by getting vaccinated today.
As families prepare for holiday celebrations, checking vaccination status and staying vigilant can help ensure a healthier start to 2026.