Diphtheria has killed 9 people in SA this year. Check your boosters
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Nine people have died of diphtheria in South Africa so far this year, and 44 cases have been confirmed in a laboratory, according to the National Institute for Communicable Diseases (NICD) report released on 23 October 2026. One new case, in the Western Cape, was added in the past week.
The figures cover 29 December 2025 to 18 October 2026 and are provisional, the NICD says.
Where are the diphtheria cases?
Most are in the Western Cape. The NICD's week 42 report breaks the 44 confirmed respiratory cases down as follows:
- Western Cape: 36 cases
- Limpopo: 5 cases
- Gauteng: 3 cases
Limpopo also has five probable cases, all linked to a household cluster in Tzaneen in May and June. Ten people were found carrying the bacteria without symptoms during contact tracing, eight in the Western Cape and two in Limpopo. Gauteng recorded two cases of the skin form of the disease (NICD).
Six of the nine deaths were in the Western Cape, two in Limpopo and one in Gauteng.
Who is getting sick?
Mostly young adults, not small children. The median age of confirmed cases is 25, ranging from 5 to 72, and 30 of the 44 patients were 18 or older (NICD).
About one in five probable and confirmed patients died (18%). The 30 to 39 age group was hit hardest, with four deaths among 11 cases, although the NICD warns the numbers per age group are small.
Of seven clusters identified this year, five were in Cape Town households and one in a correctional facility. Another 31 cases had no known link to other patients (NICD).
What are the symptoms of diphtheria?
It usually starts with a sore throat, a mild fever and chills. A thick grey-white coating then forms at the back of the throat and the neck can swell, making it hard to breathe or swallow, the Western Cape Health Department says.
It spreads through coughs and sneezes, and a person can stay infectious for up to two weeks after symptoms start. Prolonged close contact raises the risk (Western Cape Government).
The department's advice: if symptoms appear, go to your nearest health facility urgently for assessment and testing.
Which vaccines protect against diphtheria?
The national schedule gives diphtheria-containing vaccines at 6, 10 and 14 weeks, a booster at 18 months, and further boosters at 6 and 12 years (NICD guidelines). The NICD says the boosters are essential for long-term protection and that protection fades with time since vaccination.
Childhood vaccines are free at public clinics, and catch-up doses can be given to children who missed one (Western Cape Government). The City of Cape Town says to bring your child's Road to Health booklet, but to come anyway if you've lost it and a new one will be issued.
In outbreak areas, the NICD advises health workers and first responders who haven't had a Td or Tdap booster in the past 10 years to get one (NICD guidelines). Adults unsure of their own status can ask a clinic or doctor.
Is the bacteria resistant to antibiotics?
No. All 32 samples tested this year responded to penicillin and erythromycin. Every Western Cape sample sequenced belongs to the same strain, first detected in 2023 and still appearing to be confined to the province (NICD).
FAQ
How many diphtheria cases does South Africa have in 2026?
The NICD has confirmed 44 cases of respiratory diphtheria between 29 December 2025 and 18 October 2026, plus five probable cases in Limpopo. Nine people have died.
Which province has the most diphtheria cases?
The Western Cape, with 36 of the 44 confirmed cases. Limpopo has five and Gauteng three.
What are the first signs of diphtheria?
According to the Western Cape Health Department, it starts with a sore throat, mild fever and chills, followed by neck swelling and a thick grey-white coating at the back of the throat. Go to a health facility urgently if these appear.
When do children get diphtheria vaccines in South Africa?
At 6, 10 and 14 weeks, 18 months, and boosters at 6 and 12 years. The vaccines are free at public clinics, which also give catch-up doses.
Can adults get a diphtheria booster?
Yes. The NICD advises health workers and first responders in outbreak areas to get a Td or Tdap booster if they haven't had one in the past 10 years. Ask a clinic or doctor about your own status.