Measles has a long history in South Africa. It first appeared in Cape Town in 1789, leading to waves in 1806-7, 1839, 1852, 1861, and 1871, during which infections were rare but incredibly deadly (Fetter et al., 1996).
In 1858, a report was published that described two outbreaks of an epidemic that occurred at the Genadendal mission in the Western Cape (Fetter et al., 1996). The first outbreak was in 1839, and it caused 54 deaths out of 1,200 cases, which is a death rate of 45 per 1,000 cases (Fetter et al., 1996). The second outbreak was in 1852, and it caused 69 deaths out of 2,000 cases, which is a death rate of 34 per 1,000 cases. This second outbreak accounted for almost two-thirds of all deaths at the mission that year (Fetter et al., 1996).
Over the next 50 years, the virus slowly spread east and caused epidemics in places like King Williams Town, which suffered from six years of measles waves (Fetter et al., 1996). It should be noted that as the virus became more common in South Africa, it became less deadly (Fetter et al., 1996).