Cholera: 30 deaths,1,141 cases recorded as NCDC warns against nationwide outbreaks

The Nigeria Centre for Disease Control and Prevention has warned the public about a likely increase in cholera outbreaks across the country as the rainy season intensifies.

The NCDC, in a statement on Thursday, signed by its Director General, Dr Jide Idris, said from January 1st to June 11th, 2024, a total of 1,141 suspected and 65 confirmed cases of cholera with 30 deaths have been reported from 96 LGAs in 30 states.

The centre noted that the 10 states that contributed more to the burden of cholera include Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos states.

It, however, stated that a multi-sectoral National Cholera Technical Working Group, led by the centre and comprising the Federal Ministries of Environment and Water Resources, the National Primary Health Care Development Agency, the World Health Organisation, the United Nations Children’s Fund, and other partners, have been providing support to the affected states.

He stated, “This support includes risk communication, active case search, laboratory diagnosis, case management, provision of response commodities, water sanitation and hygiene interventions, and dissemination of Cholera awareness jingles in English and local languages.”

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 faeces of infected individuals.

Contamination of drinking water can occur at the source, during transportation, or storage at home.

Food may be contaminated by soiled hands, either during preparation or while eating.

“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 two hours to five days. It has a higher risk of transmission in areas that lack adequate sanitation facilities and 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,” NCDC highlighted.

Symptoms of cholera include acute profuse, painless watery diarrhoea (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 per cent) may only show mild symptoms or have no symptoms at all.

The NCDC listed those most at risk of cholera to include people of all ages living in places with limited access to clean water; people living in areas with poor sanitation and poor hygiene; people living in slum areas where basic water or sanitation infrastructure is missing; people living in rural areas who depend on surface water or unsafe piped or borehole well water sources for drinking, and people who consume potentially contaminated food or fruits without washing and cooking properly.

Others are people who do not observe hand hygiene at appropriate times, man-made or natural disasters like floods resulting in population movements and overcrowded refugee camps, relatives who care for sick people with cholera at home, healthcare workers including doctors, nurses, and other health workers who provide direct patient care in the absence of standard precautions.

It also said the disease is easily treatable if detected early as most infected people can be treated successfully through prompt administration of oral rehydration solution, to replace lost fluids and electrolytes, and appropriate antibiotics.

NCDC informed that cholera can be prevented by ensuring easy access to safe, potable drinking water; proper sanitation and waste disposal; and appropriate hygiene including handwashing.

To reduce the risk of cholera, the NCDC advised the public to ensure that water is boiled and stored in a clean and covered container before drinking, and to practice good personal hand hygiene by washing hands frequently with soap under clean running water, using alcohol-based hand sanitiser if soap and clean water are not available.

It also advised ensuring that food is well cooked before consumption, protecting food and water against contamination by flies and unsanitary handling; reheating leftover foods before ingestion, avoiding open defecation, indiscriminate refuse dumping, and proper disposal of waste and frequent clearing of sewage.

It advised healthcare workers to practice standard safety precautions and intensify surveillance efforts to report suspected cholera cases.

NCDC also urged the state governments to prioritise action for solutions that ensure access to and use of safe water, basic sanitation, and proper hygiene practices in communities.

“As the NCDC continues to work with partners to lead the health-sector response to cholera outbreaks, we call for an urgent improvement in access to clean water, proper sanitation, and hygiene,” it added.

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