Following the outbreak of cholera in some parts of the country, at least 21 persons have been confirmed dead in Lagos State, with 401 suspected cases reported to the state Ministry of Health, with an increasing number of severe gastroenteritis cases across multiple local government areas, LGAs, in the state.
Announcing the development in an update on the disease in Lagos, the Special Adviser to Lagos State Governor on Health, Dr. Kemi Ogunyemi, disclosed that the total number of cholera cases has increased to 401 across the state, with Lagos Island, Kosofe, Ikorodu and Eti Osa recording the highest numbers.
Ogunyemi, while providing an update on the outbreak after meeting with members of Lagos State Public Health Emergency Operations Centre, PHEOC, added that the death toll had also risen to 21, an increase of six from the previously reported 15 fatalities.
She said: "The rise in cases was anticipated, following the Ileya festivities, during which large gatherings occurred."
She, however, noted that suspected cases were subsiding across LGAs, particularly previously affected LGAs, due to the state government's interventions and surveillance efforts.
Ogunyemi said the Lagos State government, through the Ministry of Health and other sister agencies, was maintaining rigorous surveillance and monitoring of the situation and implementing planned programs and activities to curb the spread.
"The ministry of Health, in collaboration with the state Ministry of environment and its agency, the Lagos State Environmental Protection Agency, LASEPA, continues to collect samples of water sources, food, and beverages to identify the source of contamination.
"We have also intensified our surveillance activities in communities, particularly in affected local government areas, to address the situation head-on.
"We are also working with the Ministry of Basic and Secondary Education as well as the Ministry of Tertiary Education to ensure all precautions are taken in our schools to protect children and scholars as they return.
"Residents must, however, remain vigilant, practice good hand hygiene, and participate in community sanitation activities to stop the spread of cholera," the special adviser stated.
Ogunyemi urged citizens to seek medical attention immediately after they experienced symptoms, such as watery diarrhoea, vomiting, abdominal pain, general malaise, and fever, stressing that cholera treatment was provided free of charge at all public health facilities.
While noting that Governor Babajide Sanwo-Olu remained committed to ensuring that residents of Lagos received quality and affordable healthcare, the Special Adviser extended the gratitude of the state government to local, national, and international partners, including UNICEF, WHO, NCDC, NIMR, Red Cross, and others, for their support in combating the outbreak.
"Appreciation is also extended to the dedicated team of doctors, nurses, pharmacists, lab scientists, environmental health officers, Water Corporation officers, surveillance officers, heads of agencies, members of PHEOC, and volunteers who are working around the clock to combat the disease and keep Lagos safe," she added.
Causes of Cholera
Cholera, a severe diarrheal illness, caused by infection with the bacterium vibrio cholerae, spreads primarily through contaminated water and food, thriving rapidly in unsanitary conditions.
As part of pre-emptive measures, following the initial alert and advisory issued by the Lagos State ministry of health, the state government, activated its Public Health Emergency Operations Centre, PHEOC, at Mainland Hospital, Yaba, Lagos.
Announcing the outbreak of the disease earlier, the state Commissioner for Health, Prof. Akin Abayomi, had revealed that the initial suspected cases of cholera were reported in 29 wards across multiple local government areas, LGAs, with 17 confirmed cases and 15 fatalities.
"The laboratory investigation and test results have so far confirmed Cholera sub type O-1. This sub-type is associated with more severe disease. The pattern of new cases per day varies across LGAs, according to our ongoing surveillance and monitoring updates."
"The Directorate of Environmental Health of the Ministry of Health in collaboration with the Lagos State Environmental Protection Agency of the Ministry of Environment, have collected samples of water sources, food and beverage samples in all the affected LGAs, while inspections of facilities are ongoing.
"We are pre-positioning cholera kits in health facilities across the State. Our efforts to control the outbreak also include the distribution of Oral Rehydration Solutions, ORS, public health education campaigns," Abayomi had said.
No surge of cases in LASUTH --CMD
Meanwhile, the Chief Medical Director of the Lagos State Teaching Hospital, LASUTH, Professor Adetokunbo Fabamnwo, yesterday disclosed that the five cholera patients admitted at the hospital last week had been discharged, adding that there was no surge of cases at the facility.
Fabamwo, who spoke to Vanguard, also urged Lagosians not to panic as the numbers were reducing, saying there was no surge at LASUTH.
"We had only five cases in LASUTH last week we do not have fresh cases and they have all gone home. As you know the trend is that even across the state the number is reducing. There is no cause for panic anymore," he said.
Lagos Water Corporation issues red alert
In a related development, Lagos Water Corporation, LWC, has called on residents to be wary of untreated water in circulation, even as it initiated comprehensive measures to safeguard public health and ensure access to safe drinking water across the state.
But despite several health advisories issued by the state government, refuse heaps have continued to litter major roads of the metropolis, heightening the risk of Cholera and posing health hazards to residents.
A release by the corporation said it had commenced an extensive water sampling and quality monitoring campaign throughout the state.
Expressing deep concern about the recent outbreak of Cholera in parts of the state, particularly in Lekki and Victoria Island Areas, the LWC urged the public to refrain from consuming water from unreliable or untreated sources.
Residents were, however, encouraged to bring water samples from their homes or public spaces for testing by the qualified teams at LWC Headquarters, Ijora.
It added that the LWC water quality monitoring team would be monitoring water consumption across the state to identify and control the outbreak.
