The disease has been largely absent from Morocco’s health landscape for several decades, but has now reappeared in some parts of the country. Two family clusters have been reported in the Agadir Ida-Outanane area and Chtouka-Aït Baha province, with some cases resulting in deaths.
For Dr. Lahlou, a specialist in childhood and infant diseases, the resurgence is a reminder of the seriousness of a disease that has long been known to doctors.
“Diphtheria is an old disease, well known to healthcare professionals. Even though Morocco has not seen significant circulation for more than 30 years, it remains potentially very serious,” he said.
The disease is caused by a bacterium that can produce a powerful toxin in its most severe forms. That toxin is responsible for many of diphtheria’s complications. It can affect the respiratory tract, spread through the body and damage organs including the heart and nervous system.
“The problem with this bacterium is not just the local infection. Some forms produce a very powerful toxin that can cause systemic complications,” the pediatrician said.
Symptoms can initially be easy to miss
The first symptoms of diphtheria can look much like those of a routine upper respiratory infection. A child may develop a fever, a sore throat, fatigue and difficulty swallowing.
“At first, the symptoms can be misleading. You can have a fever, a sore throat and discomfort when swallowing, just as with many other infections,” Dr. Lahlou said.
As the disease progresses, however, a more distinctive sign can appear: a thick membrane in the throat.
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“What should raise concern is this kind of whitish or grayish membrane or skin that sticks firmly to the throat. It is not simply a white spot. It is actually attached to the tissues,” he explained.
The pseudomembrane can gradually spread and interfere with the passage of air. In severe cases, breathing can become difficult or even compromised. The World Health Organization also describes the thick membrane as one of the characteristic signs of respiratory diphtheria, which can affect the airways.
“As it progresses, this membrane can obstruct the airways and cause severe respiratory distress. That is when the prognosis can become very serious,” the specialist warned.
Why can diphtheria be fatal?
The danger is not limited to airway obstruction. The toxin produced by some strains of the bacterium can enter the bloodstream and reach other organs, with the heart and nervous system among its main targets.
“The toxin can affect the heart muscle and cause very serious complications. It can also affect the nervous system,” Dr. Lahlou said.
In the most severe cases, these complications can cause neurological disorders, coma or sudden cardiac arrest.
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This ability to progress from what may initially appear to be a routine infection to a much more serious condition is why prompt treatment is important.
“Do not wait until the child is in respiratory distress before seeking medical attention. The earlier we intervene, the more we reduce the risk of complications,” the pediatrician stressed.
Diphtheria is mainly transmitted through respiratory droplets during close contact with an infected person, particularly when the person coughs or sneezes. Close contact within families or in communal living environments can therefore facilitate transmission.
Vaccination remains the main protection
Diphtheria has become rare in Morocco largely because of vaccination. The national immunization program protects children against the disease through a combination vaccine that also covers other infections, including tetanus and whooping cough.
For Dr. Lahlou, the reappearance of cases is above all a reason to make sure children are adequately protected.
“Children who have received their full vaccination schedule are well protected. The main concern is those who have not been vaccinated or whose vaccinations are not up to date,” he said.
Vaccination should not be viewed as unnecessary simply because diphtheria has rarely been seen for years.
“The fact that we hardly see a disease anymore does not mean that it no longer exists. As long as the bacterium circulates somewhere, it can be reintroduced and affect people who are not sufficiently protected,” the doctor said.
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Morocco’s national vaccination schedule includes several doses beginning in the first months of life, followed by booster doses to maintain protection over time. The Ministry of Health says the diphtheria vaccine is administered through the national immunization program, with doses at 6, 10 and 14 weeks, followed by a booster at 18 months.
“It is essential for parents to check their children’s vaccination records and make up any doses they may have missed,” Dr. Lahlou said.
Do not wait when warning signs appear
For the specialist, the key message is vigilance without panic. A sore throat or isolated fever does not necessarily mean diphtheria.
Certain symptoms, however, should prompt a quick medical consultation, including an unusual membrane in the throat, significant difficulty swallowing, swelling of the neck and, above all, breathing difficulties.
“As soon as there is suspicion, the necessary tests should be carried out and no time should be lost,” the pediatrician said.
Early diagnosis and treatment can significantly reduce the risk of complications. The WHO recommends prompt testing when diphtheria is suspected and advises starting treatment without unnecessarily waiting for confirmation when the clinical situation warrants it.
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Treatment includes antibiotics and, depending on the situation, diphtheria antitoxin, which is intended to neutralize the circulating toxin.
People who have been in contact with an infected person may also receive preventive care and have their vaccination status checked.
“The treatment exists and it is more effective when administered early. However, when a patient arrives already suffering from suffocation or cardiac complications, treatment becomes much more difficult,” Dr. Lahlou warned.
For the doctor, prevention remains the best protection.
“Vaccination is the best protection against this disease. We must continue to vaccinate children, follow the booster schedule and not wait for several cases to reappear before remembering that diphtheria can be serious,” he concluded.
