Nigeria Declares Health Emergency Over Cholera Outbreak

Nigeria’s federal government, on Monday, activated the National Cholera Multi-Sectoral Emergency Operations Centre (EOC) following the threat of cholera epidemic in the country.

The government said as of June 24, 1, 528 suspected cases and 53 deaths had been recorded across 31 states and 107 local government areas. It put the fatality rate at 3.5 per cent since the beginning of the year.

Director General of Nigeria Centre for Disease Control (NCDC), Dr. Jide Idris, made the revelations while addressing journalists in Abuja.

The revelations came as Ogun State, on Monday, confirmed nine out of 25 suspected cases of cholera infection, with one death recorded as at June 24. The Commissioner for Health, Dr. Tomi Coker, disclosed this at a press conference in Abeokuta. Coker said efforts were in top gear to establish the actual status of the 16 cases still under close monitoring.

NCDC said the outcome of a risk assessment by the centre placed Nigeria at “High Risk” of cholera transmission and impact.

Addressing journalists in Abuja, Idris said the country faced another public health emergency after coming out of Lassa fever and Meningitis outbreaks.

As part of interventions to arrest a cholera epidemic, Idris said NCDC was embarking on a coordinated approach with the states to identify and deal with the disease spread in the affected areas.

He said NCDC will be reaching out to other stakeholders, including state governors, to try to find a lasting solution to the causative factors behind the cholera outbreak in the country.

Idris stated, “In response to the rapidly increasing cholera cases, a dynamic risk assessment was conducted by subject matter experts on cholera outbreak situation in Nigeria last week.

“The subject matter experts were drawn from relevant ministries (Health, Environment, Agriculture, Water Resources, etc.), departments, agencies, stakeholders, and major partners. The outcome of the risk assessment placed the country at ‘High Risk’ of increased risk of cholera transmission and impact. This demands our immediate and coordinated actions and, therefore, necessitated the activation of the National Cholera Multi-Sectoral Emergency Operations Centre (EOC) in Nigeria today.”

Cholera, a highly contagious food and waterborne disease, has recently erupted in several states across our country. It is caused by the ingestion of the organism, Vibrio Cholerae, in contaminated water and food.

While providing an update on the cholera epidemiological situation in Nigeria and ongoing prevention and response efforts at the national and subnational levels, the NCDC director-general said, “The decision to activate the Cholera EOC underscores the gravity of the situation and our unwavering commitment to protect the health and well-being of every Nigerian.”

He said the fatalities were not just statistics but significant loss of loved family members, and often seasoned healthcare workers and team members. He said the situation might be compounded as the rainy season intensified.

Idris said the EOC will serve as the nerve centre for the coordination of response across the country.

He said the emergency centre will also support affected states, 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.

Idris said the centre 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.

Idris further said an incident manager had been appointed, who “will coordinate the day-to-day activities involving several pillars, such as surveillance (data collection, analysis and dissemination), case management, oral cholera vaccine issues, coordination, Infection Prevention and Control (IPC), Logistics support, and Research.”

Prior to the activation of EOC, the NCDC, through the National Cholera Technical Working Group had carried out various prevention and response efforts including; repositioning and distribution of medical supplies for case management, infection prevention, and control, laboratory diagnosis, etc. to all 36 plus one states.

It also undertook provisioning of offsite/onsite support to states (e.g. Lagos and Ogun) and follow up for daily reporting and progress with response activities.

Meanwhile, Coker disclosed measures being taken by the Ogun State government to curtail the spread of the disease, at the press conference she addressed alongside the Commissioner for Environment, Mr. Ola Oresanya.

Others at the news conference were Special Adviser to the Governor on Media and Strategy; General Manager of the State Water Corporation, Mrs. Muinat Jaji; and the representative of the Commissioner for Education, Mr Olumide Majekodunmi.

Coker explained that the 25 suspected cases were recorded in seven local government areas of Abeokuta North, Abeokuta South, Ado Odó/Ota, Remo North, Odeda, Sagamu, Ijebu North, Ewekoro, and Obafemi-Owode.

The commissioner stated that the nine confirmed cases were traced to consumption of Tigernut milk by the victims, who had a history of traveling from Lagos State to Ogun State.

Coker further disclosed that the state had witnessed an upsurge in the outbreak of the cholera within the past 72 hours.

She said prior to the outbreak, as part of the state’s preparedness, a robust surveillance system was in place in all 20 local government areas to ensure prompt detection of cases.

Coker further said in support of the state’s response, its Epidemiology Unit was put on high alert. She added that local government Disease Surveillance and Notification Officers had also intensified surveillance across all 20 council areas in the state.

According to the health commissioner, “Our private health facilities and citizens have been sensitised to heighten their index of suspicion and report any suspected case immediately to the LGA DSNO, and the state response team by calling the following phone numbers 08038642812, 07034214893, and 08084250881.

“All our 20 LGAs 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 LGAs and designated treatment centres to ensure prompt diagnosis and treatment. The treatment of Cholera is free across all government facilities in Ogun State.

“Ogun State Ministry of Health is coordinating this outbreak response in collaboration with stakeholders from the Ministry of Environment, Information, and Education, WES at the LGA (water, environment, and sanitation), RUWATSAN (Rural water and sanitation), water cooperation, private hospital owners, emergency services (OGSAES) and partners.”

 The commissioner said the Emergency Operations Centre activated earlier was now in the response mode, tracking evolving situations and acting accordingly. She said some local government areas had been identified as high-risk.

Coker stated, “As a way of warning, the risk factors for cholera include eating contaminated food and drink, unhygienic sanitary conditions, and poor personal hygiene.

“Cholera can cause severe acute watery diarrhoea, which can kill within hours if left untreated. It takes between 12 hours and 5 days for a person to show symptoms.

“The prevention and control of cholera in a multifaceted approach is key with a combination of surveillance, potable water, sanitation and hygiene, social mobilisation, treatment, and oral cholera vaccines are used.”

Also speaking, the Commissioner for Environment, Mr. Ola Oresanya, said the ministry was committed to curtailing the spread of the disease.

Since cases of open defecation and drinking of contaminated water had been identified as causes of cholera, Oresanya said government had embarked on testing of wells and boreholes, while eateries and filling stations had been directed to open their facilities to members of the public.

Oresanya further advised members of the public to approach the ministry if in doubt of the source of water they wanted to drink, including sachet water.

Onyebuchi Ezigbo and James Sowole

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