The Director-General of the Nigeria Centre for Disease Control and Prevention, Dr. Jide Idris, has said a total of 2,102 suspected cholera cases and 63 deaths have been recorded across 33 states and 122 local government areas in the country.

Idris stated this in Abuja, on Tuesday while giving an update on the campaign against the cholera outbreak as the National Youth Service Corps introduced strict camp guidelines with the commencement of the 2024 Batch B Stream ‘I’ orientation course.

The orientation course runs for 21 days, equipping, and training the eligible participants of the one-year mandatory service.

To ensure a successful programme, the Director-General of the NYSC, Brig. Gen. Yushau Ahmed has issued strict instructions to camp coordinators and officials to prevent the outbreak of cholera in orientation camps nationwide.

Cholera, a highly contagious food and waterborne disease, is caused by the ingestion of the organism, Vibrio Cholerae, in contaminated water and food.

Nigeria is experiencing a significant cholera outbreak, with the cases increasing from over 1,579 suspected cases and 54 deaths in 32 states to 2,102 cases and 63 deaths in 33 states within one week.

The outbreak has notably affected Lagos, Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, and Nasarawa.

The primary cause has been linked to the consumption of contaminated water and inadequate sanitation, exacerbated by the onset of the rainy season, which often leads to increased cholera cases due to flooding and compromised water sources.

Briefing journalists on the measures deployed against the outbreak, Idris put the case fatality rate at 3.0 per cent.

He said seven of the top 10 states of Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers and Delta, which contributed about 90 per cent of the cases were southern states.

2,102 cases

The NCDC boss noted, “As of 30th June 2024, a total of 2,102 suspected cases and 63 deaths have been recorded across 33 states and 122 LGAs with a case fatality rate of 3.0 per cent since the beginning of the year.

“Of the top 10 states (Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers and Delta) that contribute about 90 per cent of the cases, seven of them are Southern states.’’

According to Idris,  the National Cholera Multi-sectoral Emergency Operation Centre which has been activated parades an array of subject matter experts and provides strategic coordination, meets daily and provides periodic situation reports for stakeholders.

 

“This also ensures effective mobilisation, harmonisation and distribution of resources to support the affected states. This is done through the relevant thematic areas of response that cover coordination, surveillance, case management, infection prevention and control, risk communication and community engagement, water sanitation and hygiene, vaccination, logistics, and research with a cost-incidence action plan for the response developed and being implemented.

“These will help facilitate rapid communication, data analysis, and decision-making. It will also ensure that we deploy resources efficiently, strengthen surveillance and diagnostic capacity, enhance treatment of affected persons, and intensify public awareness and community engagement activities,” he stated.

Before the activation of the EOC, Idris, a former permanent secretary and commissioner of health in Lagos State, disclosed that the NCDC, through the National Cholera Technical Working Group, had conducted an assessment of cholera readiness and preparedness capacity in 22 hotspots and high-burden states and shared a report of gaps with the states to guide their preparedness activities before the outbreak.

He also said the group was helping with the “provision of relevant guidelines, standard operating procedures, and advisories to states, with a view of guiding their technical readiness and how to respond to the outbreak; prepositioning and distribution of medical supplies for case management.

It is also assisting with infection prevention and control, and laboratory diagnosis, among others, to all 36 states and the Federal Capital Territory.

Working group

The working group, according to the NCDC, is supporting the capacity-building of LGA disease surveillance and notification officers across the country; LGA risk communication and community engagement/ health promotion officers across the country; provision of public health advisories and regular media engagement to sensitise the general public on the need to take responsibility and play their part in breaking the chain of transmission of the outbreak.

Also, it has reportedly been engaged in the distribution of jingles, flyers, and posters containing key messages on cholera prevention to all states and the FCT.

Idris assured that the government was ready to control the outbreak.

He lamented that only 123 of 774 LGAs or 16 per cent are free of open defecation, with Jigawa as the only state not recording the social malaise.

According to him, more than 48 million Nigerians practice open defecation without adequate toilet facilities, adding that existing ones even in many government facilities are not well maintained.

Idris said there was inadequate safe water and poor sanitation, lamenting that only 11 per cent of schools, six per cent of health facilities, and four per cent of motor parks and markets have access to basic water, sanitation and hygiene services.

“(There is) poor waste management practices, poor food, environmental and personal hygiene practices; capacity gap among health care workers at the state and LGA levels, weak regulation on the construction of soak-away and boreholes, (some sunk close to a water source and boreholes sunk in the wrong location); inadequate implementation and enforcement of public nuisance law and other relevant public health laws, inadequate capacity at state level-delayed disease reporting and response action.’’

