With the recent report on the outbreak of Cholera in at least 30 states of the Federation, The Nigerian Center for Disease Control has announced plans to declare a state of emergency after concluding its findings.
Current infections stand at over 1500 while mortality is put at 30 persons who have lost their lives to the current outbreak first reported about 3 weeks ago.
What is Cholera?
Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium, Vibrio cholera. Choleragenic V. cholera O1 and O139 are the only causative agents of the disease.
The two most distinguishing epidemiologic features of the disease are its tendency to appear in explosive outbreaks and its predisposition to causing pandemics that may progressively affect many countries and spread into continents.
Despite efforts to control cholera, the disease continues to occur as a major public health problem in many developing countries.
Numerous studies over more than a century have made advances in the understanding of the disease and ways of treating patients, but the mechanism of emergence of new epidemic strains, and the ecosystem supporting regular epidemics, remain challenging to epidemiologists.
In Nigeria, since the first appearance of epidemic cholera in 1972, intermittent outbreaks have been occurring. The latter part of 2010 was marked by a severe outbreak that started from the northern part of Nigeria, spreading to the other parts and involving approximately 3,000 cases and 781 deaths. Sporadic cases have also been reported.
Cholera caused by Vibrio cholera continues to be a global threat to public health and a key indicator of lack of social development.
Once common throughout the world, the infection is now largely confined to developing countries in the tropics and subtropics. It is endemic in Africa, parts of Asia, the Middle East, and South and Central America. In endemic areas, outbreaks usually occur when war or civil unrest disrupts public sanitation services.
Natural disasters can to outbreaks by disrupting the normal balance of nature. This creates many health problems, food and water supplies can become contaminated by parasites and bacteria when essential systems like those for water and sewage are destroyed. Developing countries are disproportionately like Nigeria are disproportionately affected because of their lack of resources, infrastructure, and disaster preparedness systems.
The organism normally lives in aquatic environments along the coast. People acquire its infection by consuming contaminated water, seafood, or other foods. Once infected, they excrete the bacteria in the stool.
Thus, the infection can spread rapidly, particularly in areas where human waste is untreated.
In Nigeria, the infection is endemic and outbreaks are not unusual. In the last quarter of 2009, it was speculated that more than 260 people died of cholera in four Northern states.
Most of the Northern states of Nigeria rely on hand dug wells and contaminated ponds as source of drinking water. Usually, the source of the contamination is other cholera patients when their untreated diarrhoea discharge is allowed to get into water supplies.
The 2010 outbreak of cholera and gastroenteritis and the attendant deaths in some regions in Nigeria brought to the forefront the vulnerability of poor communities and most especially children to the infection.
The outbreak was attributed to rain which washed sewage into open wells and ponds, where people obtain water for drinking and household needs. The regions ravaged by the scourge include Jigawa, Bauchi, Gombe, Yobe, Borno, Adamawa, Taraba, FCT, Cross River, Kaduna, Osun and Rivers. Even though the epidemic was recorded in these areas, epidemiological evidence indicated that the entire country was at risk, with the postulation that the outbreak was due to hyper-virulent strains of the organism.
Transmision of Cholera in Lagos
Cholera is an extremely virulent disease transmitted through the ingestion of contaminated food or water.
As previously pointed out, there is a strong correlation between the current rainy season and the increase in the prevalence of outbreak of Cholera in Nigeria with states such as Lagos, Ogun, and Rivers experiencing more floods than several other states of the federation.
These states have been implicated with poor sewage control, inadequate waste disposal especially in rural areas, and poor drainage systems which are factors that promote the easy spread of the bacterium through water channels.
As of 2021, the United Nations Children’s Fund (UNICEF) reported that 46 million Nigerians still practice open defecation, rating it at 23 percent. But in the latest report by The World of Statistics in 2023, Nigeria is ranked ninth and now 18 percent.
This practice of open defecation leads to an increase in ground levels for the bacterium which can thrive in harsh environments and find its way to water settlements where those who practice poor hygiene come in contact with the bacterium and get infected.
One of the most available resources for home use is water. Water is used in preparing food both at home and for commercial cooking and it is no wonder foods not properly cooked can be a source of contamination.
Due to the high amount of Sugar in carbonated drinks, Nigerians have resorted to drinking locally made drinks such as Tigernuts, Zobo, Kunu, etc as a way to stay healthy without ingesting high leveled sugar alleged to be responsible for some health conditions.
These drinks are made at home with 60-80% of their constituent being water.
The process of purchasing and processing the raw materials and water sources for this drink has been well implicated for causing food poisoning and other diseases such as Cholera, Diarrhea, Amebiosis,etc.
According to PUNCH Healthwise, one Mr. Samuel Abbey, 46, didn’t find it palatable in April, after the tiger nut drink he took landed him in the hospital. He had to battle persistent diarrhea for two days.
Abbey, an indigene of Rivers State is still thanking God for sparing his life after it was confirmed by the doctor that the tiger nut drink he had consumed on his way from work that fateful day was contaminated.
Recounting his ordeal, Abbey said that it took him over a week to regain his health and resume work, a situation he said affected his family’s welfare as he was the breadwinner.
“My wife had to rush me to the hospital where I was admitted and treated for three days. The doctor told my wife that the result of the test carried out on me showed food poisoning.
“And the only thing that I ate before I started having bowel problems was the tiger nut drink. For me, buying tiger nut drink, zobo drink or any other locally made drink packaged in used and discarded bottles of soft drinks is nothing but a death trap,” he said.
Continuing, he narrated, “I bought the tiger nut drink at Oshodi under the bridge from one of the hawkers. You have a lot of women hawking the drink and other locally made drinks there.
“Actually, why I like buying and taking the tiger nut drink is because it has some health benefits and less sugar than the carbonated soft drinks.
“So on that fateful Friday, less than an hour after taking the drink, I started having stomach pain. At some point, I started purging and sweating profusely.
“As the stooling progressed, I became restless because the stomach pain also increased at the same time. The luck I had that day was that Oshodi is not far from where I live.”
Why tiger nuts and other homemade drinks should be avoided temporarily
These drinks when contaminated with the bacterium, provide a good environment for it to thrive and when consumed become a source of health concern with adverse symptoms from mild to life-threatening ones.
So many vendors who are involved with the manufacturing and ascertaining the hygienic practices during the production of these drinks cannot be ascertained by the end consumers of the products.
This is why this article is advising the temporary suspension of consuming these products hawked at liberty by these roadside sellers.
The contaminated water which should be properly boiled and stored is not done in the right way.
You also notice that majority of the raw materials used in production are sold open without properly covering them or use of well crafted showroom tables to avoid touch by intending buyers while others are sold in wheel barrows thus increasing exposure to contamination.
Symptoms of Cholera Infection
Symptoms of cholera infection can include:
- Diarrhea. Cholera-related diarrhea comes on suddenly and can quickly cause dangerous fluid loss — as much as a quart (about 1 liter) an hour. …
- Nausea and vomiting. Vomiting occurs especially in the early stages of cholera and can last for hours.
- Dehydration.
- Fever.
Smart how we put blames meant for the ineptitude of the government on the “innocent” tigernut. Would the tiger nut be infected (if it was truly what caused it) if the government lived up to expectations?
They have cunningly shifted wages of their irresponsibility to the tiger nut. As usual, Nigerians fell for it. We await another disaster.