(By Azoma Chikwe – LAGOS)
The Lagos State Ministry of Health has raised the alarm over an upsurge of diarhhoea diseases in some communities in Isolo local government area. Following this, 45 cases were line-listed by the Epidemiology Unit of the Ministry. Six deaths were recorded among the 45 cases. Majority of the cases did not present with the classical rice-water stool, rather they presented with atypical diarrhoea and vomiting.
Briefing the media, Health Commissioner Dr. Jide Idris said ano-rectal swabs were collected from 15 cases and taken to the Central Public Health Laboratory, Yaba.
Initially, there were no growths. However, continuous culture yielded Vibro cholerae from 7 out of the 15 samples. The Vibrio cholera was later confirmed to be Ogawa strain.
The main suspected source of infection is the salad called Abacha, a staple food of the residents of Isolo and adjourning local government areas. Some domestic wells within the communities are also suspected to be sources of infection.
Samples of the Abacha salad and well water were collected and sent to the Lagos State Drug Quality Control Laboratory for analysis.
The report of the analysis revealed the presence of Vibrio cholerae, Salmonella species and E.coli in abacha and one of the 2 Well water samples.
Cholera is an acute diarrhoea disease, with or without vomiting, caused by a bacteria referred to as Vibro cholerae and it is transmitted through ingestion of food or water contaminated with infective faeces.
Food or water contamination is usually due to poor sanitation and the source of contamination is usually other cholera cases when their infective watery stool gets into food or drinking water supplies.
Prevention of cholera can be achieved through basic water sanitation, such as boiling water of unclean sources. Cholera can kill within hours if left untreated.
About 75% of people infected with V. cholera do not develop any symptoms, although the bacteria are present in their faeces for 7–14 days after infection and are shed back into the environment, potentially infecting other people.
Among people who develop symptoms, 80% have mild or moderate symptoms, while around 20% develop acute watery diarrhoea with severe dehydration.
This can lead to death if untreated. The case fatality of Cholera ranges from less than 1% in treated cases to as high as 50% in severe cases.
Cholera usually present clinically as nausea, profuse diarrhoea, vomiting (in early stages of illness), fever and leg cramp. Later presentation is dehydration, shock or coma.
The risk of contracting cholera is increased mainly by poor water and environmental sanitation, including open defecation.
“We have instituted measures towards quick containment and control of the outbreak. Our health workers, especially the Medical Officers of Health, Health Educators, Disease Surveillance/Notification Officers, Environmental Health Officers are in the community striving assiduously towards quick containment and control of spread of the disease. Chlorination of water supply has been intensified, awareness campaign is on-going and cases are been promptly diagnosed and appropriately managed in our hospitals,” Idris said.
“Twenty six (26) cases were managed at Isolo General Hospital and Lagos Mainland Hospital. Twenty two (22) have been discharged, one (1) died, while three (3) are still on admission at Lagos Mainland Hospital. All the 3 cases that are still on admission are in stable conditions.
“Seventeen (17) of the cases were managed at Private Health Facilities (Healing Cross Hospital, Isolo – 4 cases, Bola Hospital Isolo – 5 cases, West Care Hospital, Ejigbo – 5 cases and New Line Hospital, Isolo – 3 cases). Three (3) of the 17 cases died. All the 14 cases on admission have been discharged.”
Other prevention and control measures instituted by the State government are: Identified the three Vendors of contaminated Abacha at Cele Bus Stop. Ban on sale and caution in eating Abacha when not prepared by you. Distribution of factsheets on Cholera to the Medical Directors of LASUTH & 26 General Hospitals in Lagos State and Medical Officers of Health in all the 57 LGAs/LCDAs for circulation to all health workers in their facilities.
Intensive Disease Surveillance and Notification Officers in all the LGAs in the State, especially in Oshodi-Isolo and Amuwo Odofin LGAs.
“The general public is hereby advised to take the following precautionary measures to prevent the spread of the disease: Wash your hands with soap and water frequently and thoroughly especially after using the rest room.
“Boil water before drinking, especially if you are not sure of the source of infection. Keep all cooking utensils, plates, cutleries, cups and other materials clean before and after use.
“Cover foods and water sources. Cook foods adequately. Store foods in fridges. Wash fruits and vegetables thoroughly. Dispose of waste materials appropriately. There should be no open defecation
“There should be no body contact, especially hand contact with faeces. Regular food handlers’ test. Provision of effective and hygienic toilet facility
“Where cholera is suspected: Prepare oral rehydration solution (10 level teaspoonful of sugar + 1 level teaspoon of salt in two 35cl bottles).
Keep giving food as soon as it can be tolerated. Report any case of diarrhoea and vomiting to the nearest public or private health facilities.
“The general public is also enjoined to report any case with diarrhoea and vomiting to the nearest health facility or calling the following lines: 08037170614, 08052817243 and 08173577579.
“The Lagos State Government is already taking appropriate measures and has contained the outbreak,” he said.