Raging storm of Diphtheria: FG must strengthen vaccination, immunisation coverage
Infectious diseases have remained one topical health issue of the globe. In Nigeria, the state of such diseases in line with the demography is a subject ridden with depth of discourse. While there have been preventive measures most of which have found more reliance in vaccination, the coverage of such administration given the Nigerian population has been a subject of concern.
Over time, such diseases as polio and chicken pox, among others have had their record of fatal losses, especially for children. Recently cases of ebola, monkey pox, and presently raging, Diphtheria have posed their threats and losses.
The raging spread of Diphtheria is one ongoing disease whose spread is growing with losses, particularly among children. Recent records have shown that no less than 7,202 cases of diphtheria out of the 11,587 suspected cases in the Country have been confirmed across 105 Local Government Areas in 18 States in Nigeria, including the Federal Capital Territory.
The Federal Government, had earlier on Monday, 24 September, 2023, disclosed in a joint press statement signed by the Federal Ministry of Health and Social Welfare, the National Primary Health Care Development Agency, the Nigeria Centre for Disease Control and Prevention, and other development partners, that most of the confirmed cases were recorded in Kano with 6,185 cases. Other states with cases are Yobe (640), Katsina (213), Borno (95), Kaduna (16), Jigawa (14), Bauchi (eight), Lagos (eight), FCT (five), Gombe (five), Osun (three), Sokoto (three), Niger (two), Cross River (one), Enugu (one), IMO (one), Nasarawa (one) and Zamfara (one).
According to the Federal Government, 5,299 of the confirmed cases, which is 73.6 per cent, occurred among children aged one to 14 years with those aged five to 14 years bearing most of the brunt of the disease. So far, a total of 453 deaths have occurred in confirmed cases, giving a case fatality rate of 6.3 per cent
On management measures it has carried out with the wake of the spread of the disease, the Federal Government had said: “Given the escalation of the outbreak and findings that 80 per cent of confirmed cases in the ongoing outbreak are unvaccinated, the Honourable Coordinating Minister of the FMOH&SW, Prof Ali Pate, set up a national emergency task team co-chaired by the Executive Director of the NPHCDA, the Director General of the NCDC for higher level coordination of outbreak response efforts.
“This includes ensuring optimal collaboration of all relevant health stakeholders in this fight. Other prominent members of the task force include the director of Public Health-FMOH, representatives from the Federal Ministry of Information, the World Health Organisation, the United Nations Children’s Fund, USCDC, USAID, Gavi the Vaccine Alliance, other non-governmental organisations and development partners.
“For the first time for any diphtheria outbreak, the FMOH&SW through NCDC and with WHO support, procured diphtheria antitoxin and more recently intravenous erythromycin and distributed them to the affected states. With support from partners and in collaboration with the State Ministry of Health, Diphtheria Treatment Centres/Wards have been established in affected states.
“Intensified routine diphtheria immunisation and reactivated vaccination campaigns in 33 LGAs in Bauchi, Katsina, Yobe, Kano, and Kaduna by the NPHCDA. Mobilised procurement of vaccines and essential logistics for three large-scale outbreak response campaigns in 56 LGAs across seven priority states – Bauchi, Borno, Jigawa, Kaduna, Kano, Katsina and Yobe.”
To reduce the risk of diphtheria, the Government had advised parents to ensure that their children are fully vaccinated against diphtheria with the three doses of diphtheria antitoxin-containing pentavalent vaccine given as part of Nigeria’s childhood immunisation schedule.
“Healthcare workers should maintain a high index of suspicion for diphtheria and practice standard infection prevention and control precautions while handling all patients in their care. All healthcare workers (doctors, nurses, laboratory scientists, support staff etc.) with a high level of exposure to cases of diphtheria should be vaccinated against diphtheria.
“Individuals with signs and symptoms suggestive of diphtheria should promptly present to a health care facility or designated diphtheria treatment centres and where possible they and/or healthcare workers should notify their LGA, State Disease Surveillance Officer, their State Ministry of Health helpline, or the NCDC through our toll-free line on 6232,” the Government had directed.
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.
A historical gap in vaccination coverage is attributed as the driver of the outbreak given the most affected age group and results of the nationwide diphtheria immunity survey that shows only 42 per cent of children under 15 years old are fully protected from diphtheria.
Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheria that make a toxin. It is the toxin that can cause people to get very sick. Diphtheria can infect the respiratory system, which includes parts of the body involved in breathing. When the bacteria get into and attach to the lining of the respiratory system, it can cause weakness, sore throat, mild fever, swollen glands in the neck. It can also infect the skin, causing open sores or ulcers. However, diphtheria skin infections rarely result in severe disease.
Given the fact that 80 per cent of confirmed cases in the ongoing outbreak are unvaccinated, it is pertinent for the Government to embark on emergency course of massive vaccination campaign among children, particularly in areas of threat susceptible to the infection. More importantly, it is pertinent for the Government to make immunisation and vaccination programmes for children in the Country more elaborate to cover areas of disadvantage, bearing in mind the demography of the Country. This is important to foreclose issues of such outbreaks which constitute threats to the Nigerian society. Giving concerted attention to such preventive measures speak volume for a safe and healthy environment.
For the ongoing outbreak, the Government must beef up coordination for surveillance and response activities across the Country to foreclose further losses among children, who are particularly susceptible to the disease.
