Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 32, Number 6—June 2026

Synopsis

Public Health Response to Toxigenic Respiratory Diphtheria Outbreaks at Correctional Facility, South Africa, 2023–2025

Maria JoseComments to Author , Nectarios Papavarnavas, Arifa Parker, Charlene Lawrence, Janine Bezuidenhout, Levani Naidoo, Yolanda Cottee, Kathryn Grammer, Wentzel Dowling, Jocelyn Moyes, Anne von Gottberg, Mignon du Plessis, and Hassan Mahomed
Author affiliation: Western Cape Department of Health and Wellness, Cape Town, South Africa (M. Jose, N. Papavarnavas, A. Parker, C. Lawrence, J. Bezuidenhout, L. Naidoo, Y. Cottee, H. Mahomed); University of Cape Town, Cape Town (M. Jose, N. Papavarnavas, W. Dowling); Stellenbosch University, Cape Town (A. Parker, K. Grammer, H. Mahomed); National Health Laboratory Service at Groote Schuur Hospital, Cape Town (W. Dowling); National Institute for Communicable Diseases, Johannesburg, South Africa (J. Moyes, A. von Gottberg, M. du Plessis); University of the Witwatersrand, Johannesburg (A. von Gottberg, M. du Plessis)

Main Article

Table

Characteristics of 3 diphtheria outbreaks at a correctional facility, Cape Town, South Africa, October 2023–February 2025*

Characteristic Outbreak 1, Nov 2023 Outbreak 2, Dec 2024 Outbreak 3, Feb 2025
Diphtheria contacts
Inmate 55 (72.3) 53 (82.8) 60 (100)
Household 0 10 (15.6) 0
DCS staff 15 (19.7) 0 0
HCW 6 (7.9) 1 (1.6) 0
Total 76 (100) 64 (100) 60 (100)
Screening positivity of contacts, % 11 19 22
Contacts received postexposure prophylaxis vaccination 76 (100) 61 (95.3) 60 (100)
Contacts received postexposure prophylaxis antibiotics 76 (100) 61 (95.3) 60 (100)
Contacts with symptoms
 22 (28.9)
 0
 0
Diphtheria cases in inmates and staff
Symptomatic case-patients that did not receive DAT 0 0 1 (6.7)
Symptomatic case-patients that received DAT 1 (11.1)† 1 (7.7) 0
Asymptomatic carriers 8 (88.9) 12 (92.3) 14 (93.3)
Total
9 (100)
 13 (100)
 15 (100)
Diphtheria vaccinations
Inmates 481 (79.6) 240 (94.1) 44 (55.0)
DCS staff 123 (20.4) 15 (5.9) 36 (45.0)
Total 604 (100) 255 (100) 80 (100)

*Values are no. (%) except as indicated. DCS, Department of Correctional Services staff; HCW, healthcare workers. †Died.

Main Article

Page created: April 30, 2026
Page updated: May 18, 2026
Page reviewed: May 18, 2026
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external