Highlighting the measures being enforced in the orientation camps to keep cholera at bay, the NYSC Director of Press and Public Relations, Eddy Megwa, told The PUNCH that the corps DG had met with all camp officials across the country and charged them to ensure the ravaging disease did not find its way into any of the camps

 

He said, “A few weeks ago, the director-general convened a meeting of all the state coordinators of all the orientation camps, the camp commandants, and the camp directors nationwide.

“He invited everybody, and the Riot Act was read, and all the measures were put in place to ensure that everything is put in place to ensure that this cholera would not have its way into any of the orientation camps.

“And if you have your time, go to any of the orientation camps, and there you will see for yourself.  Everything is neat, and cholera cannot have its way in our orientation camps,” the spokesman further said.

Besides the marching order handed down to camp officials, Megwa also said the organisation had put in place proactive measures to forestall the outbreak of cholera.

“Everything, from sanitation to the kitchen, has been revamped to prevent a cholera outbreak”, he stated.

Megwa added, “NYSC is a very proactive organisation, which you know.  I’m sure you also saw what NYSC did during COVID-19. What we did during COVID-19 is not like any other organisation, and that was why, even amidst COVID-19, we were given a clean bill to go on and hold orientation.

“Now, cholera is here. We have taken every proactive measure to forestall the outbreak of cholera in all the orientation camps. Camp started on the 26th of June.

“Right from the sanitary, medical, and the kitchen, everything has been re-jigged, and nothing like cholera can have its way in any of the NYSC camps.”

As part of strategies to contain the disease, the NYSC South-West Coordinator, Mrs Olubukola Abiodun, reeled out measures put in place to prevent cholera outbreaks in the NYSC camps in the region, particularly in the Osun State Orientation Camp.

Abiodun said, “As they (corps members) come in, the first port of call is for them to wash their hands. When they finish, they proceed to take their accommodation. That has been well arranged to ensure that they don’t come into the registration hall in large numbers.

“Seats are provided for them to sit as they are called in to register. So, on no account will they cluster in a place. In the kitchen, the cooking staff are tested and screened before they are employed.

“At the kitchen, water is running and the cooks are in aprons with head bonnets. As much as possible, the food is served on a platoon basis, so, there won’t be any issue.”

In line with the directives from the DG, the Gombe State NYSC office has commenced a sensitisation programme for corps members in their Amada camp.

 

No fewer than 1,340 Batch B Stream I corps members, comprising 701 males and 639 females, were administered the oath of allegiance during the inauguration of the camp on Tuesday.

 

The Gombe State NYSC Head of Press and Public Relations Officer, Jennifer Laha, affirmed the NYSC’s commitment to ensuring good hygiene in the camps, adding that the necessary measures had been put in place to protect the corps members.

She said, “Daily sensitisation on personal and environmental hygiene, banners on prevention of cholera at strategic points, wash hand containers for thorough and regular use with waste baskets for disposal have been provided.”

The Sokoto State Coordinator of the scheme, Alhaji Usman Yakubu-Yaro, explained that proper arrangements were in place to curtail the spread of cholera in the state’s orientation camp

The NYSC, he said, was collaborating with the state ministry of health and NCDC officials to ensure a safe orientation programme.

Yakubu-Yaro added that consumables and people were being screened at the camp.

“We also equipped the camp health post with relevant medication for prompt response in case of emergency. All the food vendors are being screened to ensure they sell cholera-free food and drinks to the corps members while the NYSC kitchen has been mandated to prioritise hygiene.”

Similarly, the Benue State NYSC Information Officer, Mrs Victoria Ogwuche, said food vendors were screened and educated on hygiene before the camp, located in Wannue in the Tarka Local Government Area of the state, opened.

 

She reeled out several measures taken to make the camp resistant to the disease, including the provision of hand-washing basins and jingles to create awareness.

“We have put necessary measures in place before the camp opened. For instance, all the food vendors were thoroughly screened and put to a cholera test before coming to camp. Also, we have provided hand-washing basins all around the camp.  We have also done jingles to create awareness for corps members. During morning meditation, we also educate them about the disease,’’ Ogwuche hinted.

Giving specific examples of what had been done, the Kwara State Coordinator of the NYSC, Mr Onifade Olaoluwa, mentioned that the state orientation camp in Yikpata in the Edu LGA had been fumigated to fortify the camp against the outbreak of any disease.

