Rabat – After more than three decades without a reported case, the reappearance of diphtheria in Morocco serves as a reminder that a disease made rare thanks to vaccination can resurface when people are not adequately protected.
Diphtheria is a contagious bacterial infection that primarily affects the throat and nose, but can also affect the skin. Its severity stems in particular from the toxin produced by the bacteria, which can damage the heart, nerves, and kidneys. Without appropriate treatment, the fatality rate can reach 5 to 10%, according to specialists.
Absent from the Moroccan radar since 1992, diphtheria made a comeback in 2026. On September 28, the Ministry of Health reported two family clusters in the Souss-Massa region (Agadir Ida-Outanane and Chtouka-Aït Baha), affecting children who were unvaccinated or incompletely vaccinated. A few additional isolated cases were also reported, including one imported from abroad.
According to Professor Majdouline Obtel, a specialist in clinical epidemiology and professor at the Faculty of Medicine and Pharmacy in Rabat, while the number of cases remains limited and is being addressed through a public health response, this situation underscores the importance of adhering to the vaccination schedule, catching up on missed doses, and remaining vigilant for warning signs.
Ms. Obtel, also the acting director of the GST Academy at the Rabat-Salé-Kénitra Territorial Health Group (GST-RSK), indicated that the disease is primarily transmitted through respiratory droplets expelled when an infected person coughs, sneezes, or talks, as well as through direct contact with infected skin lesions.
The first symptoms generally appear two to five days after infection. They most often include a sore throat, fever, and difficulty swallowing. The appearance of thick, sticky, whitish, then grayish, pseudo-membranes at the back of the throat is a characteristic sign, the professor explained. These membranes may bleed when attempts are made to remove them.
Significant swelling of the neck, hoarseness, or difficulty breathing should also raise concern and prompt urgent medical attention. The disease can also manifest as a runny nose, sometimes bloody, or persistent skin lesions, she added.
Faced with these symptoms, the specialist emphasizes the need to consult a doctor without delay. Rapid diagnosis and treatment are essential to prevent complications and limit transmission.
For Professor Obtel, this resurgence underscores the need to maintain high vaccination coverage and ensure that no child remains insufficiently protected. Vaccination remains the most effective way to prevent the disease and its severe forms, as it allows the body to develop protection against the toxin responsible for the main complications, she explained.
In Morocco, the National Immunization Program provides three initial doses at two, three, and four months, followed by booster doses at 18 months and five years. Protection must be maintained over time, particularly through recommended booster doses, including in adulthood, the specialist reminded.
The issue also concerns children whose vaccination schedule has been interrupted, adolescents, and adults who have not received the necessary doses or whose booster shots are no longer up to date. In the event of a vaccination delay, it is generally not necessary to restart the schedule from the beginning: the missing doses can be administered according to a catch-up schedule adapted to age and vaccination history, she explained.
Professor Obtel therefore encourages parents to check their children’s vaccination records and to contact their nearest health center if they have any doubts. Vaccines included in the National Immunization Program are free of charge in public facilities.
Beyond individual protection, vaccination helps limit the spread of the bacteria. The presence of groups of unvaccinated or insufficiently protected people can promote the emergence of transmission clusters, even in a country where the disease had become rare, the specialist emphasized.
As soon as a case is suspected, response measures must be implemented immediately, she emphasized. Management includes isolating the patient, taking samples to confirm the diagnosis, and rapidly administering antibiotics and an antitoxin, as prescribed by a doctor.