Residents are being urged to remain vigilant after South Africa recorded 38 laboratory-confirmed cases of respiratory diphtheria this year, including two in Gauteng.

Although the province has recorded relatively few cases, the National Institute for Communicable Diseases (NICD) says every confirmed infection triggers an immediate public health response to prevent further spread.

The latest NICD situational report, covering the period from 29 December 2025 to 12 July 2026, recorded 38 confirmed respiratory diphtheria cases, five probable cases, one confirmed cutaneous (skin) diphtheria case in Gauteng, 10 asymptomatic carriers identified through contact tracing and eight deaths linked to confirmed or probable respiratory diphtheria.

For Gauteng, the report provides some reassurance. Only two confirmed respiratory cases — about 5% of the national total — have been recorded in the province during the reporting period, while the province also recorded the country’s only confirmed cutaneous diphtheria case.

Five suspected cases in Gauteng later tested negative. The NICD further notes that the two respiratory cases were isolated and had no known epidemiological links to one another or to any of the outbreak clusters identified elsewhere in South Africa.

No asymptomatic carriers were identified in Gauteng through contact tracing.

Most infections remain concentrated in the Western Cape, which accounts for 32 of the country’s confirmed respiratory cases, followed by Limpopo with four and Gauteng with two. Seven outbreak clusters have been identified nationally, most involving households in Cape Town, while another was recorded in Tzaneen, Limpopo. Gauteng has not been linked to any of these clusters.

Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae. It spreads through coughing, sneezing and close contact with an infected person or contaminated respiratory secretions. The bacteria produce a toxin that can damage the throat, heart and nervous system, making the disease potentially life-threatening if left untreated.

Early symptoms often resemble those of a sore throat but can rapidly worsen. Warning signs include fever, a sore throat, pain when swallowing, swollen glands in the neck, weakness, difficulty breathing and a thick grey or white membrane over the throat or tonsils.

Anyone experiencing these symptoms, particularly after close contact with a confirmed case, should seek medical attention without delay.

Although diphtheria is often associated with children, the latest figures show adults remain at risk. The median age of confirmed respiratory cases this year was 23 years, with 68% of infections occurring in adults aged 18 years and older. Cases ranged from children aged five to adults aged 72.

The NICD also recorded eight deaths among confirmed and probable respiratory cases, resulting in an overall case fatality rate of 18%, with the highest fatality rate recorded among adults aged 30 to 39 years, although the figures are based on relatively small numbers.

The NICD says all suspected cases continue to be investigated, with rapid laboratory testing and contact tracing remaining key measures to limit further spread of the disease.

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