“The NICD has confirmed a concerning increase in diphtheria cases across South Africa, raising alarms about low immunisation rates in several provinces. Authorities are launching emergency vaccination campaigns and intensifying surveillance to prevent the spread of this potentially fatal respiratory disease.”
Rising Threat of Diphtheria in South Africa
South Africa is facing a renewed public health challenge as diphtheria cases climb across multiple provinces. The National Institute for Communicable Diseases (NICD) released its latest situational report for week 24 of 2026, confirming an upward trend in laboratory-confirmed infections. While absolute numbers remain relatively modest compared to historic outbreaks, the steady increase has sparked urgent calls for enhanced vaccination coverage and community awareness.
What is Diphtheria?
Diphtheria is a bacterial infection caused by Corynebacterium diphtheriae. It primarily affects the throat and upper respiratory tract, producing a thick grey membrane that can obstruct breathing. Symptoms include sore throat, fever, swollen glands, and difficulty swallowing. Severe cases may lead to systemic complications such as myocarditis, nerve damage, and even death if untreated. The disease spreads through respiratory droplets, making crowded environments particularly vulnerable.
Why This Matters
The resurgence of diphtheria is particularly alarming because it is a vaccine-preventable disease. South Africa’s Expanded Programme on Immunisation (EPI) includes diphtheria vaccination as part of routine childhood immunisation. However, gaps in vaccine coverage—exacerbated by the COVID-19 pandemic’s disruption of health services—have left vulnerable populations at risk. The NICD report underscores that low immunisation rates in certain provinces are contributing to the spread, with clusters of cases emerging in both urban and rural areas.
Current Situation
According to the NICD, Gauteng and KwaZulu-Natal have reported the highest incidence of new infections. Laboratory surveillance shows a steady rise in confirmed cases over the past month. Public health officials are conducting contact tracing, laboratory surveillance, and rapid response interventions to contain the spread. Emergency vaccination campaigns are being rolled out in under-immunised communities, with mobile clinics deployed to reach rural populations.
Government and NICD Response
The South African government, in collaboration with the NICD, has launched emergency vaccination drives targeting children and adults who missed routine immunisations. Public awareness campaigns are being intensified, urging parents to ensure their children are fully vaccinated. Health authorities are also working closely with schools, community leaders, and healthcare providers to improve outreach and education.
Risks and Vulnerable Groups
Children, the elderly, and immunocompromised individuals face the highest risk of severe complications. Crowded environments such as schools, workplaces, and public transport hubs are particularly vulnerable to outbreaks. The NICD has warned that without swift action, diphtheria could spread more widely, straining healthcare resources and reversing progress made in infectious disease control.
Expert Commentary
Dr. Nomsa Dlamini, a public health specialist at the NICD, emphasised: “Diphtheria is preventable, but only if communities are adequately vaccinated. The current rise in cases is a wake-up call to strengthen immunisation coverage and rebuild trust in public health systems.” Experts stress that vaccination remains the most effective tool, alongside early diagnosis and treatment with antitoxin and antibiotics.
Looking Ahead
The resurgence of diphtheria highlights broader challenges in South Africa’s healthcare system, particularly in sustaining routine immunisation programmes disrupted by the pandemic. Authorities are urging citizens to participate in vaccination campaigns and remain vigilant for symptoms. With coordinated action, the country hopes to prevent diphtheria from escalating into a nationwide crisis.
