As the schools resume from the mid-term break and the Sallah holiday on Wednesday, there are fears the pupils may be at risk of contracting cholera, a food and water-borne disease caused by the ingestion of the vibrio cholera bacteria.
Public health experts noted that the disease, which broke across the country last week, could spread fast in schools if preventive measures were not in place to prevent it.
Against this background, the Chief of UNICEF, Lagos Field Office, Celine Lafoucrier, has called for extensive measures to protect school children, noting that concerted efforts must be made to prevent disruption in the academic calendar over the spread of the disease.
The Nigeria Centre for Disease Control and Prevention had recently warned the public of the increasing trend of cholera cases as the rainy season intensifies.
The NCDC stated that from January 1 to June 11, 2024, over 1,141 suspected and over 65 confirmed cases of cholera, resulting in over 30 deaths, had been reported from 96 LGAs in 30 states.
The centre noted that the 10 states contributing 90 per cent to the burden of the current cholera outbreak include Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos states.
Explaining the need to prevent the disease outbreak in schools, Lafoucrier noted that children faced substantial health risks, particularly those under five, who are prone to severe dehydration and higher mortality rates.
Lafoucrier, according to the News Agency of Nigeria, in a statement on Monday, stated, “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.
“Despite the state government’s efforts to provide water to its population, the current outbreak demonstrates the need for an urgent government focus on ensuring the water provided to the population is clean and risk-free.’’
The UNICEF official said educational disruption is another critical consequence of cholera outbreaks, as an illness and the need to care for sick family members lead to school closures and reduced attendance, hindering children’s learning and development.
UNICEF advises govt
“Addressing the challenges of cholera outbreaks requires a deliberate focus of state policies to provide high-standard water and sanitation facilities, as well as strengthened healthcare systems capable of responding to the demand in times of outbreaks, and state-led educational campaigns on cholera prevention to protect children and the population at large,” she emphasised.
A professor of public health at the University of Ilorin and Consultant Public Health Physician at the University of Ilorin Teaching Hospital, Kwara State, Prof Kayode Osagbemi, said the infection could spread in schools if measures were not taken to prevent it.
Osagbemi said, “There will be gatherings of people in schools, and the moment they (schoolchildren) 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.
“Generally, the spread in schools is not a major concern, except maybe in boarding houses. In boarding houses, one person infected may infect others through contamination of the water and their food.”
The public health expert noted that the best way to prevent the spread is with the provision of clean food, water, and hand washing among the students.
“So, for now, the students should go with their water bottles, rather than sharing water. Then, there should be hand-washing facilities in the schools, and even in their toilets.
“When they get home, they should wash their hands and take their baths before eating; and within schools, there should be no sharing of things for now, since there is an outbreak,” he explained.
Cholera spreads fast
A Consultant Paediatrician at the Federal Teaching Hospital, Katsina State, Dr Abdurrazzaq Alege, also stated that cholera could spread fast among students due to the rainy season, holidays, and poor hygiene.
“For the fact that children are coming back to school, they will be more exposed to this, especially those of them that are not taking potable water.
Most of us use municipal water, and even the so-called sachet water that we take, we cannot guarantee the hygiene around it, even the fruits and other food items that we consume. So, coming back to school is a great risk this season,’’ he warned.
The Team Leader/Chief Executive at Q-Impact Medicare, Dr Lekan Adelakun, said the infection could spread fast in schools, calling for preventive measures to curb it.
He said, “Cholera is a very infectious disease, and there has to be a lot of campaigns among the parents, and school owners. The schools too have to create awareness because of the food served in schools, and the vendors who prepare the food.
“Food hygiene is very important. There should be adequate supervision in the preparation and conservation of their food, and make sure they don’t drink contaminated water. If you are taking fruits, you want to be sure they are washed well.’’
An Osogbo-based medical practitioner, Dr Olurotimi Fagbule, said the reopening of schools after the Sallah holiday was a risk factor that must be addressed.
He called for stringent measures to be adopted to prevent the outbreak of the disease in schools as pupils resume.
Fagbule, who said prevention of cholera outbreak was cheaper than any measures to contain it, told parents to monitor closely whatever their wards would eat at home.
“Pupils returning to school after the holidays can be a risk factor. Osun State doesn’t have any suspected case yet but the situation must not be taken for granted,’’ he counselled.
Also, a former Chairman of the Association of Private Medical Practitioners of Nigeria, Dr Tunji Akintade, noted that there is a need to put up preventive measures in schools.
Akintade said, “School resumption is an event. In resumption, there are crowds and they will need water and they are going to be using the water and these are the indicators that encourage the spread of this.
“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.’’
The Lagos State Health Commissioner, Prof Akin Abayomi, said laboratory tests carried out on samples had confirmed that the identified cholera strain was highly aggressive and contagious, with potential for widespread dissemination.
According to him, through community-based case finding and contact tracing, the number of cases has peaked and is now declining.
Giving an update on the outbreak via his Instagram page @profakinabayomi on Monday, the Lagos State health commissioner noted that through community-based case finding and contact tracing, the number of cases had peaked and was declining.
The geographical distribution of suspected cases by local government areas shows that Lagos Island is the epicentre of the outbreak with 106 cases; followed by Kosofe 49; Eti-Osa 38; Lagos mainland 30; Ojo 17; Ikorodu 16; Kosofe 16; Shomolu 11.
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Others are Surulere -nine; Apapa -eight; Mushin -eight; Ifako Ijaiye -eight; Mushin -five; Alimosho -four; Ajeromi Ifelodun -four; Oshodi-Isolo -three; Ikeja three; Ibeju Lekki -two; Badagry -two; Amuwo-Odofin -one.
Abayomi, however, disclosed that there were 17 confirmed cases out of 350 suspected cases and 15 deaths so far.
He said, “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.
“We are receiving support from the Nigeria Centre for Disease Control and international partners, including the WHO and United Nations Children’s Fund.
“Local non-governmental organisations are actively raising awareness and conducting community-based surveillance efforts.”
He also said the state was intensifying its public health campaigns in light of the Sallah celebrations and the associated transmission risks from gatherings and catering services, to prevent a resurgence.
“Suspected cases are receiving free treatment at our public health facilities, in line with public health response protocols,” he added.
Meanwhile, the Lagos state government has said it will activate the guidelines used during the COVID-19 era in a bid to curb the spread of the disease.
As schools are expected to resume on Wednesday after the two-day Sallah break, the Lagos State Commissioner for Information and Strategy, Gbenga Omotoso, said an emergency response committee that included representatives from the education sector, met on Monday.
Emergency committee meets
In a telephone interview with our correspondent on Monday, Omotoso said, “The Emergency Response Committee is going to meet this (Monday) evening and the education (team) will be joining the meeting.
‘’The focus is that, since students are going to be resuming from Wednesday, all of the general warnings that we have given to people will also be given to students and all the precautionary measures that we took during the COVID (period), we are going to be activating them.”
