07 August 2017
A diagnosis of diphtheria has been confirmed in a 10-year old child who demised on 4th August 2017. In addition, two siblings of the index case confirmed diphtheria and are admitted in a Western Cape Province hospital. The index case commenced with symptoms compatible with diphtheria (fever, sore throat) during the week ending 26th July 2017. Diphtheria anti-toxin has been administered to the surviving siblings, along with appropriate antibiotic treatment, and they remain in a stable condition. To date, two contacts, including the mother of the children have tested positive for the diphtheria bacterium.
Provincial and district health services in the Western Cape were active over this past weekend to identify contacts of the family, including household members, pupils at schools attended by the siblings and health care workers who provided care in order to identify and prevent additional cases. By this morning, Monday 7th August 2017, over 400 contacts had been immunised and provided with preventive antibiotic therapy. At least 6 persons who were in contact with the family and who demonstrate symptoms compatible with diphtheria are currently being investigated and results of confirmatory laboratory tests are awaited.
Two confirmed cases of diphtheria were identified in KwaZulu-Natal province in 2016, and an outbreak of 15 cases occurred in eThekwini, KZN Province in 2015. Diphtheria is caused by a bacterium Corynebacterium diphtheriae, and is transmitted by droplet spread and direct contact with infected persons. Diphtheria is preventable by vaccination given at 6, 10, 14 weeks, with booster doses given at 18 months, 6 years and 12 years of age. Persons who are in contact with a confirmed case should receive post-exposure prophylaxis including antibiotics and vaccination to prevent spread of the bacterium, and should have a pharyngeal swab taken.
In the KwaZulu-Natal cases, the majority of children who developed disease were not vaccinated or were partially vaccinated. The public are urged to ensure that all children are up to date with vaccinations, especially with the booster vaccinations given to school-age children. Healthcare workers across the country are advised to be on the alert for patients presenting with clinical symptoms suggestive of diphtheria according to the case definition below:
“A suspected case of diphtheria is any person who presents with an upper respiratory tract illness characterised by sore throat, low-grade fever, AND an adherent membrane of the nasopharynx, tonsils or larynx.”
For more information on diphtheria, see links below: