Medical experts have warned that the latest cholera outbreak may spread to many communities and states in the country during the Eid-el-Kabir celebration if necessary measures were not quickly taken to limit the spread of the acute diarrhoeal infection.

The experts said the increase in travel over the holiday season might result in a rise in cholera cases.

This comes as the Lagos State Government confirmed 15 deaths from the infection.

Cholera is a food and water-borne disease caused by the ingestion of the bacteria— Vibrio cholerae— in contaminated water and food.

The Nigeria Centre for Disease Control and Prevention also warned the public of the increasing trend of cholera cases across the country as the rainy season intensifies.

The centre stated that from January 1 to June 11, 2024, over 1,141 suspected and over 65 confirmed cases of cholera, resulting in over 30 deaths, had been reported from 96 LGAs in 30 states.

It noted that the 10 states contributing 90 per cent to the burden of cholera include Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos states.

In Nigeria, cholera is an endemic and seasonal disease, occurring annually mostly during the rainy season and more frequently in areas with poor sanitation.

There were 473,000 cholera cases reported to WHO in 2022 – double the number from 2021. A further increase of cases by 700,000 was estimated in 2023.

The latest data from the World Health Organisation showed that a cumulative total of 145,900 cholera cases and 1,766 deaths were reported from 24 countries across five WHO regions, with Africa recording the highest numbers, followed by the Eastern Mediterranean Region, the Region of the Americas, the South-East Asia Region, and the European Region.

Speaking on the possibility of further spread during the Sallah celebration, the President of the Nigerian Association of Resident Doctors, Dr Dele Abdullahi, stated that the surge in holiday season travel could lead to an increase in cholera cases.

Abdullahi said, “Cholera is a bacterial infection, so there is a possibility of it spreading to other states during the festive season.

“Because of the Sallah celebration, a lot of migration is going to occur. People will move from one place to the other, and many of them, possibly in the incubation period, will change location. The key here is for our healthcare facilities to maintain a high index of suspicion when they encounter any cases of vomiting and diarrhoea.

“I am confident that the outbreak will not spoil the Sallah celebration,” he added.

To curb the spread, the NARD President stressed the need to maintain optimal and high standards of hygiene.

“We need a high index of suspicion. Whenever we encounter patients with vomiting, we must quickly take them to health facilities. It is better to arrive there and find out that it’s just food poisoning than to be uncertain about the health condition we’re dealing with.

“People should also avoid self-medication and refrain from using unorthodox methods to manage their health issues at home. All these measures will help in curbing the spread of the disease,” he said.

Also, a former Chairman of the Association of Private Medical Practitioners of Nigeria, Dr Tunji Akintade, said, “If someone with the disease travels without taking care of themselves and defecates in an open place, their faeces could contaminate water sources and infect others. Thus, there is a possibility of the disease spreading due to its transmission through water and poor hygiene.”

Akintade further emphasised that individuals who maintained good personal and environmental hygiene and were mindful of what and where they ate were less likely to be infected.

“If I live in the same house with someone who has cholera but we’re not eating the same things, and I’m careful about what I consume, I may not contract it. Therefore, when people travel, it’s crucial to advise them against drinking water from areas where cases have been reported.

“People need to maintain good hygiene, wash their hands after using the toilet, and ensure their surroundings are clean,” he concluded.

Also, a consultant family physician and Head of Department, Family Medicine Department at the University of Ilorin, Kwara State, Dr Ibrahim Kuranga-Suleiman, affirmed that the infection could spread as people travelled if precautionary measures were neglected.

Kuranga-Suleiman said, “The disease may spread during the Sallah period. To curb this, we must enhance our hygiene practices and ensure fruits are thoroughly washed and foods well-cooked. Even the water we drink must be sourced from safe and clean sources.

“By taking these precautions, we can prevent not only cholera but also travel-related diarrhoea, which is common among travellers.”

NCDC urges prevention

Speaking on a programme on Channels Television on Saturday, the Director General of the NCDC, Dr Jide Idris, stressed that prevention was key in fighting the disease.

Idris noted that as the rainy season intensified, there were possibilities of increasing cases of cholera in the country.

“The Nigerian Meteorological Agency has said that the rains this year are going to be heavier, and when you have rains, you’re going to have floods, and this leads to contamination of our water sources, so the chances are that cholera cases will increase.”

The DG, who blamed the outbreak of the infection on poor sanitation, personal and environmental hygiene, and lack of access to clean water, noted that the agency was conducting a risk assessment and had alerted all the states about the outbreak.

“To me, it’s a disease that is related to basic sanitation. My observation is that prevention is very weak, which also strengthens your point that we seem to have forgotten the need for prevention, or are not taking it very seriously. In a situation where resources are limited, I think that’s the best approach.

“If you go back to this cholera case, it’s a problem of poor sanitation and good personal and environmental hygiene, as well as lack of access to water. The easiest way to ensure good personal hygiene is hand-washing, especially after using the toilet and before cooking your food.

