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Nigeria

Nigeria – Diphtheria Outbreak - Operation Update (MDRNG037)

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Description of the Event

What happened, where and when?

The Diphtheria outbreak continues to pose a huge threat to at risk communities in Nigeria. This deadly disease which began in December 2022 and into the early 2023 has been spreading to other states as reported by the NCDC in the last SITREP of 7 July 2023.

Since week 1 of 2023, the outbreak has been at least 70% concentrated in Kano state. Followed by Yobe (12%), Katsina (6%), Sokoto (2%), Enugu (1%), Ogun (1%), Osun (1%), Kaduna (1%), Lagos (1%), and Zamfara (1%) states.
Since June and especially from early July, FCT and Cross River has also reported cases.

The main concern of the Diphtheria outbreak in these areas are still the same as initially highlighted: the immunization is very low, and poor uptake of routine immunization is one of the major causes of the disease. FCT has now reported cases of diphtheria, and due to its large or diverse demographic and busy economic activity or situation, with large clustered communities, sheltered housing areas, and a high population, FCT remains at risk of transmission and the spread or duplication of the disease may spiral quickly if actions are not properly taken. Also, there has also been recent surge of diphtheria cases in new LGAs in previously affected states.

In June 2023, there was 439 suspected cases reported from Kano (420), FCT (17), Osun (1) and Lagos (1) states. Out Of the 439 suspected cases reported, 160 (36.5%) were confirmed. This shows that the cases are still spreading, and continuous public health actions is required to curb the spread of Diphtheria to other states and people.

A total of 8 states have confirmed cases of Diphtheria and a total of 83 deaths were recorded among all confirmed cases (CFR: 9.9%). Kano (2,171), Yobe (95), Katsina (61), Lagos (29), FCT (22), Sokoto (14) & Zamfara (13) accounted for 98.0% of suspected cases and Kaduna with an alarming trend.

Diphtheria is a disease that affects most people without the vaccine, and the NCDC reports that out of the suspected cases, only 27 (12.5%) out of 216 confirmed cases were fully vaccinated with a diphtheria toxin-containing vaccine.
There have been laboratory-confirmed cases in addition to clinically suspected cases, and the NCDC is collaborating with state health departments and partners to improve surveillance and response to the outbreak. NCDC has been working with stakeholders to increase the awareness of the disease, however, the cases continue to increase.

NCDC was first notified of suspected diphtheria cases in Kano and Lagos states on 01 December 2022. On 20 January 2023, the Nigeria Centre for Disease Control and Prevention (NCDC) officially declared the situation as an outbreak with Diphtheria cases in Lagos and Kano States, which were the first to confirm the outbreak. Diphtheria has now quickly spread to other states such as Kaduna, FCT, Cross River and other local government areas in the already affected states.

Therefore, this operational update provides an overview of the Diphtheria outbreak in Nigeria and the Emergency response action by the Nigerian Red Cross Society.