With the new cases, Dak Nong now has 25 cases, Kon Tum 23, Gia Lai 16 while Dak Lak has reported its first case.

Four control checkpoints have been erected in Bong Hiot Village of Dak Doa District, Gia Lai, to prevent the 1,400 villagers, all of the Ba Na ethnic group, entry or exit. A four-year-old boy from the village succumbed to diphtheria on Sunday after two days of treatment.

The villagers, often toiling in their fields by day, now remain home awaiting medicine and further instructions on preventing diphtheria.

"I forbid my three children from leaving the house, occasionally letting them go to their grandmother's to play," said Nhap, 33, while looking across at where the four-year-old boy's family was busy organizing his funeral.

Half a month ago, Nhap and his wife used to tend their field early each morning, leaving their sons aged between two and nine playing at home.

Now, the family lives in constant fear.

"Since the village was placed under lockdown Sunday, we have only ventured out to a nearby grocery store to buy some necessities," he said.

Mai Thi Nhung, an official in Dak Doa District, said the deceased boy developed symptoms of fever, coughing and a sore throat before visiting relatives in Kon Tum Province.

"It remains unclear whether he was infected in Kon Tum or not," Nhung said.

In the wake of the fast-spreading disease, health authorities in Gia Lai Province on Tuesday proposed the Ministry of Health vaccinate all 100,000 district residents. The province's vaccination rate is 92 percent.

Nearly 1,000 students in the district have been allowed to stay at home for a week since Monday amid the ongoing diphtheria crisis.

Officers stand guard at a disease control checkpoint at Bong Hiot village in Gia Lai
Province which has been hit by a series of diphtheria infections, July 6, 2020.
Photo by VnExpress/Tran Hoa.

About 300 km south of Gia Lai Province lies Dak Nong Province where the diphtheria outbreak hit over a month ago with 25 infections including two deaths reported last month.

The health ministry has ordered local authorities in the Central Highlands to take more drastic steps to prevent the spread of diphtheria, as well as boost treatment capacity to minimize fatalities.

Infections must be promptly recorded and treated, while those having contact with patients must be quarantined, the ministry stressed.

Officials in Dak Nong Province were asked to prepare sufficient isolation facilities and improve the capacity of health workers regarding diagnosis and treatment of the disease.

A medical staff takes samples from a woman in Dak Nong Province for diphtheria testing,
June 2020. Photo by VnExpress/Tran Hoa.

Diphtheria, which can be prevented with vaccination, is an infection caused by the Corynebacterium diphtheria bacterium. It spreads through air and direct contact.

Symptoms include fever, a sore throat, swallowing difficulties, and white patches in the throat that could block the airway. Complications include myocarditis, kidney problems, respiratory failure, inflammation of nerves, coma, and death.

Low vaccination rate has been blamed for the repeated crisis in the Central Highlands. The General Department of Preventive Medicine under the health ministry said on June 26 the vaccination rate for diphtheria in the region was just 48-50 percent, leaving it susceptible to repeated outbreaks.

In Vietnam, children under two are given free five-in-one vaccine shots that include diphtheria.