The outbreak of diphtheria in KwaZulu-Natal, which has claimed the lives of four people, appears to be under control, according to the National Institute for Communicable Diseases (NICD).
No new cases have been confirmed in more than a month, raising hopes that the life-threatening respiratory disease caused by a poison from bacteria may soon be wiped out.
“The outbreak of diphtheria in KZN is under control. No new cases have been confirmed since June 11,” Kerrigan McCarthy, head of the outbreak response unit at the NICD, told Health24.
~bChildren are most at risk~
She said 15 cases of diphtheria have been identified by public health services in KZN, the majority of which are children under the age of 15.
“Eleven are confirmed positive, three are probable and one is a possible case,” she said. Among those who have died, one was an adult aged 41.
Dr Yacoob Coovadia, a lecturer in clinical microbiology at the University of KwaZulu-Natal, told Health24 that diphtheria is a contagious disease and infects only humans.
“Diphtheria is disease caused by corynebacterium diphtheria, which is a gram-positive organism that infects only humans,” he said.
~bHow the disease spreads~
“It is transmitted by respiratory route, including coughing or sneezing, and [by] close contact with patients’ oral secretions. It is a contagious disease which, if not treated appropriately, is potentially fatal.”
The classic sign of someone infected is a white or greyish thick coating covering the back of the throat and tonsils.
Symptoms include having a sore throat with a fever, drooling and neck swelling with difficulty in breathing.
Diphtheria bacteria release a toxin into the bloodstream that targets the heart, nerves and kidneys.
“Diphtheria is a vaccine-preventable disease and mothers should be strongly encouraged to vaccinate children appropriately,” he said.
~bDepartment acts fast~
McCarthy said the department of health has been proactive in containing the disease.
“Public health measures to prevent the spread of the organism include identification of all persons who have been in contact with a person diagnosed with diphtheria, provision of antibiotics to kill the organisms in the pharynx and immunisation with a booster vaccine against diphtheria toxin.”
She said the KZN health department has been on a vaccination drive at schools in the affected districts of eThekwini and Ugu. Ethekwini cases were reported from Umlazi, Chatsworth, Kwadabeka, Woodlands and Inanda, and Ugu cases were reported from Margate.
“We hope that these measures are why there are no new cases, but time will confirm if this is so,” said McCarthy.
The diphtheria booster vaccine – with a tetanus booster vaccine – is given at six and 12 years, but she warned that the vaccine coverage rate for this age group is low.
~bA need for the booster vaccine~
“This has made this age group highly susceptible to infection with diphtheria. We strongly advise all parents, care givers and schools to do what they can to ensure this age group receives the diphtheria booster vaccine.”
As with many other countries, SA does not keep supplies of the antitoxin used to treat diphtheria because the disease is so rare and the antitoxin can expire.
SA turned to India, Indonesia and Japan for the antitoxin, which must be administered to patients within 24 to 48 hours.
In response Japan donated 416 vials of the antitoxin, worth about R2 million.
“To date only five persons with suspected diphtheria received antitoxin,” said McCarthy.
Each patient requires a number of vials of antitoxin, calculated on his or her weight.
“There is still sufficient antitoxin in stock,” she said.