South Africa has recorded two positive cases of diphtheria, the uncommon but vaccine-preventable infection caused by a toxin-producing bacterium called Corynebacterium diphtheria. The toxin may lead to difficulty in breathing, heart rhythm problems and even death.
It spreads from person to person, usually through respiratory droplets from coughing or sneezing.
The National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), said the cases were detected in April – the first in an adult in KwaZulu-Natal and the second in the Western Cape, in a child.
Symptoms include sore throat (with the formation of a membrane on the tonsil and throat), and swollen glands in the front of the neck. Close contacts of known cases are at increased risk of infection.
Routine diphtheria vaccination is part of the childhood vaccine programme given in the first year of life. Booster doses at the age of six and 12 years should also be given.
Catch up vaccination is possible if doses have been missed. However, diphtheria antitoxin is in short supply globally; the World Health Organisation is apparently working to secure additional supplies. Treatment in the absence of anti-toxin is appropriate antibiotics and supportive care.
Clinicians (including primary health care nurses) throughout the country have been urged to notify suspected cases and to send specimens to the laboratory for testing.
Labs are encouraged to screen all throat swabs for diphtheria and send all confirmed cases to the Centre for Respiratory Diseases and Meningitis at the NICD.
The confirmation of the diphtheria outbreak means South Africa is facing its fourth outbreak of mainly childhood diseases since last year, reports Health-e News.
Earlier this month, the NICD also reported that South Africa was seeing a mumps outbreak for the first time in two decades – and is also still trying to contain the spread of measles and whooping cough after outbreaks were reported towards the end of last year.
Dr Michelle Groome, head of the Division of Public Health Surveillance and Response at the NICD, said although these diseases might be mild, complications could also occur, so it was vital to vaccinate children.
“Diphtheria and measles can result in death,” she said.
Pandemic restrictions were responsible for reducing transmission of other diseases, but since restrictions had been lifted, “we are back to pre-Covid conditions, with the opportunities for disease to spread easily again”.
Many children also missed their routine vaccinations during this time, resulting in an increase in the number of children susceptible to vaccine-preventable diseases.
The UNICEF Flagship report highlights that one in five South African children are under-immunised because of interrupted childhood vaccination programmes.
Dr Ayanda Mbuli, General Manager of Health Policy and Clinical Advisory at AfriCentric Group, said the factors driving the latest mumps outbreak are still under investigation.
“However, there is speculation that the varying vaccine coverage of 60%-90% and lowered population immunity after Covid-19 precautions may have a role,” she added.
National Health alert (Open access)
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