Yola, 8 June, 2018 - “Initially, I thought it was nothing to worry about until I visited the toilet for the third watery stool this morning,” says Rukayat Mohammed. “Suddenly, I realized that I was I losing strength. As my family was about to prepare some food for me, a team of healthcare workers arrived my household as if someone directed them. They asked if anyone was vomiting or passed two or three watery stools today. Of course, I said yes and before I knew it, an ambulance arrived and conveyed me to a cholera treatment centre at the Mubi General hospital. 

Mrs Mohammed is one of the beneficiaries of disease surveillance activities facilitated by the World Health Organization (WHO) in Mubi North and Mubi South local government areas (LGAs) to support Adamawa state contain the cholera outbreak with 1168 cases and 20 deaths recorded as at 07 June 2018.

According to Mallam Kabiru Sadiq Adamawa Incident Manager for the cholera response, new cases are being reported every day. “This is an indication of active house-to-house surveillance led and coordinated by WHO. Also, the case fatality ratio was 17% as of 12 May 2018 but dropped to 1.7% as at 07 June 2018, suggesting that cases are being detected and reported early by the surveillance team coordinated by WHO.”

Disease surveillance in emergencies can be tasking especially where insecurity, difficult terrain and frequent displacements hamper accessibility to the affected populations. Yet robust surveillance characterized by early detection, rapid and coordinated response are critical to bringing outbreaks under control and reducing threats of further spread. 

WHO is concerned that if the cholera outbreak continues, it could spread to neighbouring local government areas (LGAs), cross the international border to Cameroun and pose a major public health threat. “WHO is leaving no stone unturned to ensure that the outbreak does not spread beyond the immediate vicinities of Mubi North and Mubi South LGAs,” Dr Collins Owili, WHO Emergency Manager for the northeast response in Nigeria said. 

“That explains why we swiftly activated and managed a cholera treatment centre in collaboration with the Adamawa state health authorities for the first two weeks of the outbreak, disinfected all infected households, advocated for and supervised chlorination of commercial sources of water and still conducting house-to-house active case search”, Dr Owilli said.

In cholera outbreak response, early detection and reporting are prelude to good case management and overall control of transmission. Other partners in the overall response including UNICEF, Médecins Sans Frontières (MSF), Solidaritaire and Danish Refugee Council among others are equally implementing various cholera control measures such as water chlorination and case management under the coordination and leadership of government and WHO. 

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