Highlights
- The NICD has currently tested 3156 serum samples for measles of which 459 (14.5%) were confirmed positive from epidemiological week 40, 2022. In the past weeks (week 03 up until mid-week 04, 2023), there have been 43 new laboratory-confirmed measles cases detected across the country.
- In outbreak-affected provinces, a total of 441 measles cases have been detected from week 40 of 2022 until week 04 of 2023.
- In Gauteng Province, in weeks 03 and 04, 2023, 6 cases were notified at clinics in Daveyton, Ekurhuleni (3 from Daveyton Main clinic, two from Philip Moyo Clinic, one from Crystal Park Clinic) and 3 from the Germiston area (1 from Bertha Nxowa Hospital, one from Germiston City clinic and 1 from Wannenburg clinic). A single case was identified in Soshanguve, City of Tshwane.
- In North West province, in weeks 03 and 04, 12 of 15 cases originate from Mahikeng (Lonely Park, Mocoseng and Setlopo clinics, and Mahikeng provincial hospital). Two cases are reported from Ramabesa clinic and Makapanstad health Centre in Bojanala
- Amongst the 11 cases reported from Limpopo province, in weeks 03 and 04, three are from Giyani (Mapayeni clinic) and two from Makhado (Louis Trichardt Hospital and Clinic)
- The age distribution and origin of cases remain largely unchanged with the majority of measles cases in outbreak-affected provinces being among the 5-9 year age group (39%), and the highest proportion of cases arising from hospitals as opposed to primary health clinics in the under-1 year age group (54%). However, there is a significant number of cases in the 10–14-year age group (17%), justifying the need for a vaccination campaign to include this age group.
- Members of the public are urged to ensure their children are vaccinated against measles.
Outbreak overview
From epidemiological week 40, 2022 (ending 8 October 2022) to week 04, 2023 (ending 28 January 2023) the NICD has tested 3156 serum samples for measles of which 459 (14,5%) were confirmed measles cases (Table 1). The number of samples submitted, number and percentage that tested positive are shown in Figure 1.
From epidemiological week 40 of 2022 to week 04 of 2023, 441 laboratory-confirmed cases were reported from five provinces with declared measles outbreaks in Limpopo (158 cases), Mpumalanga (86 cases), North West (147 cases), Gauteng (30 cases), and Free State (20 cases) (Table 2). The geographical distribution of cases across South Africa from week 40 of 2022 until week 04 of 2023 is shown in Figure 2. The number of cases continues to increase daily as blood and throat swabs are submitted to the NICD for measles serology and PCR testing.
Figure 1. The number of serum samples submitted to the NICD for measles, week 40 2022, until week 04, 2023 and the number (dark green) and % tested positive (red line), by epidemiological week using the date the specimen was tested
Figure 2. Distribution of laboratory-confirmed measles cases by testing site (red dots – the size of the dot indicates the number of cases from that facility) and district of South Africa (deepening colour of blue indicates the total number of cases by sub-district), from week 40 to week 04, 2023
Table 1. Cases of laboratory-confirmed measles tested by the NICD from all provinces in South Africa from epidemiological week 40, 2022 to week 04, 2023. Outbreak-associated cases are contained within the red bordered cells* (EC=Eastern Cape; FS=Free State; GP=Gauteng; KZN=KwaZulu-Natal; LP=Limpopo; MP=Mpumalanga NW=North West; NC=Northern Cape). * A measles outbreak is classified as three or more confirmed laboratory measles cases reported within 30 days of the onset of disease, in a district.
Table 2. Age distribution of laboratory-confirmed measles cases from epidemiological week 40, 2022 to week 04, 2023, in provinces with a declared measles outbreak with age-specific attack rates. 
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