The cholera scourge 

ON June 9, the Lagos State government declared a cholera outbreak. Three days later, it announced that 324 suspected cases had been reported in the state, including 15 people who died and 40 who were discharged after treatment. Cholera, a disease caused by the consumption of food or water that is contaminated with the bacterium Vibrio cholerae, typically manifests symptoms such as severe diarrhoea, fever, vomiting, dehydration, weakness, muscle cramps, low blood pressure and thirst, and typically spreads when people do not wash their hands with soap and water after defecating; cook or serve food with unwashed hands, or fail to wash their hands before and after eating. Generally, not washing raw fruits and vegetables in clean running water before eating them, eating raw seafoods contaminated with cholera bacterium, not filtering and boiling unsafe water before drinking, or drinking sachet water that is not treated, are all cholera-causing habits, as is open defecation.

Sadly, the disease has claimed a total of 103 lives out of the 3,623 cases recorded so far in 34 states and the Federal Capital Territory, FCT. This was disclosed by the Nigeria Centre for Disease Control and Prevention (NCDC) during a news conference in Abuja this week. The event was aimed at providing an update on the ongoing cholera outbreak situation in Nigeria, the prevention and response efforts at the national and sub-national levels, as well as other epidemic-prone diseases that are typically on the rise during rainy seasons. According to the agency, the casualty figure cuts across 187 local government areas in the country, with a cumulative case fatality rate of 2.8 percent since the beginning of the year. Speaking on the occasion, the Director General of NCDC, Dr Jide Idris, said: “As of July 15, 2024, we had recorded 3,623 suspected cases and, unfortunately, 103 deaths across 34 states plus the Federal Capital Territory (FCT) and 187 Local Government Areas (LGAs), with a cumulative case fatality rate of 2.8 percent since the beginning of the year. The predominant age affected is 5 years old while males account for 52 percent of cases and females account for the rest. There was a 5.6 percent decline in the number of cases in this reporting week (8th-14th July) as compared to the preceding week. We also recorded a drop in the case fatality rate from 2.9 percent to 2.8 percent.

Dr Idris added: “There is a decline in case fatality rate from week 24 when the spike started to the present week. Whereas ongoing efforts at the national and some state levels might have yielded some results and are largely responsible for the decline being reported, given the trend from previous years, we know it is not Uhuru yet. The trend analysis from previous outbreaks shows the peak of the outbreak usually coincides with the peak of the rainy season, which is still some weeks ahead. Also, some of the northern traditional hotspot states have been reporting fewer cases, which may be connected with the delayed onset of the rainy season in this part of the country. Although almost all the states in Nigeria have reported cases of cholera, there appears to be an underreporting of the situation as required data from the states are not coming in real-time as expected given the trend in previous years. This is largely due to inadequate resources to support surveillance and disease detection activities at the subnational level. Additionally, this may likely be further complicated by the effect of a political undertone for reporting cholera, which some see as a stigma or disease proxy indicator for the inability of the affected communities/persons to have access to potable water and other basic amenities of life.”

It is indeed shameful that in this day and age, Nigeria is experiencing another round of cholera scourge.  This is coming at a time the country has been battling epidemic-prone diseases such as yellow fever, Lassa fever, and meningitis, among others. If the cholera scourge underscores anything, it is the neglect of preventive methods such as the provision of potable water, a hygienic environment and sustained public awareness on the epidemic. Today, in most communities across the country, potable water, which was readily available under the military, sounds like a strange story. The fact that this is a tragedy of epic proportions given Nigeria’s vast aquatic resources is not hard to see. Across the country, it is a case of water being everywhere with none to drink. As we have said time and again, both the federal and state governments have completely shirked their duty to provide potable water, and the so-called ministries of water resources at both state and federal levels are nothing but money-sharing, entirely useless outposts.

At the risk of sounding repetitive, we reiterate that the current crisis is patently avoidable. With proper enlightenment campaigns, provision of potable water and the enforcement of the laws of hygiene, states would have been at a vantage position to contain the scourge. Sadly, most of the affected states adopted a lacklustre and reactive approach to the disease. For instance,  the Lagos State government is now trying to seal houses without toilets, something that it ought to have done much earlier. That is the picture in most states, and it is no wonder that Nigeria is the global capital of open defecation. Really, if the government cannot prevent cholera, what can it prevent? With even the evidently hard-working NCDC saying that it has run out of vaccines, the country faces terrible prospects. It is time the Federal Government and the states got their acts together. They must halt the tide of avoidable deaths by ensuring that cholera patients are given adequate treatment. That apparently means providing vaccines.

Needless to say, the government must begin enlightenment campaigns while ensuring the observance of basic hygiene rules. The cholera scourge can be defeated with a great resolve.

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