Infectious Diseases

Updated 01 May 2015

Rare deadly disease scare grips Durban

KZN MEC for Health Dr Sibongiseni Dhlomo has moved to allay fears over diphtheria, which is a serious bacterial infection that has left one child dead in Durban.

Kwazulu-Natal MEC for Health Dr Sibongiseni Dhlomo has urged parents to get their children vaccinated as he moved to ease fears of the public after a rare and deadly disease claimed the life of one child.

An 8-year-old boy died of diphtheria, which is a serious bacterial infection, after being admitted into hospital. He was transferred from Prince Mshiyeni Hospital to Inkosi Albert Luthuli Central Hospital.

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The  child  was  severely  ill;  he  had  a  massively  swollen  anterior neck (‘bull neck’) with marked drooling and  respiratory distress, said the The National Institute for Communicable Diseases (NICD).

Two other children are also suspected of being infected with the disease, which was last seen in South Africa before 2009.

Don't panic

"I don't want us to press the panic button as if we have an outbreak of diphtheria," Dhlomo said in a statement on Thursday.

"I'm saying this because when we followed the cases of the children who have been admitted, we found that one of them does not have a Road To Health Chart [a record of immunisations and growth rate], which means we cannot ascertain when last this child was immunised; and the second child who demised at eight years of age was last immunised at 14 weeks."

Dr Dhlomo said diphtheria is a preventable disease and urged parents to make sure that they adhere to the vaccination schedules.

"I'm calling upon all our mothers, parents and caregivers in the province to really come again into our health facilities .... Whether you've forgotten or you have no information, we will help you. We'll give them vaccinations or boosters. With these boosters we give a child the strength to survive, because without it, they become susceptible to this disease. And it is a serious condition once you get it. And it can lead to death, especially among babies," he said.

Diphtheria is contagious

Health24 resident doctor, Dr Owen Wiese, warned that diphtheria is easily transmitted to others. "It is caused by bacteria called Corynebacterium diphtheria and is contagious."

The bacteria can spread from person to person via air droplets when an infected person coughs, sneezes or talks.

Although the condition is fairly rare due to the fact that the standard vaccination protocol also vaccinate children against diphtheria, Dr Wiese stressed the importance of booster shots.

"After a child has been vaccinated, a booster vaccination is necessary."

He pointed out that the classic sign of someone infected with the disease is a thick, white-greyish pseudo-membrane covering the back of the throat and tonsils.

What to look out for

Other symptoms may include high fever, bluish skin colour, bloody nasal discharge, headache, fatigue and the chills.

"The biggest concern is that this covering can cause difficulty breathing. The bacteria also produce a toxin that can cause heart and nerve damage which may also lead to significant mortality."

Dr Wiese said if diphtheria is diagnosed, antibiotics and diphtheria antitoxin therapy (DAT), which neutralizes the bacteria, is given, but it is not available in South Africa.

South Africa, like many other countries, does not keep supplies of the antitoxin because the disease is so rare and because it can expire.

The NICD noted that that it is important that clinicians are aware of the range  of  clinical  presentations  and  appropriate  diagnostic investigations  in  order  to  detect  cases  timeously and  limit  mortality.


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Image: Immunisation checklist with syringe from Shutterstock


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