NCDC Raises Fresh Alarm as Cholera Outbreak Continues

The Nigeria Centre for Disease Control and Prevention (NCDC) has warned that cholera transmission remains active across the country, urging sustained efforts to prevent further infections and deaths.

The NCDC Director-General, Dr Jide Idris, gave the warning in Abuja during a press briefing on the current situation, response and measures required to contain cholera and diphtheria outbreaks.

He said Nigeria has recorded more than 65,000 suspected cases of cholera across 35 States and approximately 195 Local Government Areas this year.

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He noted that although weekly cholera cases had declined considerably from the peak recorded earlier in the season, and the proportion of cases resulting in death was significantly lower than during the same period last year, the situation still required sustained response.

“This is important progress. But I want to be very clear: the outbreak is not over,” the NCDC Director-General cautioned.

He explained that experience in recent years showed that cholera transmission could peak between late August and October, while the continuing rainy season and risk of flooding could contaminate water sources and overwhelm sanitation systems.

Idris said the agency was particularly concerned about conditions that continued to expose communities to cholera, including unsafe water, open defecation, damaged water distribution systems, poor hygiene infrastructure and inadequate sanitation in schools, markets and other public institutions.

“While treatment saves lives, we cannot treat our way out of cholera,” he stressed, calling for sustained action on water, sanitation, hygiene, environmental health and community behaviour.

The NCDC chief identified early access to treatment as one of the clearest lessons from the current outbreak, particularly in Borno State, where the majority of this year’s cases had been recorded.

According to him, better outcomes had been recorded where treatment was brought closer to affected communities and people sought care early.

Diphtheria Remains a Concern

The NCDC also reported that Nigeria has recorded more than 10,000 confirmed cases of diphtheria this year.

The Director-General said although the disease continues to constitute a substantial burden, there has been an important improvement, with the proportion of confirmed cases resulting in death declining considerably compared with the same period last year.

He, however, said most confirmed cases remain concentrated in a few States, particularly Kano, Borno and Bauchi.

The NCDC identified low vaccination coverage as a major concern, noting that too many children remain unvaccinated or incompletely vaccinated.

He said vaccine hesitancy, insecurity, hard-to-reach communities, displacement and population movement have also made it more difficult to reach every child who requires protection.

“It is important to emphasise again that diphtheria is vaccine-preventable,” the NCDC Director-General said, calling for improved vaccination coverage and efforts to reach every eligible child who has missed a vaccine dose.

NCDC Intensifies Response

The NCDC said it continues to coordinate the public health response to both outbreaks with State Governments and partners, providing technical support where it is most needed.

It said surveillance and laboratory capacity are being strengthened, while healthcare workers are receiving support on case management, infection prevention and control. Affected communities are also being engaged with information on prevention and early care-seeking.

The agency disclosed that National Rapid Response Teams have been deployed to affected States to support investigation and response activities.

For cholera, the response is focused on ensuring early access to treatment while addressing water, sanitation and hygiene conditions driving transmission.

Borno, NCDC teams have investigated transmission sources and assessed water supply points to identify gaps in water quality, sanitation and chlorination.

In Bauchi, the agency, working with the State Government, established oral rehydration points, strengthened treatment capacity and intensified active case searches.

Oral cholera vaccination has also been implemented in high-burden areas, alongside water chlorination, rehabilitation of water sources and hygiene promotion.

For diphtheria, the response is focused on strengthening vaccination coverage and rapidly identifying and managing cases.

Reactive vaccination is being conducted in affected areas, while essential treatment and laboratory commodities continue to be provided.

States Urged to Intensify Efforts

The NCDC Director-General said Federal action alone would not be enough to bring the outbreaks under control, stressing that many of the interventions that would make the greatest difference must happen at the State, Local Government, health facility, community and household levels.

He therefore called on State and Local Governments to identify communities at greatest risk, address critical gaps and direct available resources and response capacity to areas where they are most needed.

For cholera, he urged governments to improve access to safe water and sanitation, strengthen water-quality monitoring, repair critical water infrastructure, address open defecation and ensure that high-risk Local Government Areas have functional treatment and rapid-response capacity.

For diphtheria, he called for improved vaccination coverage, particularly in affected, hard-to-reach and underserved communities, as well as stronger routine and targeted immunisation.

Healthcare Workers, Nigerians Urged to Act

The NCDC also advised healthcare workers to maintain a high index of suspicion for both diseases, ensure early recognition and reporting, and observe standard infection prevention and control precautions.

For cholera cases, the agency said dehydration should be assessed promptly and appropriate treatment commenced without delay.

“It is dehydration that kills,” the NCDC Director-General told healthcare workers, emphasising the need for prompt management.

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He urged health facility managers to ensure that healthcare workers have functional triage and isolation systems, appropriate personal protective equipment, hand-hygiene facilities and systems for prompt notification and referral of suspected cases.

The NCDC further called on traditional and religious leaders, community leaders and civil society organisations to help provide accurate information, promote preventive measures, encourage early care-seeking and address misinformation.

For cholera prevention, Nigerians were advised to ensure that drinking water is safe, maintain clean surroundings, use proper sanitation facilities, avoid open defecation and practise regular handwashing with soap and clean running water.

The agency also advised people who develop frequent watery diarrhoea, with or without vomiting, to start oral rehydration solution immediately and seek care at the nearest health facility.

Parents and caregivers were urged to ensure that their children are fully vaccinated against diphtheria, while children who have missed recommended doses should be taken to the nearest health facility to complete their vaccination.

The NCDC said diphtheria vaccines are safe, effective and available free of charge through routine immunisation services and vaccination campaigns.

Media Urged to Support Response

The NCDC also appealed to the media to support the public health response by providing accurate and actionable information capable of protecting communities and saving lives.

The Director-General urged journalists to reinforce the importance of safe water and sanitation, oral rehydration and early treatment in preventing deaths from cholera, while helping parents and caregivers understand the importance of vaccination against diphtheria.

He reiterated that although cholera cases are declining, “the outbreak is not over,” while stressing that diphtheria remains vaccine-preventable.

The NCDC said sustained action by Federal, State and Local Governments, healthcare workers, traditional and religious leaders, partners, communities, families and individuals would be required to prevent further infections and bring both outbreaks under control.