Cholera: Recurring Public Health Disaster

As Nigeria battles multiple public health threats, cholera, an age-old waterborne infection, has remained a recurring problem. Over 1,300 suspected cases and 34 deaths have been reported across 30 states as of April 20, 2025, according to data from the Nigeria Centre for Disease Control and Prevention (NCDC).

This represents a case fatality rate (CFR) of 2.6 percent, a jump from just six weeks earlier, when 1,149 suspected cases and 28 deaths were reported across 25 states.

Cholera, a preventable but highly infectious disease caused by Vibrio cholerae, has become endemic in many parts of the country, particularly in underserved communities with limited access to safe water and sanitation.

Children under five remain the most vulnerable group, closely followed by those aged 5 to 14, with an even spread across genders. Bayelsa State is the hardest-hit, accounting for over 60 per cent of all suspected cases, particularly in Southern Ijaw LGA, which alone reported 228 cases.

Other affected states include Rivers (107), Abia (44), Delta and Niger (33 each), Akwa Ibom and Benue (28 each), Katsina (21), Bauchi (17), and Kogi (12). Additional states such as Kebbi, Gombe, Ekiti, Imo, Nasarawa, Osun, Enugu, Lagos, Borno, Ondo, Oyo, Sokoto, Yobe, Taraba, and Adamawa have also reported varying case numbers, collectively accounting for the remaining 34 per cent.

Public health experts have raised concerns over the spike in cases and deaths, which is 75 per cent higher than during the same period in 2024. NCDC warns that without immediate and coordinated action, especially during peak flooding periods, the outbreak may spiral further out of control.

Director-General of NCDC, Dr. Jide Idris, stressed the link between flooding and waterborne disease transmission. “Cholera remains endemic in Nigeria, especially in communities with poor access to clean water and sanitation. It is a highly contagious bacterial infection that can be fatal without prompt treatment,” he said.

Dr. Idris emphasised that cholera is largely spread through contaminated water and food, poor sanitation, and open defecation. Street-vended beverages, raw fruits rinsed with unsafe water, and even some bottled water have been flagged as common sources.

The incubation period ranges from two hours to five days, and while 80 per cent of infected individuals may show mild or no symptoms, severe cases can cause acute watery diarrhea and vomiting, leading to rapid dehydration and death, he explained.

“Though case numbers remain relatively low, their widespread distribution during the rainy season underscores the need for heightened vigilance. We urge stronger collaboration across sectors, especially in water, sanitation, and hygiene, to prevent further spread and reduce fatalities,” Dr. Idris stated.

He emphasised that individuals at highest risk include those in areas with limited clean water and sanitation, particularly in slums, rural communities relying on unsafe water sources, and overcrowded settings such as refugee camps. He added that health workers and caregivers are also at risk if infection control measures are not strictly followed.

The DG urged the public to boil drinking water, store it safely, maintain proper hand hygiene, cook food thoroughly, and avoid open defecation and indiscriminate refuse dumping.

He also advised health workers to promptly report suspected cholera cases, adhere to infection prevention protocols, and educate communities on protective practices.

Despite the grim statistics, cholera is both preventable and treatable. The World Health Organization (WHO) and NCDC stress the importance of prompt treatment with oral rehydration solutions (ORS) and antibiotics, and the need for clean drinking water, proper sanitation, and hygiene practices. Severely dehydrated patients may require intravenous fluids and hospital care.

To strengthen the response, NCDC said it has launched readiness workshops across regions, distributed treatment protocols and test kits, and identified 134 high-risk LGAs for intervention.

As the rains intensify and the risk of flooding increases, Nigerians are urged to remain vigilant: boil drinking water, avoid open defecation, maintain hand hygiene, and seek immediate medical care at the first sign of symptoms.