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Experts worry as diphtheria resurges in Nigeria

Medical experts have said the resurgence of the diphtheria disease may be due to low vaccination coverage and waning immunity against the disease in the country.

This is even as the country is battling multiple disease outbreaks of Lassa fever, cholera, COVID-19, and measles, among others.

According to the Kano state Ministry of Health, not less than 58 suspected cases of the disease have been recorded, just as it has claimed 25 lives, while six patients were on admission as of January 13, 2023.

The Nigeria Centre for Disease Control and Prevention also said there reported cases in Lagos state and it is monitoring the situation in Osun and Yobe states where cases are now being picked up.

Diphtheria is a serious bacterial infection caused by the bacterium called Corynebacterium species that affects the nose, throat, and sometimes, skin of an individual.

Diphtheria spreads easily between people through direct contact with infected people, droplets from coughing or sneezing, and contact with contaminated clothing and objects.

The onset of signs and symptoms usually starts after two to 10 days of exposure to the bacteria. The Symptoms include fever, runny nose, sore throat, cough, red eyes (conjunctivitis), and neck swelling.

Speaking with our correspondent, the President of the Nigeria Biological Safety Association, Prof Ademola Denloye said diphtheria is a bacterial disease, and it could be a challenge to control it.

Denloye, who is also a professor in the Department of Zoology and Environmental Biology at the Lagos State University, said “We have lost some lives in Kano already, and in such a situation where houses are built close to one another and the communal way of living because it is easier for it to spread from person to person.

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He said various Ministries of Health, and health departments at all levels need to up their game in curtailing the disease.

“These days, aviation helps to spread those diseases and it is also a respiratory disease, and as you have people moving from one place to another, by road, air and it makes it very necessary to up our game.

“The Federal Ministry of Health, State Ministries of Health, and the health departments at the local government levels need to be activated now to check the spread of the disease.

“It is also possible there is a waning immunity among adolescents and adults and when immunities are low, infections will rise.We need to increase our vaccination rate for other vaccine-preventable diseases including COVID-19,” he added.

Also, a Professor of Public Health, Tanimola Akande said it is worrisome that a vaccine-preventable disease is still resurging in the country.

“It means people are not protected and our immune system is low. Routine immunisation coverage is very low in Nigeria. Officially, they say the vaccine is available but are people accessing it?

“We have a lot of problems with vaccination, people are not accessing it and some health facilities don’t do routine immunisation every day and it is meant to be a daily service. It can be as bad as facilities in some rural areas doing it once a month and that does not make any meaning.

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“So, once you miss it, you don’t have any access and some people don’t see the importance of this. Some people will take BCG at birth but will find it difficult to complete the vaccination schedule,” Akande noted.

Meanwhile, the NCDC advised healthcare workers to maintain a high index of suspicion for diphtheria and individuals with signs and symptoms suggestive of diphtheria to isolate themselves and notify the local government area, state disease surveillance officer, or the NCDC.

“Close contacts with a confirmed case of diphtheria should be closely monitored given antibiotics prophylaxis and started on diphtheria antitoxin treatment when indicated.

“All healthcare workers (doctors, nurses, laboratory scientists, support staff, etc.) with higher exposure to cases of diphtheria should be vaccinated against diphtheria,” it added.

Data from the NCDC showed that there was an outbreak of the disease in Borno state in 2011 with a total of 98 cases, and 21 deaths (case fatality ratio was 21.4 per cent).

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