Cholera outbreak in Nigeria
The Nigeria Centre for Disease Control and Prevention (NCDC) reports 2,809 suspected cholera cases and 82 deaths from the suspected cases reported (CFR 2.9%) through July 7 this year from 33 states. This includes 1,614 cases and 41 deaths reported in June alone.
82 deaths from the suspected cases were reported (CFR 2.9%).
NCDC issued a public health advisory for cholera on June 11.
Of the suspected cases since the beginning of the year, age groups <5 years are mostly affected, followed by the age groups 25 - 34 years.
Lagos state (1,560 cases) accounts for 56% of all suspected cases in the country of the 33 States that have reported cases of cholera.
Lagos Island LGA (295 cases) in Lagos State accounts for 11% of all suspected cases reported in the country.
Other States; Bayelsa (476 cases), Ebonyi (110), Abia (109), Katsina (88 cases), Zamfara (64 cases), Delta (64 cases), Bauchi (54 cases), Cross river (43 cases), Rivers (37 cases), Imo (28), Ogun (21), Nasarawa (19 cases), Kano (18), Ondo (17 cases), Oyo (15), Niger (15), Osun (11 cases) and Akwa Ibom (10) account for 42.7% of the suspected cases this year.
The following response activities are in place to include: Activation of EOC; A team was deployed to Lagos to assess the situation and came up with gaps in the response; Ongoing surveillance in all states through routine Integrated Disease Surveillance and Response (IDSR) and Event-Based Surveillance (EBS); Collect samples of all water sources and food samples in all the affected LGAs. Inspect water production facilities and collect environmental samples; Hygiene promotion, provision of safe water, water chlorination, household disinfection and sensitization on dangers of open defecation ongoing in high-risk communities by WASH sector partners and Community Health Volunteers in the affected states; Continuous construction of sanitation and hygiene facilities with boreholes in cholera hotspots; Risk communication and epi monitoring to guide ICG requests for planned vaccination campaigns.
There are a number of challenges health officials are facing to include Difficulty in accessing some communities due to security concerns; Open defecation in affected communities and Lack of potable drinking water in some rural areas and urban slums.
Cholera is a food and water-borne disease, caused by the ingestion of the organism Vibrio cholerae in contaminated water and food. Water is usually contaminated by the feces of infected individuals. Contamination of drinking water can occur at the source, during transportation, or during storage at home. Food may be contaminated by soiled hands, either during preparation or while eating.
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Beverages prepared with contaminated water and sold by street vendors, ice, and even commercial bottled water have been implicated as vehicles of transmission, as have cooked vegetables and fruits freshened with untreated wastewater. The time between infection and the appearance of symptoms is 2 hours to 5 days. It has a higher risk of transmission in areas that lack adequate sanitation facilities and/or a regular supply of clean water. Unsafe practices such as improper disposal of refuse and open defecation endanger the safety of water used for drinking and personal use.
Symptoms of cholera include acute profuse, painless watery diarrhea (rice water stools) of sudden onset, with or without vomiting. It may be associated with nausea, profuse vomiting and fever. Severe cases can lead to death within hours due to dehydration (massive body fluid loss). However, most infected people (about 80%) may only show mild symptoms or have no symptoms at all.
The disease is easily treatable if detected early. Most infected people can be treated successfully through prompt administration of oral rehydration solution (ORS), to replace lost fluids and electrolytes, and appropriate antibiotics. Cholera can be deadly when infected people do not access care immediately.
Cholera can be prevented through ensuring access to safe, potable drinking water; proper sanitation and waste disposal; and appropriate hygiene including handwashing. Raw fruits and vegetables, food from street vendors, and raw or undercooked seafood should be avoided.
To reduce the risk of cholera, the NCDC offers the following advice:
• Ensure that water is boiled and stored in a clean and covered container before drinking.
• Practice good personal hand hygiene by washing your hands frequently with soap under clean running water. Use alcohol-based hand sanitizer if soap and clean water are not available.
• Ensure that food is well cooked before consumption. Only consume raw food such as fruits and vegetables, after washing thoroughly with safe water. After cooking food or boiling water, protect against contamination by flies and unsanitary handling; left over foods should be thoroughly reheated before ingestion. Persons with diarrhea should not prepare or serve food or haul water for others.
• Avoid open defecation, indiscriminate refuse dumping, ensure proper disposal of waste and frequent clearing of sewage.
• If you or anyone you know experience sudden watery diarrhoea, please do not self-medicate, visit a healthcare facility immediately.
Since the beginning of the year, more than 120,000 total cases (confirmed, probable and suspected) and 1,857 deaths have been reported from 16 African Union Member states.