As schools resume following the mid-term break and Sallah holiday, concerns have heightened about the risk of cholera, a serious food and waterborne disease caused by ingesting the vibrio cholera bacteria, spreading among students.
Public health experts have warned that the recent cholera outbreak, which began last week, could quickly infiltrate schools if preventive measures are not implemented.
In light of these concerns, Celine Lafoucrier, Chief of UNICEF’s Lagos Field Office, has emphasized the necessity of comprehensive measures to protect school children. She stressed that efforts must be intensified to prevent any disruption to the academic calendar caused by the disease’s spread.
The Nigeria Centre for Disease Control and Prevention (NCDC) recently issued a public warning about the increasing cholera cases as the rainy season progresses. According to the NCDC, from January 1 to June 11, 2024, there have been over 1,141 suspected and more than 65 confirmed cases of cholera, leading to over 30 deaths across 96 Local Government Areas (LGAs) in 30 states. The states contributing the most to the outbreak include Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos.
Lafoucrier highlighted the significant health risks posed to children, especially those under five, who are more susceptible to severe dehydration and higher mortality rates. She explained, “Similarly, post-recovery issues in children can include malnutrition, stunted growth, and weakened immune systems, increasing susceptibility to other diseases. These outbreaks underscore the urgent need for improved access to clean water and sanitation in many areas.”
She noted that despite the state government’s efforts to supply water to its population, the ongoing outbreak indicates a critical need for ensuring the water provided is clean and safe. Lafoucrier also pointed out that educational disruption is another severe consequence of cholera outbreaks, as illness and the necessity to care for sick family members often lead to school closures and reduced attendance, adversely affecting children’s learning and development.
To address these challenges, UNICEF has advised the government to focus on providing high-standard water and sanitation facilities, strengthening healthcare systems to handle outbreaks effectively, and conducting state-led educational campaigns on cholera prevention to protect children and the broader population.
Professor Kayode Osagbemi, a public health expert from the University of Ilorin, warned that the infection could easily spread in schools if preventive measures are not taken. He emphasized, “There will be gatherings of people in schools, and the moment they are sharing items, it can spread. If any of them is infected, it can spread to others, rather than if they are in their homes.”
Osagbemi suggested that students should carry their own water bottles to avoid sharing and that schools should provide hand-washing facilities to curb the spread. He advised that students wash their hands and bathe upon returning home before eating and that they avoid sharing personal items within schools during the outbreak.
Consultant Paediatrician Dr. Abdurrazzaq Alege from the Federal Teaching Hospital, Katsina State, echoed these concerns, noting that the rainy season, holidays, and poor hygiene could exacerbate the spread of cholera among students. He warned, “Children are coming back to school, and they will be more exposed to this, especially those who do not have access to potable water.”
Similarly, Dr. Lekan Adelakun, Team Leader/Chief Executive at Q-Impact Medicare, called for increased awareness among parents, school owners, and food vendors about the importance of food hygiene and preventing the consumption of contaminated water. He stressed, “There should be adequate supervision in the preparation and conservation of food, and fruits should be washed properly.”
Dr. Olurotimi Fagbule, an Osogbo-based medical practitioner, also highlighted the risks associated with reopening schools after the Sallah holiday. He advised that stringent measures be implemented to prevent an outbreak in schools, noting that preventing cholera is more cost-effective than managing an outbreak.
Former Chairman of the Association of Private Medical Practitioners of Nigeria, Dr. Tunji Akintade, emphasized the importance of proactive measures, stating, “We need to be proactive. We don’t know the houses the children are coming from, but we do know that a lot of houses are represented in schools and if a child brings in vibrio cholera into the school, it can spread to other children.”
Lagos State Health Commissioner, Professor Akin Abayomi, confirmed that laboratory tests have identified a highly aggressive and contagious cholera strain. Through community-based case finding and contact tracing, the number of cases has peaked and is now declining. He noted, “Three hundred and fifty suspected cases of cholera were reported in 29 wards across multiple LGAs in Lagos State with 17 confirmed cases and 15 fatalities attributed to severe dehydration caused by delayed presentation.”
To combat the spread, the Lagos state government plans to reimplement guidelines from the COVID-19 era. Emergency response committees, including representatives from the education sector, have convened to ensure students and staff are well-informed and prepared.
In Ogun State, Commissioner for Health Dr. Oluwatomi Coker confirmed three cholera cases and assured that proactive measures, such as increased hygiene awareness and proper waste disposal, are being enforced. The state has mandated that all houses without toilet facilities construct one within the next three to six months, and public spaces, including schools and markets, are required to have functional toilets and running water.
Similar precautionary measures are being adopted in other states, with governments activating rapid response centers, conducting public sensitization, and ensuring compliance with hygiene standards to prevent outbreaks.
In conclusion, as schools reopen, the focus must remain on robust preventive measures to safeguard the health of students and prevent further disruption to their education. Public health officials and governments must collaborate to ensure clean water, proper sanitation, and comprehensive awareness campaigns to effectively combat the cholera outbreak.
