Following the first reported confirmed case of Diphtheria in the Federal Capital Territory (FCT), Abuja, the Nigeria Centre for Disease Control and Prevention (NCDC) said it has rolled out measures to check it’s spread.
This was just as the House of Representatives yesterday, urged the Federal Ministry of Health and the NCDC to ensure that the outbreak of the disease was contained effectively as well as reduce the fatality ratio in confirmed cases.
The NCDC stated that so far, a total of 80 deaths have been recorded among all confirmed cases in the country with a case fatality rate of 10.0.
The centre said it was aware of the death in June 2023, of a four-year-old with diphtheria in the FCT.
A statement signed by the Director General of NCDC, Dr. Ifedayo Adetifa, stated that the Centre has activated the diphtheria Incident Management System (IMS) in the FCT to coordinate outbreak response activities.
He said the Centre since December 2022, reported multiple diphtheria outbreaks in different states across the country.
“As of June 30th, 2023, there have been 798 confirmed diphtheria cases from 33 Local Government Areas (LGAs) in eight 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 percent) 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),” the statement added.
“Diphtheria caused by a toxin produced by the bacteria Corynebacterium diphtheriae, is a vaccine-preventable disease covered by one of the vaccines provided routinely through Nigeria’s childhood immunisation schedule.
“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 included recently announced FCT case,” he said.
On the likely reason for the resurgence of the disease, the NCDC said historically sub-optimal vaccination coverage was the main driver of the outbreak given that the most affected age group (2-14-year-olds).
The NCDC DG said a national survey of diphtheria immunity showed that less than half (41.7 percent) of children under 15 years old were fully protected from diphtheria.
He said: “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.
“We urge the public to remain vigilant and ensure persons with symptoms of diphtheria present early to health facilities for prompt diagnosis and treatment. Early diagnosis and institution of effective treatment are key predictors of a favourable outcome. Healthcare workers are urged to immediately notify LGA disease surveillance officers once they see a suspected case.”
While giving update on Diphtheria outbreak in the FCT, the NCDC said the FCT Health and Human Services Secretariat had activated the diphtheria Incident Management System (IMS) to coordinate outbreak response activities.
It listed key activities against the outbreak to include 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.
The NCDC stated that as at July 3, 2023, only one confirmed case had been detected in the FCT with seven suspected cases testing negative while others were awaiting laboratory results. “No other death was recorded apart from the laboratory-confirmed case,” he added.
On NCDC’s response to Diphtheria outbreak in the country, the Centre said it activated a multi-sectoral national Diphtheria Technical Working Group in December 2022, as a mechanism for coordinating surveillance and response activities across the country.
The response activities included coordination, surveillance, laboratory investigation, risk communication, case management and immunisation activities.
Coordination, establishment of a multisectoral National Diphtheria Technical Working Group (TWG), bringing together relevant stakeholders to regularly meet and monitor the disease trend and coordinate response activities in the country.
The NCDC also said it has deployed the Rapid Response Teams (RRT) to some of the affected states (Kano, Katsina, Lagos, Osun, Yobe) to support response activities in the states and supported the establishment of a diphtheria IMS in the affected states.
The Centre further said it has embarked on the development and dissemination of surveillance tools across the country – case definition, case investigation form (CIF), line listing template and support for active case finding across affected states.
In addition, the Centre said it had developed draft diphtheria surveillance and response guidelines, embarked on sensitisation/training of clinical and surveillance officers on the presentation, prevention, and surveillance of diphtheria and harmonisation of surveillance and laboratory data from across states and laboratories.
Adetifa said it has commenced the building of capacity of state-owned public health laboratories for diphtheria diagnosis and strengthening the capacity of states for sample collection, transportation, and laboratory confirmation for diphtheria with the support of the United Kingdom Health Security Agency through the following: Other response measures embarked upon by NCDC include; training of laboratory physicians and scientists from selected states across the country at the National Reference Laboratory (NRL), Abuja, on laboratory methods for diphtheria confirmation, supply of diphtheria laboratory and sample collection consumables (transport media, reagents, sample collection materials etc.) to states across the country, supply of biosafety cabinets to some of the affected states, supporting the States in confirming cultures and toxin production testing (ELEK test and PCR) at the NRL on specimens sent in from States and performing drug susceptibility testing (DST) at NRL on isolates sent in from states.
In the area of case management, the NCDC stated that for the first time in over two decades, the country with support from World Health Organisation, procured and prepositioned diphtheria antitoxin (DAT) in-country and distributed it to the affected states.
Meanwhile, the House of Representatives has urged the Federal Ministry of Health and the NCDC to ensure that the outbreak of Diphtheria is contained effectively as well as reduce the fatality ratio in confirmed cases.
The House also called on the Ministry and the NCDC to intensify its sensitisation and enlightenment campaign to prevent and eradicate the scourge of Diphtheria and other related diseases across the country.
The resolutions followed the adoption of a motion on the ‘Need to Address Emerging Outbreak of Diphtheria in Nigeria,’ moved by Hon. Muktar Tolan Shagaya, during plenary yesterday.
Shagaya noted that the sporadic increase in the number of Diphtheria cases in Nigeria based on the recent reports of the World Health Organisation (WHO).
He noted that Diphtheria remains a highly contagious vaccine-preventable disease which spreads between people mainly by direct contact or through the air via respiratory droplets.
He, however, expressed concern that the cases were being under-reported in Nigeria despite the threats it poses to public health, including respiratory complications, heart rhythm problems and other fatal outcomes in situations of late detection.
“The federal government needs to intensify its efforts in sensitising and educating the public, especially those living in rural areas on the prevention, control and treatment of Diphtheria,” he added.
The House thereafter mandated its Committees on Healthcare Services and Legislative Compliance to ensure compliance.