In a follow-up on the diphtheria outbreak in Nigeria, the Nigeria Centre for Disease Control and Prevention (NCDC) reports from 14 May 2022 to 9 April 2023, 1439 suspected cases have been reported, of which 557 (39%) have been confirmed, including 73 deaths among the confirmed cases (case fatality ratio of 13%).
The outbreak has affected 21 of the 36 states and the Federal Capital Territory. The majority (83%) of cases are reported from Kano (1188), Yobe (97), Katsina (61), Lagos (25), Sokoto (14) and Zamfara (13).
The country is currently faced with several public health emergencies such as Lassa fever, cholera, mpox, meningitis and a humanitarian emergency in the northeast of the country. Due to insecurity, especially in north-eastern Nigeria, vaccination coverage remains suboptimal, especially in the areas controlled by non-state armed groups. Therefore, the outbreak of diphtheria further complicates and strains the already overstretched resources. The global supply of diphtheria antitoxin (DAT) is limited, and this may affect the availability of the required doses in a timely manner.
According to the World Health Organization, Diphtheria is a highly contagious vaccine-preventable disease caused by exotoxin-producing Corynebacterium diphtheriae It spreads between people mainly by direct contact or through the air via respiratory droplets. The disease can affect all age groups, however unimmunized children are particular at risk. It is potentially fatal. Symptoms often come on gradually, beginning with a sore throat and fever. In severe cases, the bacteria produce a poison (toxin) that causes a thick grey or white patch at the back of throat. This can block the airways, making it hard to breathe or swallow, and also creates a barking cough. The neck may swell in part due to enlarged lymph nodes.
Treatment involves administering diphtheria antitoxin as well as antibiotics. Vaccination against diphtheria has reduced the mortality and morbidity of diphtheria dramatically. Diphtheria is fatal in 5 – 10% of cases, with a higher mortality rate in young children. However, in settings with poor access to diphtheria antitoxin, the CFR can be as high as 40%.