From Fred Ezeh, Abuja, Laide Raheem, Abeokuta and Doris Obinna,
The Nigeria Centre for Disease Control (NCDC) has confirmed that death from cholera outbreak has risen to 54 and spread to 31 states.
Director General, Jide Idris, at a press conference in Abuja, yesterday, disclosed that as at June 24, 1,528 suspected cases and 53 deaths had been recorded across 107 local government areas with a case fatality rate of 3.5 per cent since the beginning of the year.
“These fatalities are not just statistics but a significant loss of a loved family member, a spouse, a parent, and often a seasoned healthcare worker and team member. This situation might be compounded as the rainy season intensifies.”
Consequently, it has declared cholera a public health emergency after its risk assessment showed the country is now at ‘High Risk’ of increased risk of cholera transmission and impact.
“This demands immediate and coordinated actions, and, therefore, necessitated the recent activation of the National Cholera Multi-Sectoral Emergency Operations Centre (EOC) which underscored the gravity of the situation and the unwavering commitment of the stakeholders to protect the health and well-being of every Nigerian,” he said.
Idris explained that the EOC would serve as the nerve centre for the coordination of response across the country, and will also support affected states to facilitate rapid communication, data analysis, and decision-making processes, mobilise resources, expertise, and support from across the NCDC, partners, and stakeholders at all levels of government.
“It will ensure efficient deployment of needed resources, strengthen surveillance and diagnostic capacity and capabilities, enhance case management, training and intensify public awareness and community engagement activities.”
He called on all stakeholders, notably, government agencies, subnational level actors, partners, civil society organisations, healthcare professionals, community leaders, and every citizen to stem the tide of the outbreak and redouble their efforts to contain the spread and prevent further loss of lives.
He also reminded health workers of the need to always practice standard safety precautions, particularly the practice of wearing gloves while handling patients or providing care to an ill patient/relative, and also intensify surveillance efforts to promptly report suspected cholera cases.
In Lagos, the Commissioner for Health, Akin Abayomi, said fatalities have risen to 29 deaths and 579 suspected cases across multiple local government areas.
At a state multiagency news briefing and update on cholera outbreak, he disclosed laboratory confirmation of 43 cases, noting that Lagos Island, Kosofe and Eti Osa recorded the highest numbers of infections.
“Most of these deaths were caused by patients presenting very late at a stage where we could not resuscitate them because they had severe dehydration, and many patients were actually brought in dead. Out of all the samples we were able to collect, we were able to identify vibrio cholera. So, this is, indeed, a confirmed case of the cholera outbreak by a subtype O1 that is known to us to be very contagious and to cause significant sickness in those that contract it.
“Many children came down with cholera, many students, lots of traders, and artisans. Those were the predominant cases and these we suspect are people that are in crowded areas,” he said
According to him, the state recorded severe cases that led to fatalities due to severe dehydration, while some were resuscitated at the Infectious Disease Hospital, Yaba.
“In some of these cases, their kidneys had shut down from the severe dehydration and at that facility, we had access to renal dialysis; so, we were able to wake the kidneys back up with renal dialysis and rehydrate them. Those are the kinds of cases that we still have on admission because they were very, very severe. We were able to rescue them from dying,” he said.
The commissioner added that 30 patients were left on admission as of June 23, noting that the cases were declining in the state.
On the distribution of cases based on visitation to health facilities, Abayomi disclosed 209 visited general hospitals; 193 primary healthcare centres; 152 private hospitals, military/police hospital 14, tertiary hospital eight and unknown 12.
Abayomi advised citizens to seek medical attention immediately if they experience symptoms such as diarrhoea, vomiting, abdominal pain, general malaise and fever.
He stressed that immediate action on rehydration was key to survival, adding that oral rehydration salts should be promptly introduced.
The commissioner added that treatment for cholera was provided free of charge at all public health facilities in the state.
On prevention measures, Abayomi advised citizens to always drink safe boiled, treated, or bottled water and eat food that’s thoroughly cooked and hot, and avoid raw foods.
Meanwhile, Ogun State government has confirmed one person dead while nine new cases have been recorded in the state.
Commissioner for Health, Tomi Coker, told newsmen in Abeokuta, yesterday, that there were 25 suspected cases in seven local government areas.
She listed Ado-Odo/Ota, Remo North, Odeda, Sagamu, Ijebu North, Ewekoro, and Obafemi Owode councils where the suspected cases have been recorded.
She equally identified Abeokuta South, Abeokuta North, Ijebu North, Obafemi Owode, Ifo, and Ado-Odo/Ota councils as high-risk and hotspots for cholera outbreaks.
She said the fluidity of movement of people from Ogun to the neighbouring Lagos State, which is the epicentre of cholera outbreak has made the spread of diseases across Ogun borders a major public health threat, hence, the need for the state to put preventative measures in place.
She recalled that the state received an alert on June 12, 2024, about the first two cases that were tested positive with a cholera rapid diagnostic kit and were managed at the state hospital, Ota.