Speaking with The PUNCH on Tuesday, Onifade said that the state was fully prepared for the 2024 Batch B, Stream 1 orientation course.

He said that about 1,700 Corps members had reported to the camp for the 21-day exercise.

Onifade said,  “We have assured the new corps members that adequate preparations have been made at the orientation camp. The camp has been properly cleared and fumigated against insects and reptiles.

“In view of the recent cholera outbreak in some parts of the country, the NYSC management is not leaving any stone unturned in having an epidemic-free camp. Adequate preventive measures have been put in place to prevent any outbreak in our camps.’’

 

Kogi’s two cases

Meanwhile, the Kogi State Government has confirmed two cases of cholera in the state.

The cases were detected in Lokoja and Omala LGAs, according to a statement issued on Tuesday by the Public Relations Officer of the state Ministry of Health, Dorothy Onoja.

Consequently, the state government has constituted a cholera response team that would investigate reported cases, collect samples and administer appropriate treatment.

Onoja said the response team comprised healthcare workers, surveillance officers, and laboratory technicians.

“The state Commissioner for Health, Dr Abdulazeez Adeiza, announced the setting up of the team in response to the outbreak of cholera in some parts of the country,” she said.

The statement further said the government had also unveiled comprehensive infection prevention tools while reaffirming its dedication to ensuring a cholera-free environment.

 

The commissioner said the state had been fortunate to have minimal impact from the current cholera outbreak, with two confirmed cases identified in Lokoja and Omala LGAs.

“Fortunately, one case has already been discharged, and the other is currently undergoing treatment, with no fatalities recorded,” it read.

As part of efforts to combat the disease, the Oyo State Government on Tuesday, inaugurated the Cholera Technical Working Group.

The state government through the Ministry of Health set up the group with a mandate to coordinate multi-sectoral and multi-disciplinary approaches in preventing, detecting and responding to any case of the epidemic within the state.

While inaugurating the committee at the Oyo State Public Health Emergency Operation Centre, Ibadan, the Commissioner for Health, Dr. Oluwaserimi Ajetunmobi, said the highly contagious disease remained a significant public health threat in Nigeria.

The commissioner, who was represented by the Director of Public Health in the Ministry, Dr Akintunde Babatunde, said although Oyo State recently had seven suspected cases, no case of cholera had been confirmed.

She said the threat of cholera outbreak in some neighbouring states compelled the state government to put proactive measures in place.

 

The health commissioner reiterated that the CTWG would develop and implement a comprehensive cholera preparedness and response plan, and strengthen surveillance and early warning.

The representatives of the CTWG committee at the inauguration include the Ministry of Health, Ministry of Environment, Ministry of Education, Ministry of Agriculture, Ministry of Information, Oyo State Rural Water Supply and Sanitation Agency, RUWASSA, non-governmental organisations, among other stakeholders.

Meanwhile, the House of Representatives has urged the Federal Government to quickly put in place measures to check the spread of cholera across the country.

The resolution of the House followed the adoption of a motion of public urgent importance moved by the House Minority Leader, Mr Kingsley Chinda, titled, ‘Urgent need to check the outbreak of cholera in Lagos and other parts of the country.’

Following the adoption of the motion during a plenary presided over by the Deputy Speaker, Benjamin Kalu, the legislative chamber urged the federal and respective State governments “to urgently put in place measures to effectively check the outbreak of cholera in the country.”

It also mandated its Committee on Information, National Orientation, Ethics and Values to “undertake rigorous public orientation, enlightenment and education of the citizenry on the need to maintain personal hygiene at all times by relevant government agencies.”

It further mandated the Committee on Healthcare Services to urgently liaise with relevant stakeholders in the health sector “to investigate the root cause of the outbreak and report back to the House within two weeks for further legislative action/intervention.”

 

In his remark, Chinda noted that the House “is concerned about the public and personal health of teeming Nigerians largely due to lack of access to clean water, poor sanitation and poor personal hygiene.

“The House is concerned about the rapid rate at which the disease has spread across Lagos and several other parts of the country within such a short time, especially against the backdrop of reports that the government has run out of vaccines to effectively tackle it, even as the death toll continues to escalate in those States.

“There is an urgent need for quick action/intervention by the federal and respective state governments to curb the disease from further spread across the country.

“We are worried that unless urgent and proactive steps/measures are immediately adopted, the disease would spread to several other places and possibly escalate than imagined and this would not be good for the health of the citizenry and the country at large.”