Cholera Outbreak: These are what you need to know

Recently, the Nigerian government confirmed the outbreak of cholera in parts of the country, including Lagos State.

Laboratory investigations and test results in Lagos have however confirmed that the current outbreak is associated with the Cholera subtype known as Serovars O1.

The identified Cholera strain according to the Lagos State Health Commissioner, Akin Abayomi, is “highly aggressive and contagious, with the potential for widespread” concerns, heightened by the rainy season.

As of Sunday, data provided by Mr Abayomi on his Instagram account revealed that the state had recorded 350 suspected cases in 29 wards across multiple local government areas (LGAs) with 17 confirmed cases of severe gastroenteritis caused by cholera.

Gastroenteritis, also known as the stomach flu, is an infection that causes inflammation in the stomach and intestines.

The number of fatalities from Cholera in Lagos has increased from five reported on 12 June to 15 deaths attributed to severe dehydration. The breakdown of the cases in Lagos gives a strong indication of how severe the disease is.

Meanwhile, there have been speculations on social media that contaminated tiger nut drinks led to hospitalisations and deaths from Cholera in Lagos.

An X user, Kageosama, said: “My friend lost his mum and almost his sister this week, they took tiger nut, please be careful out there.”

Another user, Yosemite, posted: “My friend’s brother was hospitalised cos of Cholera & his friend passed from Cholera as well. They both had Tiger nut drink.”

Speaking with PREMIUM TIMES Monday, an Epidemiologist with NCDC, Biodun Ogunniyi, who leads the Public Health Emergency Operation Centre (EOC) activated in Lagos to address the Cholera outbreak, said a case-control study has commenced to ascertain contributing factors and dispel speculations around tiger nut.

“A case-control study needs to be done and this is about to start,” Mr Ogunniyi said.

“This is one objective and scientific way to identify possible factors associated with the outbreak…so people can stop the speculations around tiger nut drink and others.”

What is Cholera?
Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.

People living in places with unsafe drinking water, poor sanitation, and inadequate hygiene are at the highest risk of cholera, as it spreads through direct transmission by eating or drinking contaminated food or water.

Cholera can cause severe diarrhoea, and dehydration, and can kill within hours if left untreated. Apart from diarrhoea, other symptoms include nausea/vomiting, dehydration, low blood pressure, rapid weight loss and muscle cramps.

Every year, an estimated 1.3 to 4 million people worldwide get cholera, and between 21,000 to 143,000 people die, according to the Centre for Disease Control and Prevention (CDC).

The Nigerian Centre for Disease Control and Prevention (NCDC) recently reported that Nigeria has recorded 65 confirmed cases of Cholera with 30 deaths from 1 January to 11 June across 96 local governments in 30 states.

Types of Cholera
WHO explains that there are many serogroups of Vibrio cholerae, but only two – O1 and O139 – cause outbreaks, noting that the Vibrio cholerae O1 has caused all recent outbreaks.

“A serogroup refers to a group of serovars that share common antigens,” Mr Ogunniyi noted, adding that in the case of Vibrio cholerae, the serogroup O1 includes two serovars: Ogawa and Inaba.

“Serovar, on the other hand, is a distinct variation within a species of bacteria or virus. Serovar is sometimes used interchangeably with serotype,” the epidemiologist noted.

“In summary, serogroup is a broader classification that encompasses multiple serovars, and serovar is a more specific classification within a serogroup.”

Who is at risk?
According to the latest NCDC advisory, people of all ages living in places with limited access to clean water are more susceptible to cholera.

It noted that people living in areas with poor sanitation and poor hygiene, slum areas where basic water or sanitation infrastructure is missing, or do not perform hand hygiene are also at risk.

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