RED ALERT!!! CHOLERA EPIDEMIC IN NIGERIA - By Dr. Obieze Nwanna - Nzewunwa

Cholera is back to Nigeria and this time, it is with a raging fury. Officially 6 states ( Lagos, Plateau, Zamfara, Ogun, Oyo and Sokoto states) have been hit in a space of 2 weeks with a total of over 1580 victims, claiming about 86 lives at present. In Zamfara state alone, 1,110 people have been infected by the illness which has already claimed many lives. The table below describes the distribution of the illness as well as the death toll and the map below shows the geographical disposition of the affected states.

STATE	NUMBER OF INFECTED PEOPLE	DEATHS
Zamfara	1110	51
Nassarawa	105	9
Lagos	134	4
Plateau	130	11
Ogun	115	5
Oyo	29	6
TOTAL	1584	86

Table 1: Distribution of infection and death toll due to Cholera Infection in Nigeria

States in Nigeria affected by Cholera

What is Cholera?

Cholera is a bacterial infection that is extremely easy to spread and in turn very easy to pick up. It is caused by a bacterium called Vibrio Cholerae. Annually, there are an estimated 3-5 million cases and 100,000-120,000 deaths (i.e. 2-4% fatality/ mortality rate).Contrary to popular myths, it can affect both adults and children equally and with the capacity to kill victims within hours if left untreated. Till date there have been 7 recorded pandemics (worldwide epidemics). 

How can one get Cholera? 

A person can get cholera by drinking water or eating food contaminated with the cholera bacteria. In an epidemic, such this, the source of contamination is usually the faeces of an infected person which contaminates food and/or water. This may also occur in areas with inadequate sewage treatment or areas where people defaecate in rivers and streams that also serve as a source of water supply for cooking and drinking. 

As many as 75% infected people who become infected do not develop any symptoms, despite carrying the infective cholera bacteria in their body. Such people have the ability to shed these bacteria in their faeces which then becomes infectious. Anyone who comes in contact with the infected faeces either by direct contact and handshake (and then transfers the bacteria to his/her mouth), or ingestion of contaminated water  and/or food which has been contaminated with infected faeces could and most likely would get infected. Such people are called asymptomatic carriers and they pose a huge risk and health hazard because:

1. They serve as a reservoir of the infection

2. Being mobile, these persons would help spread the illness to other geographical locations outside the primary area of infection if and when they travel to other geographical locations.

How can I know if someone has cholera?

You don't need to be a doctor to nor do you need to be witchdoctor's apprentice to make the diagnosis. All you really need is awareness and a reason for suspicion which doctors would call symptoms (no pun nor rhyme intended). Symptoms can manifest as early as 2 hours after picking up the infection or it may even take as long as 5 days in some cases for symptoms to manifest. If that person is living in or coming from an area with an epidemic of cholera and has any of the following symptoms:

• Diarrhoea (watery or loose stools)
• Vomiting
• Nausea
• Headache
• Stomach pain/ cramps
• Weakness/ lethargy
• Thirst and dehydration
• Fainting/ Loss of consciousness
• Death 

How do you protect yourself?

1. Awareness, health campaigns etc.
2. Personal hygiene; wash your hands properly before eating or preparing food and after taking a poop! 
3. Environmental sanitation ( don't let urine or faeces come in contact with your food and water supply.
4. NEVER eat raw fish 
5. Boil, filter and even chlorinate your water if necessary and if possible.
6. Cholera vaccines exist and may offer some protection where available and affordable.

Treatment of Cholera

Early detection is the most important tool in the treatment of cholera. 

Followed by reporting to a hospital ASAP

Note that 80% of cases are successfully treated with simple O.R.S. (Oral Rehydration Salts). 

Dehydration and shock are the commonest causes of death in Cholera patients.  

 Let us all join hands to fight this vicious epidemic and halt its killing spree. You can do a lot to stop it, but only if you decide to. Every life is important and irreplaceable. As always, the time to act is now. 

Kind Regards

Dr. Obieze Nwanna - Nzewunwa