Nigeria Centre for Disease Control and Prevention (2024)

STOP CHOLERA: Public Health Advisory

Wednesday, June 12, 2024

The Nigeria Centre for Disease Control and Prevention (NCDC) hereby alerts the public of the increasing trend of cholera cases across the country as the raining season intensifies. An outbreak in Lagos State has recently been reported.

From the 1st of January to the 11th of June 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 10 states that contributed 90% to the burden of cholera include Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa and Lagos States.

The multi-sectoral National Cholera Technical Working Group, led by the Nigeria Centre for Disease Control and Prevention (NCDC) and comprising the Federal Ministries of Environment and Water Resources, the National Primary Health Care Development Agency (NPHCDA), the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and other partners, has been providing support to the affected states. This support includes risk communication, active case search, laboratory diagnosis, case management, provision of response commodities, water sanitation and hygiene (WASH) interventions, and dissemination of Cholera awareness jingles in both English and local languages.

ABOUT CHOLERA

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 during 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 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.

People most at risk are:

• 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

• People who consume potentially contaminated food or fruits without washing and cooking properly

• People who do not perform hand hygiene at appropriate times

• Man-made or natural disasters like flood 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.

SYMPTOMS OF CHOLERA

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%) may only show mild symptoms or have no symptoms at all.

CHOLERA TREATMENT

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. The ORS solution is a powder that can be reconstituted in boiled or bottled water. Cholera can be deadly when infected people do not access care immediately.

CHOLERA PREVENTION

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.

ADVICE TO THE PUBLIC

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 diarrhoea 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.

ADVICE TO THE HEALTH WORKERS

• Healthcare workers are advised to always practice standard safety precaution i.e., wearing gloves while handling patients or providing care to an ill patient/relative.

• Intensify surveillance efforts to promptly report suspected cholera cases.

ADVICE TO STATE GOVERNMENTS

NCDC continues to advocate to State Governments to prioritize 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.

About NCDC

The Nigeria Centre for Disease Control and Prevention (NCDC) is the country's national public health institute, with the mandate to lead the preparedness, detection, and response to public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018, by President Muhammadu Buhari. The mission of the NCDC is 'To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response, using a One Health approach, guided by research and led by skilled workforce'.

Contact

Signed:

Dr Jide Idris

Director General

Nigeria Centre for Disease Control and Prevention.