The Health and Social Protection Ministry announced on Monday, September 28, that two limited clusters had been identified in the prefecture of Agadir Ida-Outanane and the province of Chtouka Ait Baha. One case has been confirmed by laboratory testing, while eight others are under investigation, including two deaths.
Initial investigations found that the affected children had either not been vaccinated or had not completed the doses recommended under Morocco’s national immunization schedule.
A warning sign for community immunity
Dr. Tayeb Hamdi, a physician and health policy and systems researcher, said the detection of two family clusters was particularly significant.
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In a statement distributed to the media, Hamdi said the cases point to active transmission within close family settings rather than isolated infections. He called for epidemiological teams to identify the source of the bacteria and trace any further spread.
Hamdi attributed the return of the disease to declining levels of community immunity in certain population groups. He said the fact that diphtheria has remained under control for years does not mean the bacteria has disappeared. Rather, it reflects the protection provided by vaccination.
A drop in vaccination coverage can create pockets of people who are not protected, he said. Immunity among adults can also decline over time in the absence of booster doses.
Echoes of Morocco’s measles outbreak
Hamdi pointed to the measles outbreak that hit Souss-Massa in late 2023 as a warning sign. Vaccination coverage for the two recommended doses fell below the 95% threshold before the outbreak spread to other regions.
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He said measles often serves as an early warning of gaps in population immunity. The appearance of diphtheria in the same region therefore represents another warning that vulnerable groups remain insufficiently protected against diseases that vaccination had brought under control.
The developments also come amid a wider resurgence of diphtheria in Africa over the past two years. Neighboring countries, particularly Algeria and Mauritania, have been dealing with outbreaks, raising concerns about cross-border transmission.
Diphtheria and the response
Diphtheria is an acute infection caused by the bacterium Corynebacterium diphtheriae. Some strains produce a toxin that can cause severe illness.
The infection can cause severe throat inflammation and thick gray membranes that obstruct the airways, as well as serious complications affecting the heart and nervous system. It is mainly spread through respiratory droplets and close contact.
Hamdi called for health services to immediately trace close contacts, conduct laboratory testing and provide preventive treatment, including antibiotics and antitoxin when available.
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He also urged authorities to launch broad field vaccination campaigns to catch up children who have fallen behind on their immunization schedules in the affected areas.
Hamdi said the current situation does not warrant public panic but does require a firm official response and close surveillance.
He stressed that public-health gains cannot be taken for granted, warning that declining vaccination coverage can allow diseases that had been brought under control to return.