“But in a situation where people are told to practice hand-washing and there’s no access to water, it’s a problem. So, I think everybody, including the Federal Government, state governments, different agencies, local governments, and even the community, have to come together.”

The DG said the state governments must ensure access to clean water and toilets for their citizens.

1. Operatives of the Abia State Police Command have rescued three abducted children from their abductors in Anambra and Delta States. The command’s spokesperson, ASP Maureen Chinaka, disclosed this in a statement on Saturday, adding that the rescue mission led to the arrest of five suspects, including a Reverend Sister.

2. Nasarawa State Governor, Abdullahi Sule has vowed to flush out criminals, terrorists and bandits in the state. Governor Sule stated this on Saturday in a statement he personally signed on his Eid-El-Kabir festival message to the people of Nasarawa State.

3. Kano State Government on Saturday expressed concern over how the Police command in the State has been disobeying the “legitimate instructions” of Governor Abba Kabir Yusuf, the Chief Security Officer of the State. Attorney General and Commissioner of Justice, Haruna Isah Dederi, while addressing journalists on Saturday rejected the ban on Eid-el-Kabir festivities in Kano State.

4. Former national chairman of the All Progressives Congress (APC) and ex-governor of Edo State, Sen. Adams Oshiomhole, has promised to ensure the victory of the party during the September 21 governorship election. Oshiomhole, who represents Edo North Senatorial District at the National Assembly, made the remark while inaugurating the Party’s Campaign Council for the election.

5. President Bola Tinubu has directed Mr. Mamman Ahmadu to resign from office as the Director-General/Chief Executive Officer of the Bureau of Public Procurement (BPP). Ajuri Ngelale, Special Adviser to the President on Media and Publicity, made this known in a statement on Saturday.

6. President Bola Tinubu has described the Eid-el-Kabir as an event that denotes sacrifice, faith and Obedience to the will of the Almighty and promised Nigerians that their sacrifice will not come to nought. The President who called on Nigerians to reflect on the teachings of Sacrifice and unity, reassured that his administration is prioritizing their social, economic well-being.

7. Police officers from the Federal Capital Territory have killed a bandit and arrested three others during a clearance operation. The police during the operation stormed an identified hideout of kidnappers in Chikara, a community that shares a border with Kogi State.

8. Zamfara State Government has commenced the payment of N30,000 minimum wage to workers in the Northwest state. This followed a meeting the state governor, Dauda Lawal, held with the leadership of labour unions where he pledged to commence the payment of the minimum wage in June.

9. A Jigawa State High Court sitting in Birnin Kudu on Friday sentenced two persons to death for conspiring and killing one Yakubu Ibrahim and dumping his dead body by the roadside. The suspects were arraigned before the court for conspiring and robbing the deceased of his phone, money and taking away his car, after killing him.

10. About three persons, including foreigners, have been abducted by armed men suspected to be kidnappers in Lagos State. It was gathered that the victims include the Managing Director of Fouani Company and three other Lebanese nationals.

Cholera has killed 15 persons in Lagos State with 350 suspected cases reported in the state.

The Lagos Ministry of Health said there are 17 confirmed cases of cholera in the state.

“Lagos State Commissioner for Health Professor Akin Abayomi, disclosed this while speaking on steps taken to control the outbreak in Lagos State. He revealed that 350 suspected cases of cholera were reported in 29 wards across multiple LGAs in Lagos State with 17 confirmed cases and 15 fatalities so far,” the ministry said in a Saturday statement.

It quoted Abayomi as saying, however, that the cases of cholera in the state are on a downward move.

“The laboratory investigation and test results have so far confirmed Cholera sub-type O-1. This subtype is associated with more severe disease. The pattern of new cases per day varies across LGAS, according to our ongoing surveillance and monitoring updates,” the health commissioner said in the statement signed by the ministry’s Director of Public Affairs Tunbosun Ogunbanwo.

“Although this is an increase from the numbers published three days ago, cases are now dramatically subsiding in previously affected LGAs due to our interventions and surveillance efforts, however, we are recording some new cases in previously unaffected LGAs, signalling the need for residents to adhere strictly to precautionary, personal, and environmental hygiene measures.”

Reporting Symptoms
He said, “inspections of facilities are ongoing. We are prepositioning cholera kits in health facilities across the State. Our efforts to control the outbreak also include the distribution of Oral Rehydration Solutions (ORS), and public health education campaigns”.

The commissioner called on residents of Lagos State to adhere strictly to precautionary measures, cooperate with health authorities, and participate in community-wide sanitation activities to mitigate the spread of cholera, particularly as the Eid-al-Adha celebration approaches.

“Reporting symptoms like watery diarrhea or vomiting immediately is also crucial, to save lives and prevent transmission to other members of the community,” he said. “Treatment for suspected cholera is provided free of charge at all government facilities as part of government’s standard public health response.”