The National Institute for Communicable Diseases (NICD) has warned that cases of toxigenic respiratory diphtheria are increasing, particularly in the Western Cape, where booster dose vaccination against the disease has declined.
Cape Times reports that while that province accounts for most cases of toxigenic respiratory diphtheria, a decrease in the uptake of Tdap (tetanus, diphtheria, and whooping cough) booster doses among older children is especially concerning and compounding the issue.
The latest report from the NICD revealed that nationally, 91 laboratory-confirmed cases of toxigenic respiratory diphtheria were recorded between January 2024 and 18 January 2026, with the Western Cape accounting for most cases, reporting 67.
The NICD said a public health response was initiated for every case, which involves swabbing, isolating, providing prophylaxis, and vaccinating close contacts, and in both the Western Cape and Limpopo, additional vaccination campaigns were being conducted in schools and communities.
“Of the 91 respiratory diphtheria cases, 21 (23%) occurred among children aged 12 and under. Vaccine history was available for seven of these cases. One case (aged eight years) had received four infant doses but no booster, two cases (aged nine and 10 ) had received three infant doses and no booster, two cases were reported as unvaccinated, and two cases (aged six and 12 years) were reported to be up to date with their vaccinations,” the NICD said.
Diphtheria prevention forms part of the routine childhood immunisation programme, with Tdap booster doses provided at six and 12 years of age to maintain protection.
National Department of Health spokesperson Foster Mohale said the Big Catch-Up Campaign, a continuing initiative, was launched in November by the department in partnership with the provinces.
It targets districts that are recording outbreaks not only of diphtheria, but also focuses on measles and rubella vaccination.
Mohale identified several challenges in closing the vaccination gap, a key issue being inconsistency of parents and caregivers in taking children for booster doses when they were older than 24 months. He said this was compounded by vaccine hesitancy, along with mis- and disinformation about vaccines.
See more from MedicalBrief archives:
Waning immunity, low jab rate, trigger SA diphtheria cases
Diphtheria prison outbreak contained