The Nigeria Centre for Disease Control and Prevention (NCDC) has warned of a possible fresh surge in cholera cases between late August and October, as more than 65,000 suspected cases have been recorded across 35 states and about 195 Local Government Areas this year.
NCDC Director-General, Dr Jide Idris, gave the warning on Friday, saying the continued rainy season, flooding, unsafe water and poor sanitation could reverse the progress made in containing the outbreak.
Idris said the decline in weekly cholera cases and deaths was encouraging but should not create a false sense of security, noting that transmission was still ongoing.
He said previous outbreaks showed that cholera could peak during the current period, particularly when flooding contaminates water sources and overwhelms sanitation systems.
“Cholera transmission is ongoing, and we must therefore consolidate the gains made so far and prevent another rise in cases,” Idris said.
The NCDC boss also disclosed that more than 10,000 confirmed diphtheria cases had been recorded this year, although the case fatality rate had declined considerably compared with the same period last year.
He identified Kano, Borno and Bauchi as among the states with the highest burden of diphtheria, attributing continued transmission largely to inadequate vaccination coverage.
Idris said vaccine hesitancy, insecurity, displacement, population movement and difficulties reaching underserved communities were undermining efforts to protect children against the vaccine-preventable disease.
He stressed that Nigeria could not rely solely on treatment to defeat cholera, identifying unsafe water, open defecation, damaged water infrastructure and poor sanitation in schools, markets and other public places as major drivers of transmission.
“While treatment saves lives, we cannot treat our way out of cholera,” he said.
According to him, early access to treatment had improved outcomes, particularly in Borno State, which has recorded the majority of this year’s cholera cases.
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The NCDC said it was working with state governments and partners to strengthen surveillance, laboratory support, case management, infection prevention and control, community engagement and the deployment of National Rapid Response Teams to affected states.
It said response measures included investigating transmission sources, assessing water quality, chlorinating water, rehabilitating water sources, promoting hygiene and providing oral cholera vaccination in high-burden communities.
In Borno, NCDC teams have assessed water supply points to identify gaps in water quality, sanitation and chlorination, while Bauchi has established oral rehydration points, strengthened treatment capacity and intensified active case searches.
For diphtheria, reactive vaccination campaigns are being conducted in affected communities alongside case detection, treatment and the provision of essential laboratory and treatment supplies.
Idris said federal intervention alone would not be enough to end the outbreaks, urging state and local governments to commit resources to high-risk communities.
He called for urgent action to provide safe water and sanitation, repair critical water infrastructure, tackle open defecation and ensure that high-risk communities have functional treatment and rapid-response capacity.
On diphtheria, he urged governments to strengthen routine and targeted immunisation and identify children who had missed recommended vaccine doses.
“Many of the interventions that will make the greatest difference must happen in our states, Local Government Areas, health facilities, communities and homes,” Idris said.
He also urged healthcare workers to maintain a high index of suspicion for both diseases, report suspected cases promptly and adhere strictly to infection prevention and control measures.
Idris advised Nigerians to begin oral rehydration immediately when someone develops frequent watery diarrhoea and seek medical care without delay.
He urged parents and caregivers to ensure that children are fully vaccinated against diphtheria, stressing that the vaccines are safe, effective and available free through routine immunisation services and vaccination campaigns.
The NCDC director-general also appealed to traditional and religious leaders, civil society groups and the media to counter misinformation and promote preventive measures.
He said early action and sustained collaboration could help prevent further infections, save lives and bring the outbreaks under control.
