A sharp rise in measles cases has been recorded across Africa, with young children most affected, according to new surveillance data from the World Health Organization – Regional Office for Africa.

Between January and September 2025, a total of 81,315 suspected measles cases were reported across the continent. Out of this number, 34,222 cases (42.1%) were confirmed. This translates into a regional incidence of 26.9 confirmed measles cases per million people, a level health experts describe as worrying.

Children are carrying the biggest share of the outbreak. About 63 percent of all measles cases were among children under five years, while 23 percent were recorded in children aged five to nine years. This confirms that measles remains a major threat to young children, especially in countries with gaps in routine immunisation.

The Western African subregion accounted for 47 percent of all confirmed measles cases, making it the hardest-hit part of the continent. Overall, 77 percent of confirmed cases came from just eight countries which include Angola, Nigeria, Ethiopia, the Democratic Republic of the Congo, Niger, Cameroon, Uganda, and Togo.

Rubella, another vaccine-preventable disease, was also reported during the same period. Health authorities recorded 2,349 laboratory-confirmed rubella cases, with an incidence of 1.9 cases per million people. However, four island nations including Cape Verde, Mauritius, Sao Tome and Principe, and Seychelles reported no suspected measles or rubella cases, showing that elimination is possible with strong surveillance and vaccination systems.

Data from the first nine months of 2025 show that measles incidence reached the level of “large and disruptive outbreaks” defined as more than 20 cases per million population in Benin, Burkina Faso, Guinea, Niger, Nigeria, Togo, Angola, Burundi, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of the Congo, Ethiopia, Malawi, and Namibia.

In response, several countries stepped up vaccination efforts. Nationwide measles or measles–rubella vaccination campaigns were planned for the last quarter of 2025 in Chad, Congo, Central African Republic, Democratic Republic of the Congo, Nigeria, and Togo. Meanwhile, Ethiopia, Guinea, and Niger carried out Supplementary Immunization Activities earlier in the year.

Laboratory surveillance remains a challenge in some countries. During the first three quarters of 2025, 38,303 blood specimens were received at national measles serological laboratories across the region. However, low specimen collection rates were recorded in Angola (31%), Madagascar (53%), South Sudan (51%), and Nigeria (51%), which can weaken outbreak detection and response.

Data sharing gaps were also noted. Eritrea did not submit an updated case-based surveillance database, while Rwanda, South Africa, and South Sudan failed to provide complete laboratory datasets. In some countries, differences between laboratory and case-based surveillance records were identified, pointing to the need for regular data harmonisation. In Ethiopia, the laboratory database lacked specimen receipt dates, making it difficult to calculate some key performance indicators.

Despite these challenges, the World Health Organization praised countries and partners for their continued commitment.

“Our appreciate all Member States, partners, and donors for their continued collaboration and efforts to strengthen measles and rubella surveillance across the African Region,” said Team Lead for the Vaccine Preventable Disease Programme at the WHO Regional Office for Africa, Dr. Kalu Akpaka.

Health experts say closing immunisation gaps, improving laboratory reporting, and strengthening surveillance systems will be critical to preventing further outbreaks and protecting Africa’s children from preventable diseases.