The increasing diphtheria deaths

AMID the raging protests over scarce naira notes and fuel and as political campaigns dominate the public space, Nigerians may be ignoring a dangerous killer in town: diphtheria. A severe infection caused by strains of bacteria called Corynebacterium diphtheriae, diphtheria is associated with fever, runny nose,  sore throat,  cough, red eyes (conjunctivitis) and swollen neck. The disease can result in breathing difficulties, heart failure, kidney failure and paralysis. The bacteria spreads from one person to another through respiratory droplets, and from coughing or sneezing. People can also get infected from touching infected open sores or ulcers. According to reports, those at increased risk of infection include people in the same household, people with a history of frequent, close contact with the patient and people directly exposed to secretions from the suspected infection site  (mouth, skin) of the patient.

Given this backdrop, it is really disturbing that as of January, Nigeria had recorded no less than 123 diphtheria infections and 38 deaths across four states. According to the latest data released by the Nigeria Centre for Disease Control (NCDC), Kano State recorded the highest number of cases with 100 confirmed infections and 32 deaths, followed by Yobe with 17 infections and three deaths. This is certainly not good news as the country is currently battling with a Lassa fever epidemic in addition to the lingering COVID-19 crisis. What is more, the Federal Government recently reported the outbreak of meningitis, another deadly disease, in Jigawa State. The increasing death toll from diphtheria infection in the country is a sure sign of the possibility of an epidemic if it is not immediately and adequately curbed.

Amidst the surge in cases, experts recently called for a closer look at Nigeria’s vaccination programme. This was with a view to ruling out vaccination failure from poor vaccines, health system failures and vaccination hesitancy against DPT, a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis and tetanus. According to Dr. Hannah Dada-Adegbola, a consultant medical microbiologist at the University College Hospital, Ibadan, diphtheria is not a new disease and for a long time, doctors had stopped worrying about it because there are effective treatments and vaccines to prevent it. She said: “It is a largely forgotten disease because of vaccination. It was a killer disease before immunisation for it became a routine. We need to find out if these cases are due to its new strains that are not covered by the vaccine, whether people affected are those that were vaccinated and completed the expected doses, if the immunity from the vaccine wanes or the vaccines were not potent because of a bridge in the cold chain.” Professor Aderemi Kehinde, head of the Department of Medical Microbiology and Parasitology, College of Medicine, UCH, Ibadan, also linked the upsurge in cases of diphtheria to climate change and the harmattan which he said supported the easy spread of airborne diseases, including diphtheria. He declared emphatically that the cases were a result of poor immunisation coverage, especially among children.  He canvassed a number of measures, including avoidance of crowded areas, keeping social distance, staying in well-ventilated environments and giving booster doses to increase herd immunity in the community. Health practitioners have also asked Nigerians to take cases of cough and sore throat seriously.

If the suggestions by experts are anything to go by, diphtheria infections need not lead to further fatalities. It is important for governments at all levels to quickly stop the growing diphtheria infection in its track and not allow it to overwhelm the health system and cause more deaths. They should act with dispatch in enlightening Nigerians about how to conduct themselves in order to prevent diphtheria infection while also ensuring that there are enough vaccines to cover children, who are said to be more susceptible to the infection. We expect the government to work assiduously to prevent a diphtheria epidemic in the country; this is the way to arrest the increasing deaths resulting from the infection.