The cholera outbreak in Nigeria has claimed 103 lives from 3,623 suspected cases across 34 states and the Federal Capital Territory (FCT), it emerged on Tuesday, July 16. The Nigeria Centre for Disease Control and Prevention (NCDC) reported that the cases and deaths covered 187 Local Government Areas (LGAs) as of July 15, 2024. Lagos, Bayelsa, Abia, Ebonyi, Katsina, and Zamfara states lead in the number of cases and fatalities, contributing 83% to the overall burden of the disease. Despite this, the nation has been recording declining cases and fatalities compared to preceding months when the outbreak was first recorded in 2024, the agency stated. Yellow fever outbreak has also been recorded in Ekiti and Bayelsa states with 3 cases and one death. 0:00 / 0:00 Recall that in its June public health alert, the agency reported that between January and June 11, 2024, there were 30 deaths from 1,141 suspected cholera cases, with 65 confirmed cases across 96 LGAs in 30 states. While by that period, 15 States accounted for 90 percent of the disease burden, by June 21, 2024, the number had risen to 34 deaths from 1,288 confirmed cases, with 15 states responsible for over 80 percent of the cases. However, between June 21 and June 23, the figures surged to 53 deaths (an increase of 19 in three days) from 1,528 suspected cases across 107 LGAs in 31 states. In the June 23 update, Lagos led the 15 states that contributed 90 percent of the disease burden, with 29 deaths. NCDC Director General (DG), Jide Idris at a press briefing on Tuesday said the cholera cumulative case fatality rate since the beginning of the year stands at 2.8% while the predominant age affected is 5 years old while males account for 52% of cases and females account for the rest. He however announced that there was a 5.6% decline in the number of cases in this reporting week (8th -14th July) as compared to the preceding week. “We also recorded a drop in the case fatality rate from 2.9% to 2.8%. Definitely, there is a decline in case fatality rate from week 24 when the spike started to the present week,” he said. According to him, the improvement can be attributed to the concerted efforts of stakeholders and weather conditions in some parts of the country. The DG said: “Whereas ongoing current efforts at the national and some State levels might have been yielding some results and largely responsible for the decline being reported, however, given the trend from previous years, we know it is not uhuru yet. “The trend analysis from previous outbreaks shows the peak of the outbreak usually coincides with the peak of the rainy season, which is still some weeks ahead. “Also, some of the northern traditional hotspot States have been reporting fewer number of cases, which may be connected with the delayed onset of the rainy season in this part of the country. “Although almost all the States in Nigeria have reported cases of cholera, there appears to be an underreporting of the situation as required data from the states are not coming in real-time as expected given the trend in previous years. This is largely due to inadequate resources to support surveillance and disease detection activities at the sub-national level. “Additionally this may likely be further complicated by the effect of political undertone for reporting cholera, which some see as a Stigma or disease proxy indicator for the inability of the affected communities/persons to have access to potable water and other basic amenities of life”. He however assured that NCDC would not relent in its efforts to prevent and mitigate the disease outbreak, saying, “NCDC is implementing the national incident action plan for the response, intensifying efforts targeted at supporting states to conduct active case search, optimize laboratory capacity, with prepositioning of cholera management supplies and capacity building in anticipation of possible surge ahead. “We have our eyes on the ball, as we continue to strengthen case management efforts to sustain the decline in fatality ratio until we report the global target CFR of less than 1%. “Using the National Cholera Multi-Sectoral Emergency Operations Centre (EOC) we continue to lead the coordination, communication, and cooperation of all stakeholders involved in the national response. In addition, we have deployed national rapid response teams (NRRT) to the top 6 states contributing about 83% of cases. “The States are Lagos, Bayelsa, Abia, Ebonyi, Katsina and Zamfara States and plans are in place to deploy to more states, to strengthen surveillance system, improve case management, infection prevention and control and community engagement towards building community resilience. “We continue to monitor the trends and will escalate the required support as the situation demands”. Regarding yellow fever, Idris stated that the prevailing weather contributes to its outbreak and spread, adding, that maintaining good hygiene, among other measures, is an effective way to prevent the disease. “The disease, although preventable using a single dose of yellow fever vaccine which provides immunity for life; can lead to death within a few days if care is not sought early. “Currently, there are 3 presumptive positive cases which are reported from Ekiti (2) and Bayelsa (1) and 1 death. “1 confirmed case is generally considered an outbreak,” he noted. He also assured that the agency continues to monitor reports of yellow fever cases in Nigeria all year round, adding that due to the rainy season, it is also observing an increase in suspected cases. “In view of this we offer the following advice to the public, vaccination with the yellow fever vaccine provides life-long protection and is the most important means of preventing yellow fever; use mosquito repellent and wear protective clothing; clear surroundings of any stagnant water where mosquitoes can breed; ensure proper waste disposal and drainage maintenance; prompt reporting increases the chance of recovery, “If you experience sudden onset of fever, chills, severe headache, back pain, general body aches, nausea, and vomiting, seek immediate medical attention