Diphtheria: Vaccination As Most Effective Prevention

As confirmed cases of Diphtheria continue to rise across in the country,  vaccination has been identified as the most effective prevention against the disease.

Diphtheria is caused by a toxin produced by the bacteria Corynebacterium diphtheriae. It is a vaccine-preventable disease covered by one of the vaccines provided routinely through Nigeria’s childhood immunisation schedule.

Nigeria has recorded 13,204 suspected cases of Diphtheria out of which 8,406 were confirmed cases from 114 local government areas in 19 States including the FCT.

According to the National Primary Health Care Development Agency (NPHCDA), six states are bearing the brunt of the outbreak, accounting for a staggering 97ercentn of all reported cases.

The states are Kano, Yobe, Katsina, Borno, Kaduna, and Bauchi, while  Kano alone carries the weight of over 84 percent of the cases, making it the epicenter of this outbreak.

Executive director of the NPHCDA, Dr Faisal Shuaib, said the burden falls disproportionately on young people ,with over 73percent of cases occurring in children aged 1 to 14 years.

Alarmingly, only about 18 percent of those affected had received any vaccinations,“ said Shauib.

Director-general of the Nigeria Centre for Disease Control (NCDC) Dr Adetifa Ifedayo, gave breakdown by states; „Kano – 7,188 (86%), Yobe – 775, Katsina – 232, Borno – 118, Jigawa -23, Bauchi -20, Kaduna – 17, Lagos – 8, FCT – 6, Gombe – 5, Osun – 3, Sokoto – 3, Niger – 2, Cross River -1, Enugu – 1, Imo – 1, Nasarawa – 1, Zamfara – 1, Kebbi -1.

He said „As of today, the 3rd of October 2023, there have been 13,204 reported suspected cases out of which 8,406 were confirmed cases from 114 Local Government Areas in 19 States including the FCT.“

Adetifa said records have shown that most of the confirmed cases of diphtheria in the country were unvaccinated against diphtheria, saying of the 8,406 confirmed cases, 5,371 (64%) are either unvaccinated or partially vaccinated, 966 (11%) with unknown vaccination status while 2,069 (25%) are fully vaccinated against diphtheria.

Meanwhile, in response to the ongoing outbreak, the federal government, on the 19th of September 2023, set up a national emergency task team for higher level coordination of outbreak response efforts.

This includes ensuring optimal collaboration of all relevant stakeholders such as political, religious and traditional leaders.

Governors of the affected states were urged on prompt release of counterpart funds to ensure availability of operational resources to compliment the federal government’s contributions.

NPHCDA boss said vaccination has long been humanity‘s armor against deadly diseases, and diphtheria is no exception.

He said “The federal government recognises the power of vaccines in safeguarding public health, and our response to this outbreak centers around the belief that vaccination is our most formidable weapon.

“We have two vaccines at our disposal: the Pentavalent vaccine, administered to children aged 6 weeks to 4 years, and the Tetanus-diphtheria (Td) vaccine, provided to children aged above 4 years to 14 years.”

“In recent months, we have launched rapid and comprehensive vaccination campaigns across the affected regions. These campaigns have been meticulously planned and executed, with a laser focus on the epicenter of the outbreak.”

Kano, as the epicenter of this outbreak, has been at the forefront of our vaccination efforts. Working with the State governments, we implemented rounds 1 and 2 of the vaccination campaign in five high-burden Local Government Areas (LGAs) in February and April 2023 respectively. Subsequently, round 3 was integrated with routine immunization intensification, further bolstering our response. An additional 8 LGAs in Kano underwent reactive vaccination exercises in the last week of August.

Beyond Kano, we expanded our response to include Kaduna, Katsina, Bauchi, and Yobe in our Phase One response. These states engaged, trained, and executed vaccination campaigns in 25 high-burden LGAs within their borders with the commencement of reactive vaccination in August 2023. Borno State also conducted reactive vaccination exercises in four LGAs during the same period.”

Shauib urged the affected 19 states on reintroduction of use of facemask, saying

“Diphtheria is an airborne disease. Like COVID-19, we can reduce air contact with the bacteria by adopting non pharmaceutical intervention such as the use of facemasks, handwashing and physical distancing from affected persons.

Accordingly, I would like to call on Governors of affected states to institute face covering requirements such as facemasks in public gatherings. By so doing, we can add another intervention to slow the progress of the outbreak.”

However, he said this should be done in a way that does not stigmatise nor discriminate against sick people.