There were indications Saturday that the spread of Cholera in the country is on the upward spiral.
At the last count, no fewer than 34 deaths had been recorded as the disease spreads to 31 states, with Lagos and Bayelsa as states with the highest number of infections.
Suspected cases nationwide now stand at 1,283.
The development has raised so much concern as to warrant calls in some quarters for declaration of a state of emergency, while the Nigeria Centre for Disease Control and Prevention (NCDC) has already activated its Emergency Operations Centre.
The Director-General of NCDC, Dr Jide Idris, told The Nation in an exclusive interview yesterday that the nation had recorded 34 deaths from confirmed and suspected cases of cholera outbreak in 15 states with a high burden of the disease between January and June 21, 2024.
While declaring that there is no cause for alarm over the outbreak of the epidemic in 31 states across the country, Idris said Lagos and Bayelsa states have the highest burden.
Based on this development, he said, the agency would commence an emergency operation centre on Monday.
Since June 12 when the last public health alert was raised by NCDC, the spread of the disease as well as the number of confirmed cases and deaths have risen.
According to the agency, about 1,141 cases of suspected cholera cases were recorded between January and June 11, 2024 while 65 have been confirmed.
As of June 12, 30 deaths were reported from 96 local government areas (LGAs) in 30 states, with 10 states (Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos) contributing 90 per cent to the burden of the disease.
By June 20, the figures had increased, with the breakdown showing that while Lagos has recorded the highest number of fatalities so far with 18 deaths, Bayelsa State had the highest number of confirmed cases with 466 and two deaths.
The DG of NCDC gave a breakdown of the spread and fatalities of the disease as follows:
Bayelsa: 466 confirmed cases, 2 deaths;
Lagos: 409 confirmed cases, 18 deaths;
Zamfara: 64 confirmed cases, 0 deaths;
Abia: 51 confirmed cases, 4 deaths;
Bauchi: 46 confirmed cases, 0 deaths;
Cross River: 42 confirmed cases, 1 death;
Ebonyi: 38 confirmed cases, 0 deaths;
Katsina: 34 confirmed cases, 3 deaths;
Delta: 34 confirmed cases, 4 deaths;
Imo: 28 confirmed cases, 0 deaths;
Nasarawa: 19 confirmed cases, 1 death;
Ondo: 17 confirmed cases, 0 deaths;
Kano: 13 confirmed cases, 1 death;
Niger: 11 confirmed cases, 0 deaths;
Osun: 11 confirmed cases, 0 deaths.
Total deaths: 34; confirmed cases: 1,288.
Noting that the 15 states are responsible for more than 80 per cent of the cases at hand, Idris said: “What we want to do now, based on the analysis before us, is convene an emergency operations center on Monday to show that we are not complacent about this.”
“Based on the risk assessment profile we were given on recognition of need, we will activate the Emergency Operation Centre on Monday.”
“We have appointed an Incident Manager, who will be responsible until it is eliminated. We will meet every day to look at the data and problems from all the affected states.
“On the response level, what we will do is concentrate more on the states mostly affected; those recording the highest number of cases and deaths, which is about 15 states that are responsible for a lot of these cases.
“At the same time, we try to support them as much as possible.”
He said commodities, including reagent consumables and technical personnel, have been sent to the high-risk states.
On the issue of the cholera vaccine, Idris said the public should not depend on the vaccine, adding that the agency responsible for vaccines could not have stockpiled it due to its early expiration period.
According to him, preventive measures by the public and the provision of public sanitary utilities by the government at sub-national levels should be emphasised.
The DG also corrected the impression that the figures ascribed to Bayelsa State were incorrect, saying that NCDC relies on states for its data.
“Here, our role is to support states, but we rely on their data collected from trained personnel epidemiologists, which we collate and analyse. This is what we have been doing for years.
“I personally called the state’s epidemiologist a couple of days ago about what is happening there because of the high number of cases from there because they are topping the list.”
“He did tell me that yes, they don’t have any recent cases; what they have are what have been recorded since the beginning of the year.
