The Nigeria Centre for Disease Control and Prevention, NCDC, has said that a total of 798 confirmed cases of diphtheria have been recorded in Nigeria with one death since December 2022.
In an official press statement signed by the Director General of NCDC, Dr Ifedayo Adetifa also disclosed that 654 cases of the 798 confirmed cases were not vaccinated.
Acknowledging that the Centre was aware of the death of a four-year-old with diphtheria in June 2023 in the Federal Capital Territory (FCT), Abuja, he also noted that since December 2022, the country has reported multiple diphtheria outbreaks in different states across the country.
The statement stated that: "As of June 30th, 2023, there have been 798 confirmed diphtheria cases from 33 Local Government Areas (LGAs) in eight (8) States including the FCT.
"Most of the cases (782) were recorded in Kano. Other States with cases are Lagos, Yobe, Katsina, Cross River, Kaduna, and Osun. The majority (71.7 per cent) of the 798 confirmed cases occurred among children aged 2 - 14 years. So far, a total of 80 deaths have been recorded among all confirmed cases (case fatality rate of 10.0 per cent).
Adetifa explained that Diphtheria is caused by a toxin produced by the bacteria Corynebacterium diphtheriae, but can be prevented with one of the vaccines provided routinely through Nigeria's childhood immunisation schedule.
He said despite the availability of a safe and cost-effective vaccine in the country, the majority i.e., 654 (82 per cent) of 798 confirmed diphtheria cases in the ongoing outbreak were unvaccinated. "Unfortunately, this also includes this recently announced FCT case. Historical sub-optimal vaccination coverage is the main driver of the outbreak given the most affected age group (2-14-year-olds) observed, and a national survey of diphtheria immunity that found less than half (41.7 per cent) of children under 15 years old are fully protected from diphtheria.
"Just like in other States reporting cases, we are working with the FCT Health and Human Services Department to implement control measures and avert the further spread of the disease."
He urged the public to remain vigilant and ensure persons with symptoms of diphtheria present early to health facilities for prompt diagnosis and treatment, adding that early diagnosis and institution of effective treatment are key predictors of a favourable outcome.
Adetifa also urged healthcare workers to immediately notify LGA disease surveillance officers once they see a suspected case.
On the update of the FCT case, he said the FCT Health and Human Services Secretariat has activated the diphtheria Incident Management System (IMS) to coordinate outbreak response activities.
"The key activities include but are not limited to active case finding in health facilities and communities, and risk communication and community engagement (RCCE) activities to raise awareness of diphtheria. Sample collection is also ongoing among suspected cases of diphtheria.
"As of 3rd of July 2023, only 1 confirmed case has been detected, with 7 suspected cases testing negative
while others are awaiting laboratory results. No other death was recorded apart from the laboratory-confirmed case.
NCDC said in response to the outbreak in December 2022, it has activated a multi-sectoral national
Diphtheria Technical Working Group as a mechanism for coordinating surveillance and response activities across the country. The response activities include coordination, surveillance, laboratory investigation, risk communication, case management, and immunisation activities.
To reduce the risk of diphtheria, the NCDC advised parents to ensure that their children are fully vaccinated against diphtheria with the 3 doses of diphtheria antitoxin-containing pentavalent vaccine given as part of Nigeria's childhood immunisation schedule.
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They added that healthcare workers should maintain a high index of suspicion for diphtheria. Continuing, he advised: "Individuals with signs and symptoms suggestive of diphtheria should isolate themselves and notify their LGA, State disease surveillance officer (DSNO), their State Ministry of Health helpline, or the NCDC through our toll-free line on 6232. Individuals who have come in close contact with a confirmed case of diphtheria should be closely monitored, given antibiotics prophylaxis, and started on diphtheria treatment when indicated. Healthcare workers should practice standard infection prevention and control precautions while handling patients and body fluids. All healthcare workers (doctors, nurses, laboratory scientists, support staff, etc.) with a high level of exposure to cases of diphtheria should be vaccinated against diphtheria."
