Diphtheria Resurgence in Morocco: A Growing Concern for Public Health
After being dormant for over thirty years, diphtheria has resurfaced in Morocco, first detected in the Souss region and subsequently spreading to Marrakech. The alarming resurgence has prompted health authorities to intensify surveillance measures across the entire nation. In the evening hours at the Mohammed VI University Hospital in Marrakech, the urgent care unit is filled with the cries of children struggling to adapt to the oxygen masks they are required to wear. Their anxious mothers are tasked with keeping the masks securely in place as medical staff rush around attending to patients. Many of these healthcare workers had never encountered this diagnosis before, as diphtheria had seemingly vanished from the collective memory of the medical community in Morocco. This health alert was first raised in Agadir just four days prior, on September 28, when the Ministry of Health reported two family clusters in Agadir and the adjacent Chtouka Aït Baha province. A laboratory-confirmed case was noted, along with eight others pending investigation. Among the afflicted were two brothers from Aït Amira who tragically succumbed to the illness. Six individuals, five of whom belonged to the same family, were admitted to the Agadir hospital, where all healthcare workers have since received vaccinations. According to the Ministry, none of the affected children had received the full vaccination against diphtheria, or were only partially immunized.
The situation has escalated, with the disease now reaching the Marrakech-Safi region. In Youssoufia province, a twelve-year-old girl from the Sidi Chiker community died after being transferred to the hospital. She had not received any vaccinations. Shortly thereafter, a young man from the same household tested positive for the disease. Similar to the outbreak in Agadir, the spread of diphtheria appears to primarily affect families. Local health authorities claim that the situation remains stable; however, the unconfirmed death of another young girl from Safi has raised concerns about the reliability of the information being communicated. In the absence of official updates, rumors are proliferating, causing anxiety among parents who are now considering keeping their children at home. While the immunization coverage theoretically meets the World Health Organization's objectives, international estimates suggest that around 96% of children are vaccinated against diphtheria. However, this national average obscures areas where vaccination rates are alarmingly low, particularly in rural regions, thereby allowing the bacteria to resurface.
Jaafar Heikel, an epidemiologist, firmly believes that the primary cause of this outbreak is the number of unvaccinated or partially vaccinated children. He emphasizes that complete protection against diphtheria requires a minimum of three doses, followed by booster shots at one and a half years of age and then every five years thereafter. This scenario eerily mirrors the resurgence of measles, which has re-emerged in 2023 due to declining vaccination rates following the COVID-19 pandemic. The Ministry of Health attributes the current dilemma to a global decline in vaccination coverage and the spread of misinformation regarding vaccines. In response to this health threat, authorities have expanded active monitoring across the country, from Tangier to Lagouira.
The protocol, as outlined by Heikel, involves isolating infected individuals, providing immediate treatment, and tracing their contacts to break the transmission chain primarily spread through respiratory droplets. Family clusters, daycare centers, and schools with unprotected children are receiving special attention from health teams. Heikal states, "When adequately protected, there is no risk; this disease is not transmitted." The Ministry is urging parents to check their children's vaccination records and ensure that any missing doses are administered, free of charge at approximately 3,000 public health centers nationwide. The pending lab results for the eight suspected cases will determine if the spread of Corynebacterium diphtheriae has been effectively contained or if additional clusters remain undiscovered.
As reported by leseco.ma.
