Diphtheria Health Alert: NICD Reports Increased Cases and Calls for Immediate Action

The National Institute for Communicable Diseases (NICD) has issued a public health alert regarding respiratory diphtheria, which has been prevalent across South Africa since 2024. The disease, caused by the toxic bacterium Corynebacterium diphtheriae, affects the mucous membranes of the nose and throat and can lead to severe complications if left untreated.

Symptoms of Respiratory Diphtheria

Diphtheria typically presents with several symptoms, including:

• A sore throat
• Low-grade fever
• A sticky, greyish-white membrane in the nose, throat, tonsils, or larynx
• Enlarged glands in the neck, often referred to as “bull neck”

The NICD confirmed that 40 people across South Africa tested positive for the diphtheria-causing bacterium between January 1, 2024, and January 15, 2025. Among these, 20 individuals exhibited respiratory diphtheria symptoms, while the other 20 were asymptomatic carriers who tested positive following contact tracing.

The Western Cape has experienced a marked increase in cases since November 2024. Twelve cases of respiratory diphtheria and twelve asymptomatic carriers were reported in the City of Cape Town. This surge prompted a testing campaign in December 2024, where over 300 individuals in the Philippi farmlands were tested following the death of an elderly woman from the Riemvasmaak informal settlement.

Fortunately, respiratory diphtheria is preventable through vaccination, and early treatment can significantly reduce the risk of serious outcomes. Antibiotics, such as azithromycin or penicillin, are used to clear the bacteria from the throat, while diphtheria anti-toxin (DAT) is critical in treating severe cases.

The NICD stressed the importance of administering DAT promptly to save lives and prevent further transmission. Although supplies are currently limited, DAT is accessible through provincial pharmacies, and health professionals are encouraged to establish emergency supply lines.

In light of recent outbreaks, the Western Cape Department of Health and Wellness is urging residents to remain vigilant and not to panic. Health spokesperson Byron La Hoe emphasized the need for continued monitoring and swift action to curb the spread of this dangerous disease.

Residents are advised to contact the NICD’s doctor-on-call service at 080 021 2552 for guidance on specific cases and to consult with infectious disease experts as needed.

As the NICD continues to monitor the situation, it is crucial for communities to stay informed about the risks and take preventive measures, including ensuring timely vaccinations and seeking medical attention at the first sign of symptoms.

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