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NICD warns of increase in German measles cases in Western Cape

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The National Institute for Communicable Diseases has reported a spike in German measles or rubella cases in the Western Cape.

The NICD said that to date, 19 cases have been detected in children aged between five and nine years old.

“Whilst sporadic cases have been noted across the country, a week-on-week increase in laboratory-confirmed cases has been noted in the Khayelitsha sub-district of the City of Cape Town,” the NICD said.

It said that before 2020, seasonal rubella outbreaks usually occurred in the first week of September.

The NICD explained that Fever Rash Surveillance usually identified at least 800-1,000 cases of rubella annually.


Picture: The NICD


It said that during 2020–2023, fewer than 50 cases of rubella were identified across the entire country as the non-pharmaceutical interventions that were implemented for the Covid-19 pandemic interrupted rubella transmission.


Picture: The NICD


Picture: The NICD


“As the country has not experienced the usual seasonal rubella outbreaks, we are likely to see a large number of cases in 2023,” the NICD said.

What is German measles/rubella?

Rubella is a mild illness in children and adults but can have severe consequences in pregnant women, particularly those infected in the first trimester of pregnancy.

The rubella virus may infect the foetus, leading to congenital rubella syndrome (CRS). In children and adults, rubella infection presents with a rash, low-grade fever (°C), nausea, sore throat, mild conjunctivitis (red eyes), headache, cough, runny nose, and swollen lymph nodes in the neck. The rash usually starts on the face and neck before spreading to the rest of the body. The rash lasts for about 5 days.

Congenital rubella syndrome may lead to foetal death or congenital anomalies, including congenital heart disease, cataracts, and deafness.


As measles and rubella present with similar signs and symptoms (fever, a maculopapular rash with any conjunctivitis, cough, or runny nose), clinicians may notify the case as either measles or rubella. Once confirmatory laboratory testing is done, the case will be classified correctly by the NICD Centre for Vaccines and Immunology together with the Notifiable Medical Conditions Surveillance Officers.

Healthcare workers are advised to be vigilant for symptoms of rubella and notify and report cases.

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