Officials with the National Institute for Communicable Diseases (NICD) in South Africa are reporting a diphtheria outbreak that has affected four people, including one fatality, according to a local media report today.

Image/Alvaro1984 18
Image/Alvaro1984 18

The four cases were reported in Helderberg in the Western Cape. The patients include a mother and two children and a neighbor. It is not published who died.

Professor Lucille Blumberg with the NICD said it was likely the infected children did not receive all their vaccines.

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.

Related: Vaccines: How they work and some common misconceptions

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.