The last laboratory-confirmed case of respiratory diphtheria in South Africa occurred in February 2010.
In a follow-up to a report in late April, the number of cases of the acute, toxin-mediated disease has grown in the KwaZulu-Natal Province (eThekwini and Ugu districts).
According to a posting on ProMed Mail by experts at the National Institute for Communicable Diseases in Johannesburg, as at 6 Jul 2015, a total of 15 diphtheria cases (11 of which are laboratory-confirmed as toxin producing) including 4 deaths have been reported. 6 asymptomatic carriers of laboratory-confirmed toxigenic Corynebacterium diphtheriae were identified in contacts of 4 diphtheria cases.
Cases range in age from 4 to 41 years (median 10 years). Where vaccination history has been verified (6), 4 case-patients were not up to date with their diphtheria immunizations according to age.
Diphtheria antitoxin treatment (DAT) was procured through a generous donation by the Japanese government, and has been administered to 6 case-patients to date. Outbreak response has included a number of public health interventions, notably the provision of antimicrobials to close contacts and catch-up vaccination campaigns and health promotion activities. In addition, molecular characterization of isolates is being undertaken.
Since the last suspected case of diphtheria was identified on 12 Jun 2015, 3 weeks have passed. Heightened surveillance will continue for any new cases.