Nigeria: Elevated diphtheria activity reported in multiple areas, especially in Kano, through September /update 1

Event

Nigerian health authorities have reported elevated diphtheria activity in multiple states, with 5,898 confirmed cases reported since the beginning of June 2023. Kano is the most affected state, reporting over 1,815 confirmed cases. Other states reporting high disease activity include Katsina (234 cases), Yobe (158 cases), Bauchi (79 cases), Kaduna (45 cases), and Borno (33 cases). Most confirmed cases (59.4 percent) in this ongoing outbreak were unvaccinated. Nigerian health officials urge the public to remain vigilant and ensure that anyone experiencing symptoms of diphtheria present early to health facilities for prompt diagnosis and treatment. This represents the most complete data available as of Sept. 21.

Context

Diphtheria vaccination coverage in Nigeria is estimated at 56 percent, much lower than the 83–86 percent required to prevent wider community transmission. Diphtheria cases are underreported in Nigeria, with few reports of outbreaks in the past. Authorities reported 2,289 cases nationwide in 2019 and 1,870 cases in 2018.

Diphtheria is a contagious bacterial disease spread through respiratory droplets created when an infected individual coughs, sneezes, or speaks. Infected individuals can also expose people around them by contaminating surfaces with secretions from the nose, mouth, and throat. In rare cases, the bacteria can spread through contact with infected skin lesions. Symptoms typically appear 2-5 days after exposure but can develop up to 10 days after exposure. Symptoms of diphtheria vary depending on where the bacteria accumulates in the body. If the bacteria accumulate in the nose, throat, or tonsils, symptoms generally include sore throat, fever, chills, and a characteristic white or grayish coating on the back of the nose or throat. If the bacteria accumulate on the skin, symptoms generally include a characteristic non-healing, gray ulcer on the skin, or a scaling rash.

Advice

Visit a doctor to ensure vaccination against diphtheria or immunity through previous infection. Practice basic health precautions. Call your medical provider if symptoms develop within two weeks of being in affected areas.