Lagos State Commissioner for Health, Dr Jide Idris, is concerned about reported cases of diarrhoea related diseases in parts of the state, following the heavy rains and resultant flooding. In this call he made recently, the Commissioner advised the citizenry to observe strict infection control measures, be on the alert and notify government of suspected cases
Following the heavy rainfall being experienced in the State recently and the aftermath flooding of some areas in the State, the Ministry has been receiving notifications on upsurge of acute diarrhoea diseases in some Local Government Areas. Specifically the upsurge has been reported in Somolu LGA (on 19th July 2017), Oshodi-Isolo LGA (on 20th July 2017) and Surulere LGA (on 21st July 2017).
Twenty-seven cases have been line-listed by the Epidemiolgy/Disease Surveillance Officers in the State as at today, 25th July, 2017. Regrettably, two deaths were recorded from the 27 cases.
Somolu LGA: Six cases were recorded in Somolu LGA, one of which died. Four were managed at Somolu General Hospital (GH), one was managed at a private hospital, another one was managed at Mainland Hospital, while one died at home. Only two of the cases are still on admission.
Oshodi-Isolo LGA: Two cases were recorded in Oshodi-Isolo LGA. One was managed at a private hospital and he is alive, while one died at home.
Surulere LGA: Fourteen cases were reported at Surulere LGA and managed at Randle General Hospital. No death was recorded.
Two cases were managed at Mainland Hospital, both are alive. Three cases were managed at Gbagada GH and all are alive. The cases managed at the two hospitals are currently being investigated.
Majority of the cases presented with the typical diarrhoea and vomiting associated with cholera.Ano-rectal swabs were collected from two cases from Somolu GH and taken to the Central Public Health Laboratory, Yaba. One of the two specimen yielded Vibrocholerae001 Ogawa serotype growth. The result came in just a few hours ago.
The main suspected source of infection is the contamination of water sources with faecal matter from faulty septic tanks and soak-away following the heavy rainfall. Samples of well water were collected and sent to the Lagos State Drug Quality Control Laboratory. We are still expecting the results of the analysis.
It has become necessary to remind the general public once again that acute diarrhoea disease with or without vomiting is caused by a bacteria disease 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 they are infective watery stool gets into food or drinking water supplies. Prevention can be achieved through basic water sanitation.
Provision of safe water and sanitation is critical in reducing the impact of cholera and other water-borne diseases. About 75% of people infected with V. cholera do not develop any symptoms, although the bacteria are present in their faeces for seven to 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.
The clinical manifestations of Cholera are nausea, profuse diarrhoea, vomiting (in early stages of illness), fever and leg cramp. Later presentations are 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. The Medical Directors of our General Hospitals have been placed on alert and fact sheets on Cholera forwarded to both public and private hospitals. Our community 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 being promptly diagnosed and appropriately managed in our hospitals.
Other prevention and control measures instituted by the state government are:
- Community sensitisation and awareness creation through airing of jingles on Cholera on electronic media and public address system on environmental sanitation, avoidance of open defecation and water sanitation.
- 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.
- Designation of isolation wards in all General Hospitals.
- Intensification of Disease Surveillance and Notification activities in all LGAs.
The Lagos State Government hereby advisesthe general public to take the following precautionary measures to prevent the spread of the disease:
- Wash your hands with soap and water frequently and thoroughly.
- Boil water before drinking, especially if you are not sure of the source.
- 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.
- Ensure 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.
Health workers, both in public and private health facilities in the state are hereby advised to observe strict infection control measures and be on the alert and notify the Ministry of Health of suspected cases.
I call on the general public to report any case of diarrhoea and vomiting to the nearest health facility.
The Lagos State Government is well prepared to sustain the good health being enjoyed by the citizenry and we have already taken appropriate measures towards containment of the outbreak. I wish to appeal to all to remain calm as there is no cause for panic.