Coker added that the two cases had travel history to Lagos State 24 hours prior to presentation.
She, however, disclosed the state has nine confirmed cases and has recorded one death, pointing out that the development has made it imperative to declare an ongoing cholera outbreak in Ogun State.
“Prior to this outbreak, as part of the state preparedness, a robust surveillance system was in place in all 20 local government authorities which ensured prompt detection of cases. The initial eight cases originated from Lagos State, the reported epicentre of the cholera outbreak and a state that shares a border with four of our local governments. The eight cases had travel history to Lagos and six of them reported taking tiger nut drinks while in Lagos.
“Furthermore, we also promptly diagnosed cholera in five of the contacts of the patients with a travel history to Lagos State.
“To support the state response, the state epidemiology unit is on high alert. All council disease surveillance and notification officers (DSNO) have also intensified surveillance across all 20 councils.
“Our private health facilities and citizens have been sensitised to heighten their index of suspicion and report any suspected case immediately to the council DSNO, and the state response team by calling the following phone numbers 08038642812, 07034214893, and 08084250881.
“All our 20 councils have trained rapid-response teams ready to respond to calls at short notice in collaboration with Ogun State Emergency and Ambulance Service.
“Also, cholera test kits and other consumables needed for treatment have been distributed to all councils and designated treatment centres to ensure prompt diagnosis and treatment,” she said.
Also, Commissioner for Environment, Ola Oresanya, said no fewer than 60 public toilets had been constructed by the ministry in communities that lack toilets, as part of prevention of cholera outbreak in Ogun.
He said the ministry had mandated all eateries, banks, malls, and fuel stations, to make their toilets available for public use to prevent open defecation.
Intensify environmental surveillance
The Federal Government has urged states and local governments to scale-up environmental health surveillance in places where food and drinks are sold nationwide.
The places include markets, garages, schools, restaurants, stadia, religious and sporting events venues.
Minister of State for Environment, Iziaq Salako, in a statement in Abuja, said the measures would help avert further spread and transmission of cholera, as well as aid in the prevention and control of the disease.
He also urged all commissioners for environment and the local government chairpersons to support environmental health officers across the country to step up sanitation and hygiene activities through enhanced community-led total sanitation.
According to him, it is also to strengthen collaboration with the health authorities and other stakeholders in line with the one health approach of the Federal Government.
The minister said arrangements had been made to support most affected states with chlorine solution or tablets, water and food testing resources to avert further transmission across the country.
“The ministry has been actively involved through the Department of Pollution Control and Environmental Health Council of Nigeria in activities to curtail further transmission of the deadly disease.
“The ministry has been involved through water and food testing to identify sources of infection, environmental sanitation campaigns and household water chlorination,” he said.
The minister identified cholera as a poor sanitation and hygiene driven disease and an acute diarrhoea infection caused by ingestion of unwholesome food or water contaminated with the bacterium vibrio cholera.
Salako said the disease remained a global threat to public health, affecting both children and adults and could lead to death if untreated promptly.
He further identified it as an extremely virulent disease that takes the period of 12 hours and five days for its symptoms to manifest.
Minister tasks principals on measures to curtail outbreak
Minister of State for Education, Yusuf Sununu, has tasked principals of Federal Unity Colleges (FUCs) to put in place necessary measures to curtail the outbreak of cholera disease.
Speaking in Abuja at an interactive session with all principals FUCs, the minister urged them to tackle the spread of the disease in their various schools and as well detect early signs of the outbreak.
“The country is challenged with a cholera outbreak and it is the responsibility of all principals to put in place necessary measures to detect early signs.
“This is to ensure it does not get to our schools. Any issue must be communicated to the ministry, so that our schools will be protected. It is a collective effort to ensure hygiene in our schools as this will help the government to curtail the outbreak,” he said.
Sununu also charged the principals to ensure professionalisation in the teaching profession, by ensuring all teachers within their domain get certification from Teachers Registration Council of Nigeria.
According to him, many staff of the Federal Government colleges have not regularised their certificate.
He, therefore, called on the principals to encourage their teachers to renew their annual practicing licences, noting that they would be termed as quacks for failing to do so.
Also, Idowu Akinbamijo, principal, Federal Science and Technical College (FSTC), Ilesa, said there were moves to secure the colleges.
Akinbamijo said measures had been taken to secure the schools in terms of security of lives and properties as well as the health situations.
She canvassed the employment of more teachers, especially in critical trade subjects’ areas.
“We cannot afford an outbreak of any such in our colleges. So, all principals are giving the marching orders and we are all set. Our staff members need to be increased, we are seriously lacking critical subject areas and we need teachers that can do this. This is something that will go far beyond the ministry; it has to do with the teacher production methods. More students have to be admitted into the colleges of education and universities to be trained as teachers and more of them should be deployed to teach and not find their ways in other professions,” she said.