“That could be the reason for the number of fatalities, which is two, compared to confirmed cases of 466.
“So, Bayelsa can dispute the figures, but I rely on the figures given to me by my people and the people on the field.
“The state cannot say they don’t have cholera cases.”
He also explained that the agency would not create panic by issuing incessant alerts over the outbreak because it is a disease that can be prevented with personal hygiene observance.
He also added that commodities and the agency’s technical officers have been deployed to the states to assist in controlling the outbreak.
However, a source close to the National Primary Health Care Development Agency (NPHCDA), who pleaded anonymity, said the agency, though responsible for immunization and vaccine management in the country, could not have stockpiled cholera vaccine.
Noting that NPHCDA could not have stockpiled vaccines for diseases like cholera, she gave reasons, saying: “This is because cholera can be easily taken care of with simple practices of hygiene. The reason why they cannot stockpile cholera vaccines is it expires easily.
“Luckily, the vaccine can be sourced from foreign countries. But the problem is once it is bought, within a few weeks, it will expire.
“We all also know that for cholera, we don’t normally experience cholera. For years, sometimes you might not even hear about cholera. So, why would the agency embark on a waste?
“I see it as a waste if you store it in anticipation of a breakout and it never happened before it expires.
“In this country of today, everyone will politicise it and condemn the agency for not knowing what it is doing, forgetting that it was only trying to be proactive.
“So, if the agency does not stockpile the vaccine, how would it run out of what was not in its cold store in the first place?
“It’s only when there’s an outbreak like this that they will respond.”
Asked why there hasn’t been any response from the Federal Government yet, she said: “I have no doubt that efforts are being made by the relevant agencies to respond to those who have been infected already or who are already downed by cholera.”
Also, a United Nations Children’s Fund (UNICEF) source, who is familiar with the development but pleaded anonymity because he was not authorised to make a statement on the issue, told our reporter that the agency has no immediate plan to procure the cholera vaccine.
According to the source, the agency had earlier released a statement on the outbreak, urging people to adhere strictly to the observation of personal hygiene, adding that children of school age are mostly prone to being affected.
“Nothing for now, especially on vaccine procurement,” he said in a terse response to inquiries on what steps the agency is taking in Nigeria to address the outbreak in furtherance of its collaboration with the Nigerian government.
However, speaking on the subject, Christiana Fashola, a global vaccine expert, said the outbreak should not be a surprise because basic preventive mechanisms were lacking.
Noting that the government is not entirely to blame and echoing NCDC’s position, she said: The recent outbreak of cholera is not surprising as the country has not strongly invested in access to safe water, sanitation, hygiene, quick testing and detection of outbreaks, as well as improving healthcare access.
“To manage the current outbreak, residents need to be educated on incorporating strict hygiene measures in their daily activities to urgently reduce the spread of cholera.
“The deployment of the cholera vaccine is not obtained through the usual channels of routine vaccines, as the International Coordinating Group (ICG) manages emergency vaccine supplies including the cholera vaccine stockpile and coordinates its provision.
“The ICG continues to monitor epidemiological data of the cholera burden to determine the allocation of the vaccine to countries.
“Given the limited doses of the cholera vaccine, the ICG considers several factors in determining the amount of vaccine to be allotted: target population, disease burden, risk factors such as flooding and vaccine availability, etc.
“With the ongoing outbreak in Lagos, it is expected that the country has informed the ICG and fulfilled the necessary steps to obtain the cholera vaccine, aligning with the ICG’s mandate to respond to outbreaks and break the transmission of diseases to save lives.
“ICG uses several metrics to allocate vaccines hence it is uncertain whether the government will receive the requisite vaccine supply.
“I therefore recommend that the government takes proactive steps to supplement the vaccines expected from ICG.
“Also, investing in long-term improvements in water, sanitation and healthcare infrastructure including fast tracking in-country vaccine manufacturing, is crucial to prevent future outbreaks and ensure a more resilient health system”. (TheNation)
