Borno, 21 January 2019 -  It is safe to say that the cholera outbreak in the North East is under control. 

In a synchronized event, the Commissioners of Health in Borno, Adamawa and Yobe States recently declared the end of the Cholera outbreak. It has been over two weeks since the last cases of Cholera were detected and as required by epidemiological protocols and standards, when the number of suspected cases in an epidemic area significantly declines and all samples from suspected cholera cases test negative for a minimum period of two weeks, the outbreak is considered controlled.

Following the intense outbreak response which was led and coordinated by the Nigerian Government with support from the World Health Organization (WHO), the last cases of cholera were reported in Borno state on 14 December 2018, while Adamawa and Yobe states reported their last cases on 23 November and 04 December 2018 respectively indicating an end of the outbreaks according to epidemiological standards. 

Since the outbreaks of cholera were declared in each of the states at different times in 2018, close to 11,000 cases including 175 deaths with a case fatality ratio of 2.1% were reported across the three states as of 15th January 2019. 

WHO Emergency manager for the North East Nigeria, Dr Collins Owili explained that the outbreaks affected close to 11,000 people across 28 Local Government Areas (LGAs) with Borno contributing 58%, Adamawa, 25% and Yobe state 17%.  

“Atypical of cholera outbreaks, suspected cases were reported in early February 2018 from three wards in Kukawa LGA, Borno state,” said Owili. “Similarly, in Yobe state, on the 28th of March 2018, an outbreak of cholera was confirmed by the Honourable Commissioner for Health after samples collected from Gashua town in Bade LGA, tested positive to the bacteria vibrio cholerae. While, in Adamawa, cases were reported in Mubi north and South as early as 17 May 2018.”

In an address to the media on the official closure of the outbreak in Maiduguri, Borno state, the Commissioner for Health, represented by the Permanent Secretary, Alhaji Bukar Mustapha Allau commended WHO’s technical leadership and coordination of the health sector response. 

Allau disclosed that 15 LGAs of Borno state accounted for 6,367 reported cases of cholera in 2018, with 73 associated deaths indicating a case fatality ratio (CFR) of 1.15%. According to him, “Jere LGA with 2,482 cases, Maiduguri Municipal Council with 1,556 and Ngala LGA with 1,052 contributed 80% of all reported cases in the state. Other LGAs that reported various cases include Magumeri Konduga, Kwaya-Kusar, Chibok, Shani, Damboa, Kaga, Askira-Uba, Bama, Dikwa, Guzamala and Kala/Balge.” 

He commended the multi-sectoral approach, swift response and effective health partner coordination by all health partners as soon as the outbreak was confirmed. 

In Yola, Adamawa state, the Commissioner for Health, Dr Fatima Atiku-Abubakar explained that WHO’s robust surveillance activities including early detection, timely reporting and coordinated response guided interventions and helped in controlling the spread of the outbreaks which reached 2, 755 cases including 43 deaths as of 23 November 2018.

Her counterpart in Yobe state, Dr Muhammed Bello Kawuwa, stated that WHO’s strategic community surveillance even in difficult to reach locations, effective health partner coordination and capacity building of health workers enabled timely control of the outbreaks. 

Yobe state reported more than 1,800 cases with 61 associated deaths, giving a Case Fatality Rate (CFR) of 3.36% with 591 cases reported from Gulani LGA, 485 cases from Gujba LGA and 489 cases from Damaturu LGA. In Fune LGA, 181 cases were reported and 67 cases were reported in Potiskum LGA.

Although, cholera outbreaks are endemic in North East Nigeria, the outbreaks have remained persistent following the disruption of healthcare services as a result of the ongoing insurgency in the region. More than 1.7 million people have been internally displaced in Borno, Adamawa and Yobe states, and thus, rendered vulnerable to communicable disease infections especially cholera, Yellow fever and meningitis. Through its health emergencies programme, WHO is coordinating 45 health sector partners to respond to multiple as well as concurrent outbreaks of diseases in the region.