No fewer than 38 persons have died out of the 123 diphtheria cases recorded in Nigeria so far, the Nigeria Centre for Disease Control (NCDC), has confirmed.
The states currently facing the disease caused by serious infection of the nose and throat that is easily preventable by vaccine, are Kano, Lagos, Yobe and Osun, respectively.
The nation’s disease control and prevention agency, which disclosed this at a ministerial press briefing, organised by the Federal Ministry of Health, said more cases of the disease were being expected in days ahead, as it spreads to other places.
Speaking through its Director of Special Duties, Dr Priscilla Ibekwe, NCDC said: “As of January 22, NCDC have 123 confirmed cases and 38 deaths. 100 cases are from Kano, with 32 deaths. In Lagos there are five cases with three deaths. In Yobe, there 17 confirmed cases and three deaths, and Osun has recorded one case with no death”.
According to Ibekwe, besides clinically suspected cases, there have been laboratory-confirmed cases.
Ibekwe said the agency was working with state ministries of health and partners to enhance surveillance and response to the outbreak.
She said,”Given the sub-optimal coverage for the third dose of the diphtheria containing pentavalent vaccine (54percent – 2021 MICS & NICS) in the country, we expect more cases from more states.
“The centre has collaborated with the UK Health Security Agency (UKHSA) to organize a 5-day workshop on enhancing laboratory diagnosis of diphtheria in Nigeria for laboratory scientists working in NCDC’s National Reference Laboratories and its lab network (this was planned before cases were reported as part of preparedness), and;
“Written to all states HCHs to institute immediate and necessary public health measures for timely detection and response to diphtheria at state level”.
Speaking on measures being put in place to prevent the disease from spreading further, Ibekwe said NCDC has published a public health advisory, accessible on its website, which educates Nigerians on risk factors and offers advice.
She said:”Parents ensuring that their children are fully vaccinated against diphtheria with 3 doses of the pentavalent vaccine. Healthcare workers should maintain a high index of suspicion for diphtheria”.
She also spoke on how to better understand and contain the prevailing global outbreaks of SARS-CoV-2 COVID-19 variants.
She said:”The sub-lineages i.e., XBB.1.5 partly responsible for the current increase in COVID-19 cases in the US and elsewhere countries have not yet been detected in the country.
“However, this variant has not been associated with increased severity of illness and now appears to be levelling off.
“The variants reported in China so far have been those circulating globally including in Nigeria for some time.”
However, the Nigeria Centre of Disease Control and Prevention has attributed the current outbreak of diphtheria in some parts of Nigeria to a drop in the childhood vaccination coverage in some areas of the country.
The Director-General of the Agency, Dr Ifedayo Adetifa, who spoke about the development on a television programme, said that there were 34 deaths recorded over the weekend from the outbreak which hit four states.
He said due to the effectiveness of the childhood vaccination programme, most people have forgotten what it looks like.
He said, “Diphtheria, a vaccine preventable disease that used to be common decades ago is on the increase in some states in Nigeria. The fact that there is a resurgence suggests that there is significant reduction in vaccination coverage among pockets of the population and this reduced pockets of immunity has given rise to the cases we have seen.
“It is not a matter of diphtheria spreading from state to state, the bacteria that causes the disease is present everywhere and it spreads, and any state in which you find the disease now is likely to be associated with suboptimal vaccination rates, either in general or in particular in pockets of population. Failure of childhood vaccination in the failed states causing the diphtheria outbreaks.
“Kano has highest number of cases followed by Yobe, by weekend, there were 34 deaths in total.”
He warned that although diphtheria was highly preventable and treatable, fatality can increase without antibiotics and appropriate conditions, including the diphtheria antitoxin. He assured that with early detection and prompt treatment, the fatal outcomes are usually low.
Adetifa stressed that the really severe cases require the diphtheria antitoxin, even as he assured that the NCDC had distributed vials of the antitoxin since December for use in Lagos and Kano states, and was planning to extend availability to every state where the disease cases are found.
“It is important that patients should be recognised early, and laboratory confirmation carried out so that treatment can commence immediately.”
Adetifa said there were arrangements for trainings of personnel for laboratory diagnosis of the toxin including testing for most of the clinical effects.
“We are in a good state to help, but patients need to be recognised early and diagnosis made quickly and they are placed on the right treatment.
“We are using the National Primary Healthcare Development Agency, NPHCDA data to predict high risk states, there is connection with low socioeconomic situation, and we need to look out for healthcare workers who can be given courses of antibiotics.