Understanding Diphtheria and the Current Situation in Morocco
During a recent presentation of the surveillance and response device, Fatiha Smihrou from the Directorate of Epidemiology and Disease Control (DELM) highlighted the critical reasons for maintaining a high level of vigilance against diphtheria, a highly contagious bacterial infection caused primarily by *Corynebacterium diphtheriae*. This infection is known for its toxic effects and has a basic reproduction rate (R0) estimated between 6 and 7, indicating its potential for rapid spread. The mortality rate associated with diphtheria ranges from 5% to 10%, which further underscores the necessity for stringent monitoring and response protocols. Diphtheria is classified among the diseases that require mandatory reporting, alongside other conditions included in vaccination programs. Vaccination efforts have historically managed to control this disease effectively; however, Smihrou noted a troubling rise in outbreaks attributed to a probable increase in vaccine hesitancy. Neighboring countries, including Mauritania, Senegal, and Mali, have also reported cases, exacerbating concerns in the region.
Since early 2026, Morocco has experienced several episodes of diphtheria outbreaks. The initial identification of two clusters revealed three confirmed cases in one, one of which resulted in a fatality, while the second cluster recorded only one confirmed case, which also ended in death. To date, the current outbreak, which emerged several weeks ago, has reported a total of 11 confirmed cases, including one death. The procedural manual developed since the alert in February has facilitated the standardization of surveillance and response activities, ensuring a well-coordinated approach to managing this public health threat.
Effective Surveillance and Contact Management Strategies
The current phase of the outbreak surveillance aims to achieve six key objectives: the early detection and rapid confirmation of suspected cases, documentation of toxin production and antibiotic resistance, identification of transmission trends, high-risk zones and populations, monitoring the evolution of the outbreak, and evaluating the effectiveness of the response measures in place. A suspected case is characterized by upper respiratory tract symptoms like pharyngitis, rhinopharyngitis, tonsillitis, or laryngitis, accompanied by a thick grayish pseudomembrane that does not detach easily. Moreover, a compatible otorhinolaryngological infection associated with marked deterioration in the patient's general condition or signs of complications is also sufficient for classification as a suspected case.
When a suspected case is identified, healthcare professionals are advised to isolate the patient and have them wear a surgical mask, all while avoiding panic. The case must then be promptly reported to local health authorities, specifically provincial surveillance units. The local rapid response team then takes over to validate the case, thereby preventing false notifications that could overwhelm the system during the winter season. Following validation, the case is reported to the national epidemiological surveillance service, which assigns a tracking code to facilitate monitoring of the patient's treatment at every stage.
During this outbreak phase, all validated suspected cases are required to be hospitalized, where isolation and sample collection occur. These samples are sent to the laboratory under the coordination of the central service. Notably, the laboratory is obliged to inform regional and provincial teams immediately, including preliminary results, to anticipate an effective response. Ultimately, data is centralized on a national platform, allowing for the analysis of outbreak trends, risk populations, and informed decision-making.
For more information on the current diphtheria situation in Morocco, please refer to the original article published by es.le360.ma.
