“The National Institute for Communicable Diseases (NICD) has released its latest situational report confirming an increase in diphtheria cases across South Africa, raising alarms about vaccine coverage gaps. Health authorities are intensifying surveillance, vaccination drives, and public awareness campaigns to curb 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 the National Institute for Communicable Diseases (NICD) issued its latest situational report on diphtheria for week 24 of 2026. The report highlights a concerning increase in confirmed cases, sparking urgent calls for enhanced vaccination coverage and community awareness. Diphtheria, a bacterial infection caused by Corynebacterium diphtheriae, primarily affects the throat and upper respiratory tract, and can lead to severe complications including myocarditis, nerve damage, and even death if untreated.
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, several provinces have reported new infections, with Gauteng and KwaZulu-Natal showing the highest incidence. Laboratory-confirmed cases have risen steadily over the past month, and while the absolute numbers remain relatively small compared to historical outbreaks, the upward trend is worrying. Public health officials are conducting contact tracing, laboratory surveillance, and rapid response interventions to contain the spread.
Symptoms and Risks
Diphtheria typically presents with sore throat, fever, swollen glands, and a thick grey membrane in the throat that can obstruct breathing. Severe cases may lead to systemic complications, including damage to the heart and nervous system. The disease spreads through respiratory droplets, making crowded environments particularly vulnerable. Children, the elderly, and immunocompromised individuals face the highest risk.
Government and NICD Response
The South African government, in collaboration with the NICD, has launched emergency vaccination campaigns targeting under-immunised communities. Mobile clinics are being deployed to rural areas, while urban centres are intensifying outreach through schools and community health centres. The NICD is also leveraging its digital surveillance platforms, such as CoughWatchSA, to monitor respiratory illnesses and detect potential diphtheria cases early.
Regional and Global Context
South Africa’s diphtheria outbreak comes at a time when the African continent is grappling with multiple infectious disease challenges, including Ebola in Central Africa and hantavirus in South America. The NICD has emphasized the importance of regional collaboration through the Southern African Development Community (SADC) to strengthen disease surveillance and response capacity.
Public Health Recommendations
Health experts are urging South Africans to:
- Ensure children are fully vaccinated according to the national immunisation schedule.
- Seek medical attention immediately if symptoms such as sore throat and breathing difficulties occur.
- Support community awareness campaigns to combat misinformation about vaccines.
Looking Ahead
The NICD warns that without swift action, diphtheria could escalate into a larger outbreak, straining South Africa’s already burdened healthcare system. The situational report serves as both a wake-up call and a roadmap for action: strengthen vaccination coverage, improve surveillance, and foster public trust in health interventions.
As South Africa mobilises resources to contain diphtheria, the outbreak underscores a broader lesson—vaccine-preventable diseases can resurge if vigilance lapses. The coming weeks will be critical in determining whether the country can halt the spread and protect vulnerable populations from this deadly but preventable infection.
