Dr. Kemi Ogunyemi, the Special Adviser to the Lagos State Governor on Health, discussed the cholera outbreak in the state with VICTORIA EDEME.
What are the primary causes of the recent cholera outbreak in Lagos State?
Cholera cases have been a recurring issue in Nigeria, with sporadic occurrences that are usually managed individually. However, a noticeable surge in cases on June 10th and 11th, 2024, classified the situation as an outbreak. The hardest-hit areas include Lagos Island, Kosofe, and Eti-Osa. The Nigeria Centre for Disease Control and Prevention had anticipated this outbreak, particularly during the rainy season, which is the current scenario. Such occurrences are not surprising, and we are equipped with the necessary protocols to address them. The root causes are primarily tied to environmental conditions and the social determinants of health. Areas with inadequate clean water sources, dependence on wells, and prevalent open defecation are at high risk. Contaminated water sources due to factors like overflowing canals and poor sanitation practices exacerbate the situation. Our swift response, prevention campaigns, and awareness efforts such as promoting regular handwashing contributed to the reduction in cases.
What factors specifically led to the increased cholera prevalence in the mentioned areas?
In response to the outbreak in Eti-Osa Local Government Area of Lagos, Environmental Health Services officials from the Ministry of Health and the Ministry of Environment conducted investigations. A common link identified during the survey was the consumption of a tiger nut drink, which emerged as a significant contributing factor. Patients admitted to hospitals reported drinking this beverage. To verify the claim, samples of the drink were tested since it was unregistered with the regulatory body responsible for ensuring the safety of consumables, the National Agency for Food and Drug Administration and Control. Contact tracing was initiated, akin to COVID-19 protocols, to locate sellers of the drink. Despite finding empty bottles with identifying information, no tangible leads could be established as the producers were unregistered. Further testing revealed the presence of Vibrio cholera subtype 01, the most infectious strain, in stool samples of affected individuals. While cases were widespread across Lagos Island, Eti-osa, and Kosofe, targeted interventions and monitoring helped contain the outbreak in other areas.
How has the fatality rate evolved from the initial 15 deaths before the festivities?
The fatality toll has sadly risen to 21 cases as of Thursday morning from the previous count. An emergency meeting highlighted a recent death of a patient who succumbed shortly after arriving at the hospital. The individual had been exhibiting symptoms at home, emphasizing the importance of early medical intervention in cholera cases.
What are the key symptoms besides diarrhoea and vomiting that residents should be aware of?
The onset of cholera typically presents with abdominal pain followed by diarrhoea, which may be accompanied by fever, vomiting, muscle pains, and cramps. Electrolyte loss can lead to a rapid heart rate, malaise, fatigue, and dehydration due to the rapid fluid loss. Identifying the distinct watery diarrhoea resembling water itself is crucial, distinguishing it from other causes of diarrhoea.
What is the usual timeline for symptom development post-infection, and how is cholera diagnosed?
Symptoms may manifest within hours if the individual has ingested contaminated food or water with high bacterial loads. The incubation period varies, similar to the diverse onset of symptoms observed in COVID-19. While some may display symptoms within a few days, immediate medical attention is crucial to manage cholera effectively.Symptoms may manifest in as little as 24 hours, prompting an immediate need for medical attention. Cholera diagnosis typically relies on symptom suspicion, but a stool specimen is necessary for confirmation. The Nigeria Centre for Disease Control and Prevention has distributed rapid diagnostic tests to hospitals for on-site testing and also conducts confirmatory tests in labs.
Upon hospital arrival, individuals with diarrhea or vomiting are promptly given intravenous infusion for rehydration, prioritizing fluid and electrolyte replacement essential for kidney function and overall health. Those arriving late may require dialysis to manage dehydration-related complications. For individuals unable to access immediate hospital care, oral rehydration with boiled water, salt, and sugar is recommended as a temporary measure to maintain electrolyte balance until professional medical treatment is obtained.
How has the cholera outbreak impacted the health and daily lives of affected areas in Lagos?
Extensive sensitization campaigns in affected communities have raised awareness, leading to proactive measures like the absence of certain beverages from the market. The goal is to promote caution among residents, emphasizing practices such as boiling water, handwashing, and discouraging open defecation. Despite ongoing challenges, communities are showing resilience and vigilance. The spread of the outbreak beyond Lagos to states like Oyo and Bayelsa highlights the importance of nationwide monitoring and support by the NCDC.
What are the potential implications of a cholera emergency declaration by the NCDC?
While an emergency declaration has not been made yet, the NCDC is closely monitoring trends to assess risks. Collaboration with local authorities, ministries, and health organizations like UNICEF and the Red Cross aims to contain the outbreak and prevent panic. School protocols and awareness campaigns are in place to manage symptoms and ensure hydration measures. The situation is under constant evaluation, with free-of-charge treatment available at public healthcare facilities.
Are there collaborations with national or international health organizations in crisis management?
A collaborative effort with partners like UNICEF, the Red Cross, and the World Health Organization is crucial in monitoring and preventing a potential pandemic. Daily monitoring, data analysis, and community surveillance are ongoing to address evolving challenges. While not considered an emergency presently, the situation is continuously monitored to provide timely responses and free medical treatment at designated facilities. Economic concerns should not deter individuals from seeking necessary healthcare services during this public health concern.