The Western Cape Department of Correctional Services has contained the diphtheria outbreak at Pollsmoor Prison after a 19-year-old prisoner died and eight others tested positive for the disease.
National Commissioner of Correctional Services Makgothi Thobakgale said the department was vaccinating prisoners to control the spread of the disease, and that 15 staff had been identified as contacts while three others had shown symptoms and were recovering at home.
The National Institute for Communicable Diseases had issued a diphtheria alert as early as April after confirming a case in a child in the Western Cape and another in an adult in KwaZulu-Natal, reports News24.
Diphtheria is rare, but a drop in vaccine coverage, waning vaccination rates in adults, and children not completing their vaccination schedule are linked to its resurgence.
“Key measures we have conducted include a vaccination campaign; 342 inmates have been vaccinated and 36 officials have also been vaccinated. We have heightened our hygiene practices, and our facilities have been deep-cleaned as well,” said Thobakgale, adding that overcrowding in prisons continues to remain a concern, especially in the remand detention facility.
Western Cape Health Department spokesperson Byron La Hoe said they had responded to several cases of diphtheria at Pollsmoor Prison since 3 November.
"So far, nine cases have been laboratory-confirmed, including one death. The eight cases that tested positive have all been isolated and treatment provided. Of the eight inmates who tested positive, only two were symptomatic. The rest were asymptomatic positive contacts. No new cases have been reported in the past five days.”
Diphtheria is a contagious and potentially life-threatening bacterial infection with a toxin-producing strain of Corynebacterium diphtheriae or, more rarely, Corynebacterium ulcerans or Corynebacterium pseudotuberculosis.
It occurs in two forms: respiratory diphtheria, which is spread by respiratory drops, and cutaneous diphtheria, which is spread through lesions on the skin via prolonged contact.
Symptoms usually start two to five days after exposure, although the incubation period can range from one to 10 days.
Initial signs and symptoms include fever, malaise, chills, loss of appetite, sore throat, nausea and vomiting. Within days, a whitish/greyish pseudomembrane may form over the throat and tonsils, making it hard to swallow and breathe.
Typically, the membrane, which is made of dead tissue, sticks to the pharynx and cannot be dislodged. The infection can also cause the lymph glands and tissue on both sides of the neck to swell, causing a “bull neck”.
Complications include respiratory obstruction and myocarditis, with cardiac arrest or cardiac failure.
The cutaneous form of diphtheria looks like a non-healing ulcer with a dirty grey membrane.
The anti-toxin to treat the disease is in short supply globally, so treatment is usually through antibiotics.
The NICD said children who were not immunised, or who did not complete their immunisation schedule, were at increased risk of contracting diphtheria.
Since the implementation of diphtheria immunisation in South Africa in the 1950s, only sporadic cases of diphtheria, mostly involving children under 15, have been identified and reported.
News24 article – Diphtheria outbreak has been contained at Pollsmoor Prison (Open access)
News24 article – Diphtheria outbreak kills inmate at Pollsmoor Prison (Open access)
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