Health officials in South Africa have issued a health alert due to recent diphtheria cases reported in KwaZulu-Natal Province. Since Mar 30, three diphtheria cases, aged 20, 11 and 10 years, have been reported.
Two of the cases were confirmed toxin-producing Corynebacterium diphtheriae, while another case was classified as probable. This resulted in two fatalities.
A cluster of respiratory diphtheria cases occurred in Kwazulu-Natal in 2015. Subsequently, two additional cases from the same region were reported in 2016. In 2017, a cluster of three cases occurred in the Western Cape (WC) and a single case in the Eastern Cape.
Health officials are urging providers to have a high awareness of the suspected diphtheria case definition and to notify these cases, as well as submit specimens for laboratory testing. Any person who presents with an upper respiratory tract illness characterized by a sore throat, low-grade fever and an adherent (pseudo)membrane of the nose, pharynx, tonsils or larynx should be considered as a suspected case.
In addition, they are reminding labs to actively screen for C. diphtheriae.
Diphtheria is a dangerous respiratory disease is caused by a potent toxin produced by certain strains of the bacterium Corynebacterium diphtheriae. Diphtheria is extremely contagious through coughing or sneezing. Risk factors include crowding, poor hygiene, and lack of immunization.
Symptoms usually appear within a week of infection. This infection is characterized by a sore throat, coughing and fever very similar to many common diseases like strep throat. Additional symptoms may be bloody, watery discharge from the nose and rapid breathing. However, a presumptive diagnosis can be made by observing a characteristic thick grayish patch (membrane) found in the throat. In more severe cases, neck swelling and airway obstruction may be observed. In the tropics, cutaneous and wound diphtheria is much more common and can be a source of transmission.
The real serious danger is when the toxin that is produced by the bacterium gets into the bloodstream and spreads to organs like the heart and nervous system. Myocarditis, congestive heart failure and neurological illnesses of paralysis that mimic Guillain-Barre syndrome are most severe. Even with treatment, fatalities are still seen in up to 10% of cases.
Diphtheria can be treated and cured successfully with antitoxin and antibiotics if started early enough. The prevention of diphtheria is through vaccination.