Cholera: NCDC warns of fresh surge despite decline in cases

The Nigeria Centre for Disease Control and Prevention (NCDC) has warned of a potential fresh surge in cholera cases despite a recent decline from the peak of the outbreak.

NCDC Director-General, Dr Jide Idris, gave the warning on Friday during a briefing on the cholera and diphtheria outbreaks in Nigeria.

Idris said more than 65,000 suspected cholera cases had been reported in 35 states and around 195 local government areas since the beginning of the year.

Although the number of cases has fallen, he said the death rate among reported cases was much lower than during the same period last year.

“This is important progress. But I want to be very clear: the outbreak is not over,” Idris said.

He warned that cholera infections could rise again between late August and October because of the rainy season and possible flooding.

He said experience from previous outbreaks showed that cholera could peak during the current period, particularly where flooding contaminates water sources and overwhelms sanitation systems.

Idris disclosed that more than 10,000 confirmed diphtheria cases had also been recorded this year, although the case fatality rate had declined considerably compared with the same period last year.

He identified Kano, Borno and Bauchi as among the states carrying the heaviest burden of diphtheria, attributing continued transmission largely to inadequate vaccination coverage.

“The central issue is that too many children remain unvaccinated or incompletely vaccinated,” he said.

According to him, vaccine hesitancy, insecurity, displacement, population movement and difficulty reaching underserved communities continue to undermine efforts to protect children against the vaccine-preventable disease.

Idris stressed that Nigeria could not rely solely on treatment to defeat cholera, noting that unsafe water, open defecation, damaged water infrastructure and poor sanitation in schools, markets and other public places remain major drivers of transmission.

“While treatment saves lives, we cannot treat our way out of cholera,” he said.

He explained that early access to treatment had improved outcomes, particularly in Borno State, which has recorded the majority of this year’s cholera cases.

NCDC said it was coordinating the response with state governments and partners through strengthened surveillance, laboratory support, case management, infection prevention and control, community engagement and deployment of National Rapid Response Teams to affected states.

For cholera, response activities include investigation of transmission sources, water-quality assessments, chlorination, rehabilitation of water sources, hygiene promotion and oral cholera vaccination in high-burden communities.

In Borno, NCDC teams have assessed water supply points to identify gaps in water quality, sanitation and chlorination, while in Bauchi, oral rehydration points have been established, treatment capacity strengthened and active case search intensified.

For diphtheria, reactive vaccination campaigns are being conducted in affected communities alongside case detection, treatment and provision of essential laboratory and treatment commodities.

Idris, however, said federal intervention alone would not be sufficient to end the outbreaks, urging state and local governments to commit resources to high-risk communities.

He called for urgent action to provide safe water and sanitation, repair critical water infrastructure, tackle open defecation and ensure that high-risk communities have functional treatment and rapid-response capacity.

On diphtheria, he urged governments to strengthen routine and targeted immunisation and identify children who have missed recommended vaccine doses.

“Many of the interventions that will make the greatest difference must happen in our states, Local Government Areas, health facilities, communities and homes,” Idris said.

The NCDC boss also urged healthcare workers to maintain a high index of suspicion for both diseases, report suspected cases promptly and adhere strictly to infection prevention and control measures.

He advised Nigerians to begin oral rehydration immediately when someone develops frequent watery diarrhoea and seek care without delay.

Parents and caregivers, he added, should ensure that children are fully vaccinated against diphtheria, stressing that the vaccines are safe, effective and available free through routine immunisation services and vaccination campaigns.