Durban diphtheria alert

By NOSIPHO MNGOMA Time of article published Apr 29, 2015

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A disease last seen in Durban 26 years ago has killed a child and has two others critically ill, with doctors fighting to save them with antibiotics.

A health official said three more children were “strongly suspected” of being infected with diphtheria, a highly contagious bacterial disease.

“One was admitted to hospital this past weekend. This patient and another were being treated in a public hospital. The third case is in a private hospital. We say suspected because although there has been a clinical diagnosis, lab tests are yet to confirm it,” he said.

The disease is preventable through vaccination, but requires booster shots.

The National Institute for Communicable Diseases (NICD) said that the

8-year-old boy who died was transferred from Prince Mshiyeni Hospital to Inkosi Albert Luthuli Central Hospital after running a fever for three days. He had massively swollen tonsils and a “bull neck” which made it difficult for him to breathe.

An emergency tracheotomy had to be performed.

In spite of some initial improvement with antibiotic treatment in intensive care, he “developed unexpected complications and died”, the NICD said.

University of KwaZulu-Natal clinical microbiology lecturer, Dr Yacoob Coovadia, said diphtheria could damage the heart, nerves or kidneys within 10 to 14 days.

“So even if the child initially survives because of proper care, they can still die from the damage caused to the body.”

He said because the disease was so uncommon, South Africa – as well as many other countries – did not keep the antibody which neutralises the toxin released by the diphtheria bacteria.

“It is only stocked in India and Israel, and by the time the procedure to import it is complete, it may be too late because the antibody only works if administered early,” Coovadia said.

Diphtheria could only be eradicated through a successful immunisation programme, he said. “Children are vaccinated at 6, 10 and 14 weeks and booster doses at 18 months, 6 and 12 years old.”

The NICD said the mother of the boy who died confirmed her son had not received the second booster vaccine two years ago. It was also discovered that this was the case with the second child, also 8 years of age. The third, a 9-year-old, had not received booster doses either.

Two of the children are from the same section in uMlazi, and the other child is from Chatsworth, and is being treated at RK Khan Hospital.

This being Global Vaccination Week, Coovadia said the sudden resurgence of diphtheria was extremely concerning especially because the bacteria was airborne and spread through inhalation when the infected person sneezed or coughed.

Patients were generally kept in strict isolation. Because of this, their families and those who had been in close contact with the children were tested and given antibiotics as a preventative measure.

After the outbreak, the Department of Health conducted a “catch-up” vaccination campaign in the area and schools.

In a statement issued during the observation of Child Health Week earlier this month, Health MEC, Dr Sibongiseni Dhlomo, said his department was “determined to accelerate child health services drastically to save more children’s lives”.



* It is preventable through vaccination.

* Sub-Saharan Africa, India, Indonesia see the most cases.

* Hippocrates described the symptoms in the 5th century BC.

* It killed Queen Victoria’s daughter, Alice.

* South Africa does not have the antitoxin.

* Those with Aids are high risk.



* High fever

* Bluish colour to the skin

* Sore throat

* Difficulty breathing

* Bloody nasal discharge

* Headache

* Cough

* Fatigue

* The chills

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