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The Nigeria Centre for Disease Control and Prevention (NCDC) on Monday confirmed the outbreak of diphtheria disease in four states of the federation. The affected states are Kano, Yobe, Lagos, and Osun. The Director-General of NCDC, Dr. Ifedayo Adetifa, also disclosed that as at January 22, 2023, Nigeria had recorded 123 confirmed cases and 38 deaths across the country.
While Kano State had 100 confirmed cases and 32 deaths; Yobe State had 17 confirmed cases and three deaths. Lagos State recorded five confirmed cases and three deaths and Osun State had one confirmed case and no death. According to medical experts, diphtheria is a highly contagious and potentially life-threatening bacterial disease caused by Corynebacterium diphtheria.
The disease affects the tonsils, throat, larynx and nose. There are two types of diphtheria: respiratory and cutaneous. While respiratory diphtheria affects the nose, throat and tonsils, cutaneous diphtheria affects the skin. The disease affects mostly children and adults who do not have up-to-date vaccinations. It also affects people living in crowded and unsanitary conditions. It can equally affect anyone who travels to an area where diphtheria infections are common. Others at risk of contracting the disease include healthcare workers and others who are exposed to suspected and confirmed cases of diphtheria.
The symptoms of diphtheria include sore throat, fever, swollen lymph nodes, cough, runny nose, and weakness. Some of those affected may experience chills, fatigue, noisy breathing or shortness of breath and change of voice. Although the disease can be treated with medications, in advanced stages, diphtheria can damage the heart, kidneys and nervous system. It has also been established that even with treatment, diphtheria can be deadly, especially in children. Despite its deadly nature, diphtheria is both treatable and preventable with a vaccine.
The human-to-human transmission of the disease occurs through the air when an infected person coughs or sneezes. Also, breathing in particles released from the infected individual leads to infection. The government should ensure that the required vaccine for the disease and other medications are readily available. Let the routine immunisation exercise against the disease be intensified in all the 774 local government areas of the country.
To halt further spread of the disease, we urge parents to ensure that their children are fully vaccinated with the required doses of the pentavalent vaccine. At the same time, health workers are enjoined to be vigilant and look out for the symptoms of the disease. All health workers should be vaccinated against the disease. Although the NCDC is working with health officials in the affected states to contain the disease, it should do more to halt further spread of the disease to other states.
Therefore, ministries of health in all the states must work with the NCDC to enhance surveillance and response to the diphtheria outbreak. We urge the NCDC and health officials in the 36 states to create more awareness campaigns on the symptoms of the disease, preventive measures and how to access treatment.
Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has reportedly been adequately controlled, with an incidence of approximately 1000 cases reported yearly. Available statistics revealed that before the use of vaccination to treat diphtheria, at least 200,000 cases occurred annually in the United States (US).
Nevertheless, the disease has continued to cause illness globally and there have been reported outbreaks of diphtheria in some countries in recent years. Most of the outbreaks occurred in developing countries, especially in sub-Saharan Africa. In 2019, diphtheria caused 4,370 deaths globally. And most of these deaths occurred in children under the age of 5 in sub-Saharan Africa. In 2020, the World Health Organisation (WHO) reported 10,107 cases of diphtheria.
There were about 8,639 cases of diphtheria in the world in 2021. Ethiopia has the highest number of diphtheria cases in the world. As of 2021, Ethiopia had 4,453 cases or 51.55 per cent of the world’s diphtheria cases. Currently, the top five countries with the highest diphtheria cases in the world are Ethiopia, India, Yemen, Indonesia and Pakistan. These countries account for 94.24 per cent of the global diphtheria cases.
Apart from curtailing the spread of diphtheria, the government needs to pay serious attention to the resurgence of the COVID-19 pandemic, cholera, Lassa fever and other diseases still ravaging the country.
