UN raises alarm as cholera threatens one billion people from Nigeria, 42 countries

The World Health Organization (WHO) and UN Children’s Fund (UNICEF) say 43 countries, including Nigeria, now face outbreaks as increasing numbers of cholera cases are reported.

They said the outcome for patients was worse than 10 years ago.

In a statement on Friday, the UN agencies said that after years of steady decline, cholera was making a devastating comeback and targeting the world’s most vulnerable communities.

“The pandemic is killing the poor right in front of us,” said Jérôme Pfaffmann Zambruni, Head of UNICEF’s Public Health Emergency unit.

Echoing the bleak outlook, WHO data indicates that by May 2022, 15 countries had reported cases, but by mid-May this year, “we already have 24 countries reporting.

“And we anticipate more with the seasonal shift in cholera cases,” said Henry Gray, WHO’s incident manager for the global cholera response.

“Despite advances in the control of the disease made in the previous decades, we risk going backwards.”

The UN health agency estimates that one billion people in 43 countries are at risk of cholera, with children under-five particularly vulnerable.Cholera’s extraordinarily high mortality ratio is also alarming.

Malawi and Nigeria registered case fatality rates as high as three per cent this year, well above the acceptable one per cent.

Southeastern Africa is particularly badly affected, with infections spreading in Malawi, Mozambique, South Africa, Tanzania, Zambia and Zimbabwe.

The development follows the destructive passage of Cyclone Freddy in February and March this year, leaving 800,000 people in Malawi and Mozambique internally displaced and disrupting healthcare.

These vulnerable communities are at high risk of cholera, a preventable disease in areas affected by heavy rains and floods.

A deadly combination of climate change, underinvestment in water, sanitation and hygiene services – and some cases, armed conflict – has led to the spread of the disease, agreed the two UN agencies.

Although vaccines exist to protect against cholera, supply is insufficient to face the increasing demand.

According to the WHO, 18 million doses of vaccines have been requested globally, but only eight million have been made available.“Increasing production is not an overnight solution,” Mr Grays said.

“The plan is to double the production of doses by 2025, but we won’t have enough if the current trend continues.”WHO’s wake-up call was echoed by UNICEF.

“Not only (do) we need long-term investments, but immediate investments in the water system to ensure access to clean water, sanitation, and dignity,” Mr Zambruni said.

To respond to the growing cholera threat, WHO is launching a 12-month Strategic Preparedness, Response and Readiness Plan, requiring $160 million, alongside UNICEF’s Call to Action for $480 million.

The combined cholera response plan will cover 40 countries in acute crisis. It will include coordination, infection surveillance and prevention, vaccination, treatment, and water, sanitation and hygiene.

Cross River, Zamfara and Ebonyi with most cholera cases in Nigeria- NCDC

The Nigeria Centre for Disease Control and Prevention (NCDC), has said that six states, Cross River (397), Zamfara (25), Ebonyi (11), Abia (9), Bayelsa (3) and Kano (2), reported 447 suspected cholera cases in weeks 5 to 9 of 2023.

The NCDC, via its official website on Monday, said, however, that 12 states have reported suspected cholera cases since the beginning of 2023 – Abia, Bayelsa, Benue, Cross River, Ebonyi, Kano, Katsina, Niger, Ondo, Osun, Sokoto and Zamfara.

The agency said that as of March 5, a total of 922 suspected cases, including 32 deaths (CFR 3.5%), were reported from the 12 States in 2023, including Cross River (16), Ebonyi (six), Abia (six), Niger (two), Zamfara (one) and Bayelsa (one).

The NCDC’s epidemiological report showed that of all the cases recorded since the beginning of 2023, Cross River state accounted for 70 per cent of the cumulative cases across the country, with its 647 cases.It said that Cross River’s 16 deaths, accounted for 50 per cent of all cholera deaths in the country.

The NCDC said:

“National multi-sectoral Cholera Technical Working Group (TWG) continues to monitorresponse across states.

It said that of the suspected cases since the beginning of 2023, the age group above 45 years is the most affected for males and females.

The NCDC said that of all suspected cases, 54 per cent were males and 46 per cent were females.The World Health Organization (WHO), defined cholera as an acute diarrheal illness caused by infection of the intestine with Vibrio cholera bacteria.

WHO said that people can get sick when they swallow food or water contaminated with cholera bacteria. The infection is often mild or without symptoms, but can sometimes be severe and life-threatening.

It said that about one in 10 people with cholera will experience severe symptoms, which, in the early stages, include, profuse watery diarrhoea, sometimes described as “rice-water stools”, vomiting, thirst, leg cramps and restlessness or irritability.

Cholera kills 233 in 31 states, 173 die of Lassa Fever – NCDC

The Nigeria Centre for Disease Control (NCDC) has revealed that a total of 10, 217 suspected cases of cholera, including 233 deaths, have been recorded in 31 states this year.

Speaking at a ministerial briefing where he gave an update on COVID-19 response and development in the health sector, Director-General of the NCDC, Dr Ifedayo Adetifa said on Tuesday October 11, that there’s a 47 percent increase in the number of new suspected cholera cases in August epidemiological week 36-39 (4017) compared with July epidemiological week 31-35 (2151).

Adetifa also said there’s been 933 confirmed cases and 173 deaths from Lassa fever as at Week 39, from 25 states. Out of all the confirmed cases, 71 percent were from Ondo, Edo and Bauchi States.

He also said that out of 18,545 confirmed measles cases, 234 deaths were recorded as at week 39 in 36 states and the Federal Capital Territory (FCT).

Out of 1,180 suspected Monkeypox cases, 481 cases were confirmed and seven deaths have been recorded this year.

Adetifa also said that COVID-19 cases had continued to decline in various countries, and case trends in Nigeria have varied.

20 Boko Haram members who surrendered die of Cholera

A cholera outbreak in Hajj camp where about 12,000 surrenders are currently kept in Maiduguri, Borno state’s capital, has led to the death of about 25 people including 20 surrendered Boko Haram fighters.

Daily Trust reported that seven of these people died on Tuesday September 20, while 14 other causalities were recorded in the Hajj camp on Wednesday September 21.

It was also learnt that health workers with the support of Non-Governmental Organisations and the World Health Organisation are battling to control the fatalities.

A source told the publication;

“At least 20 Boko Haram surrenders have died as a result of cholera outbreak in Hajj and four others died in Bama camp.

Also, three reportedly died in the Muna Garage IDP camp. Nearly 1,000 cases have been reported so far, and hundreds are currently receiving treatments in various health centres.”

A top ministry of health staff who spoke on the condition of anonymity confirmed the incidents but claimed that only 11 repentant Boko Haram insurgents and three others in the Muna Garage IDP camp were killed by cholera, not 20 people.

The source added that the ministry and its partners are on top of the situation.

CHOLERA: Kogi confirms eight deaths, 129 cases

The Kogi State government on Wednesday confirmed 129 cases of cholera and eight deaths in the state.

The state’s Epidemiologist, Dr. Austin Ojotu, who disclosed this in a statement in Lokoja, said the cholera outbreak was recorded in Kogi, Bassa, Lokoja, Ankpa, and Kabba -Bunu local government areas of the state.

He added that the cases were recorded between February and August.

Ojotu said: “Seven communities were affected in the aforementioned council areas with 129 cases.

66 cases were recorded in three communities in Kogi, Lokoja, and Ankpa local government areas where all the eight deaths were also recorded.

These are border communities with hard to reach terrains.

“It is important to mention at this point that most of the deaths occurred before the reports got to the local government/state authorities.

“Our findings also revealed that majority of the deaths in all the outbreaks occurred at home.”