Diphtheria is a highly contagious and potentially life-threatening bacterial infection of the respiratory tract. It can be treated with antibiotics and antitoxin. Two cases of diphtheria, one in the Western Cape and one in Gauteng, have been confirmed in South Africa since April. 

There is currently a large outbreak of the disease in Nigeria. 

Health Minister Dr Joe Phaahla said there was a global shortage of the diphtheria antitoxin.  

“The World Health Organization is working to secure additional supplies of antitoxin. Treatment in the absence of antitoxin is appropriate antibiotics and supportive care,” he added. 

Diphtheria is caused by infection from a toxin-producing strain of Corynebacterium diphtheriae. It is one of the childhood diseases included in the Department of Health’s vaccination programme for children. Adults are also at risk of contracting the disease as immunity can wane over time. 

According to the National Institute for Communicable Diseases (NICD), diphtheria is uncommon in South Africa. Between January 2008 and March 2015, only three laboratory-confirmed cases of respiratory diphtheria were reported, and one case in 2016.  

What are the symptoms? 

According to the NICD’s fact sheet on the disease, symptoms of respiratory diphtheria usually start two to five days after exposure. Symptoms include fever, malaise, chills, loss of appetite, sore throat, nausea and vomiting. Within days, necrotic tissue, looking like a whitish/greyish membrane, forms, making it hard to swallow or breathe. 

The infection can also cause myocarditis (infection of the heart muscle). Diphtheria must be confirmed by a laboratory test.  

Phaahla said the bacteria are transmitted from person to person, usually through respiratory droplets from coughing or sneezing, and close contacts are at an increased risk of infection. 

“Routine diphtheria vaccination is part of the childhood vaccine programme and parents are encouraged to get their children vaccinated. The vaccine should be given to all children as part of the routine vaccines in the first year of life. Booster doses at the age of six and 12 years should also be given.”  

He said catch-up vaccination was possible if doses had been missed, and urged parents to make sure that their children’s vaccinations were up to date. DM