Nigeria records over 65,000 suspected cholera cases across 35 states — NCDC

Nigeria has recorded more than 65,000 suspected cases of cholera across 35 states and about 195 Local Government Areas (LGAs) in 2026, the Director-General of the Nigeria Centre for Disease Control and Prevention (NCDC), Dr Jide Idris, has disclosed.

Idris, who spoke on Friday during a press briefing on the current cholera and diphtheria outbreaks, however, said weekly cholera cases had declined substantially from the peak recorded earlier in the year, while the proportion of cases resulting in death was significantly lower than during the corresponding period last year.

He cautioned that the decline should not be interpreted as the end of the outbreak, warning that cholera transmission remained active and could worsen as the rainy season continues.

“Our experience in recent years shows that cholera transmission can peak between late August and October. We are also still in the rainy season, and flooding remains an important risk because it can contaminate water sources and overwhelm sanitation systems,” Idris said.

He said the country must consolidate the gains recorded so far and prevent a resurgence of cases.

According to him, one of the clearest lessons from the outbreak was the importance of early access to treatment, noting that outcomes had improved in Borno State, which recorded the majority of the cases, where treatment was brought closer to affected communities.

“But the data are telling us something equally important: while treatment saves lives, we cannot treat our way out of cholera,” the NCDC DG said.

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He identified unsafe water, open defecation, damaged water distribution systems, poor hygiene infrastructure and inadequate sanitation in schools, markets and other public institutions as persistent drivers of cholera transmission.

Idris said sustained interventions in water, sanitation and hygiene, environmental health and community behaviour were therefore required to prevent recurrent outbreaks.

On diphtheria, he disclosed that Nigeria had recorded more than 10,000 confirmed cases this year, although the case fatality rate had declined considerably compared with the same period in 2025.

He said most confirmed diphtheria cases were concentrated in Kano, Borno and Bauchi states, attributing the continuing burden largely to inadequate vaccination coverage.

“The central issue is that too many children remain unvaccinated or incompletely vaccinated. Vaccine hesitancy, insecurity, hard-to-reach communities, displacement and population movement make it more difficult to reach every child who needs protection,” he said.

Idris stressed that diphtheria was vaccine-preventable and urged intensified efforts to identify and vaccinate children who had missed recommended doses.

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

He said oral cholera vaccination had been implemented in high-burden areas, while water chlorination, rehabilitation of water sources and hygiene promotion were continuing in affected communities.

In Borno, he said NCDC teams had investigated transmission sources and assessed water supply points to identify gaps in water quality, sanitation and chlorination, while in Bauchi, oral rehydration points had been established, treatment capacity strengthened and active case searches intensified.

For diphtheria, he said reactive vaccination was being conducted in affected areas, alongside the provision of essential treatment and laboratory commodities.

Idris, however, stressed that the Federal Government alone could not end the outbreaks, urging states and local governments to provide the human, material and financial resources required to sustain interventions.

He called for improved access to safe water and sanitation, water-quality monitoring, the repair of critical water infrastructure, the elimination of open defecation, and functional treatment and rapid-response capacity in high-risk LGAs.

On vaccination, he urged states to strengthen routine immunisation and targeted vaccination, particularly in affected, underserved and hard-to-reach communities.

‘Enugu only state without reported cholera case’

Responding to a question on states reporting cholera cases, Idris clarified that Enugu State was, for now, the only state without a reported cholera case, but warned against interpreting the absence of reported cases as evidence that cholera did not occur sporadically in other states.

He said the NCDC did not rank states according to disease burden but focused attention on states where cases had reached outbreak or epidemic levels.

“Because they are not reporting cholera doesn’t mean that they are hiding information,” Idris said, adding that he had visited Enugu State about three weeks earlier and found the state government proactive in its response to public health issues.

He explained that cholera could occur throughout the year but was exacerbated during the rainy season.

“Virtually all states have cholera. It may not be on an outbreak level,” he said.

According to him, some states may record small numbers of cases that are treated in health facilities without reaching the threshold that would warrant classification as an outbreak.

Idris said the NCDC instead concentrated resources on hotspot states where disease numbers were considered unacceptable.

“We have not rated states yet, but for those states where the numbers are unacceptable, and that’s why I mentioned for cholera, those states, because they are responsible for very, very high number of cases, and that’s why we need to concentrate on to reduce the number,” he said.

He also attributed the detection of diphtheria cases in more states partly to improved disease surveillance.

“For diphtheria, it used to be three, four states up north. Now it has spread to one or two this way. And the spread again is just a reflection again of increased surveillance systems. More cases are being detected unlike before,” Idris said.

He described increased detection as a positive development but stressed that identified cases must be followed by effective control and response.

The NCDC DG also rejected the argument that poverty should be used to explain poor hygiene practices that contribute to cholera transmission.

“Because you are poor doesn’t mean that you cannot express personal hygiene. Because you are poor doesn’t mean you should just open defecate, defecate anyhow,” he said.

Idris acknowledged that governments had responsibilities to provide water and sanitation infrastructure but maintained that individuals and communities also had responsibilities.

He said communities could reduce their risk by ensuring drinking water was safe, maintaining clean surroundings, using proper sanitation facilities, avoiding open defecation, washing hands regularly with soap and clean running water, and properly preparing and protecting food from contamination.

He urged Nigerians who develop frequent watery diarrhoea, with or without vomiting, to begin oral rehydration immediately and seek treatment at the nearest health facility.

“Do not wait until the illness becomes severe,” he said.

Idris also urged parents and caregivers to ensure children were fully vaccinated against diphtheria, stressing that vaccines were safe, effective and available free through routine immunisation services and vaccination campaigns.

He attributed the decline in cholera cases in some states partly to improved responses by state governments, saying the NCDC had been engaging states and demanding accountability for the resources deployed to fight the outbreak.

“The states are getting more money. And when they come, we say, ‘What have you done?’ So, you understand me. So some states have taken it up there, said they are active, actively working,” he said.

He warned that leadership and governance gaps in some states could undermine the national response, stressing that such failures should not be allowed to persist.