"According to the Lagos State Ministry of Health, the primary cause of the cholera outbreak has been linked to the consumption of contaminated water and inadequate sanitation.
"Every individual must take responsibility for ensuring their water is safe for consumption. The Lagos Water Corporation remains committed to providing safe and clean drinking water to all residents of Lagos State. We urge the public to cooperate with our teams and follow precautionary measures to prevent further spread of the disease," LWC added.
PSP operators on 24hrs waste evacuation
Similarly, the state government also yesterday, directed assigned Private Sector Participant, PSP, operators to ensure a-24 hour seamless evacuation of wastes as part of measures to prevent further spread of cholera outbreak in the state.
The Managing Director of the Lagos Waste Management Authority, LAWMA, Dr. Muyiwa Gbadegesin, who stated this, however, called on residents to observe the best personal and domestic hygiene, as well as proper waste management practices to curb the spread.
Gbadegesin said the measure had become necessary, following the increasing rate of deaths, leaving many hospitalised.
"The outbreak of cholera in the state is a serious public health concern. It is imperative that every resident takes proactive measures to prevent further spread of the disease.
"Ensuring proper personal and domestic hygiene, including efficient waste management, will go a long way in curbing the spread of the fatal disease," he added.
Precautionary measures
The LAWMA boss suggested several precautionary measures, including: proper waste disposal; ensuring safe drinking water; frequent hand-washing with soap; food safety practices and use of proper sanitation facilities, among others.
Gbadegesin admonished residents to shun indiscriminate refuse disposal and imbibe the practice of bagging and disposing off their waste using covered bins to prevent the possible spread of the diseases by vectors, and to ensure seamless evacuation by assigned PSP operators.
"LAWMA will continue to intensify efforts at making sure that waste generated across the state is promptly and efficiently managed, with PSP service providers who are working round the clock to clean up black spots.
"We are fully committed to the health and safety of every Lagosian. Our teams are on the ground, ensuring that waste is properly collected and disposed off to minimise health risks. However, we need the cooperation of all residents to maintain a clean and safe environment," he said.
Why Lagos is prone to cholera outbreaks -- Analysis
Lagos, Nigeria's bustling metropolis and commercial capital, is a city of contrasts, with crumbling shantytowns coexisting with glistening skyscrapers. Amid it all, are open drains crisscrossing the streets and people are exposed to the toxic contents of the overflowing, filthy contents.
Over the years, Lagos has witnessed a series of significant cholera outbreaks. The primary factors have been traced to the high level of migration, unhygienic living conditions, overcrowding, open defecation, and ignorance about the spread of the disease.
Cholera has a long history in Lagos, dating back to the first recorded cases in 1970, when the first major outbreak struck Lagos, causing thousands of cases and hundreds of deaths.
According to the World Health Organisation, WHO, from the 1990s to the 2000s and beyond, there have been a series of intermittent outbreaks, highlighting the persistent risk of cholera in Lagos.
Silently, cholera spreads from the dirty street vendor who wipes sweat from his forehead and the wary Lagos commuter or inhabitant who unintentionally drinks tainted water. Persons who are not strict about hand washing and personal hygiene are most at risk of the threat, and once infected, the bacteria grow and spread, creating a web of infection.
Cholera spreads so quickly around the slums as a result of migration, unhygienic living conditions, overcrowding, open defecation, and ignorance about the spread of the disease. The limited sanitation facilities in the city are a significant factor. Many Lagosians lack access to proper toilets, and resort to open defecation near the canals and drainages, leading to the contamination of water sources, creating cesspools and breeding grounds for the cholera bacteria.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
In the densely populated slums and remote areas of Agege, Ikotun, Ejigbo, Ijeshatedo/Itire, Ilaje, Iwaya, Badiya and Ajegunle among others, overcrowding is a major issue. The same can be said for the floating Makoko community where the sanitation infrastructure is improper and grossly inadequate.
The overcrowding creates ideal conditions for the spread of waterborne diseases like cholera. Lagos perpetually struggles with blocked drainage systems, leading to stagnant water pools. that are breeding ground for vermin that can transmit cholera. The main routes of transmission are contaminated food and water.
The problem of unsafe water in Lagos is legendary. Unequal access to potable water forces many of the residents to rely on contaminated sources like wells or vendors selling untreated water. This can also contribute to the spread of cholera. These factors combine to create the perfect storm for cholera outbreaks in Lagos. Unsafe water sources, drinks sold on the street, and fruits that haven't been thoroughly cleaned all contribute to the malady.
Water contamination and the spread of cholera are largely caused by widespread unsafe practices, such as open defecation and inappropriate waste disposal. The dense population makes it difficult to maintain hygiene and avoid close contact between sick and healthy people.
Public transportation, crowded markets, and gatherings all raise the risk of transmission. Healthcare systems are strained by the outbreak. For early diagnosis, case management, and outbreak containment, adequate resources, qualified staff, and well-equipped facilities are needed.
There are various obstacles to effectively combating cholera in Lagos. mainly the inadequate hygienic conditions and sanitation in densely populated urban slums where access to clean water is limited and adequate sanitation facilities are scarce.
It is essential to keep spreading the word about cholera prevention. People can learn about good hygiene habits and early symptoms through community education, risk communication, and ongoing public health campaigns. The wet season also plays a role because floods can worsen the situation by contaminating water sources and causing outbreaks.
A concerted effort involving community involvement, public health authorities, and healthcare professionals is needed to address these challenges. Effective cholera control requires giving priority to interventions related to water, sanitation, and hygiene.
