"Fears Rise as West Africa Grapples with Worst Diphtheria Outbreak in Recent History"

In Nigeria’s northern state of Kano, doctors and health workers are contending with one of the most severe diphtheria outbreaks in recent memory. While cases have been reported since May of the previous year, the outbreak has escalated rapidly in recent months, with a reported 17,000 suspected cases across Nigeria. Alarmingly, the outbreak has now spread to other West African countries such as Niger and Guinea, where Médecins Sans Frontières (MSF) has identified some of the most severe outbreaks of this vaccine-preventable disease ever recorded on the continent.

Kano remains the epicenter of the outbreak, according to MSF health workers, who have confirmed 9,310 cases and 368 deaths so far this year. At its peak, MSF reported up to 700 cases per week in Kano, although this number has since decreased to 500 weekly.

Diphtheria is a bacterial disease that produces a toxin affecting respiratory function, making breathing and swallowing difficult. If the toxin enters the bloodstream, it can cause damage to the nervous system, heart, and kidneys, or even paralysis, even after recovery.

One resident, Murjanatu Muhammad, shared the harrowing experience of having all her children hospitalized with diphtheria. Another mother, Firdausa Salisu, revealed that her son had missed vaccinations due to advice from a traditional healer, a decision she now regrets.

Dr. Dagemlidet Tesfaye Worku, emergency medical program manager for West and Central Africa at MSF, emphasized the severity of the outbreak, describing cases with vomiting blood and paralysis, particularly in children.

Medical workers have faced challenges in treating patients due to a shortage of diphtheria anti-toxins (DAT). MSF has provided only 5,000 DAT doses so far, which falls far short of the required amount. Without treatment, the mortality rate for diphtheria is around 50%, reducing to 5% with proper treatment.

The scarcity of DAT doses and antibiotics is attributed to limited production capacity and high costs. Dr. Dagemlidet stressed the need to improve production capacity and invest in research and development for long-term solutions.

Vaccination has played a critical role in addressing the outbreak, but there have been challenges in achieving high vaccine uptake due to mistrust and limited awareness. Only 30% of patients in Kano and 6% in Sokoto have received full vaccine protection. Efforts by WHO and UNICEF to increase vaccination coverage are underway.

Dr. Juma, involved in vaccination efforts, highlighted the need to address vaccine hesitancy and improve awareness. WHO recommends six vaccine doses for infants at six weeks old to ensure long-term protection.

As the outbreak continues to spread, there is a growing emphasis on the importance of strengthening routine vaccination systems to prevent future outbreaks. GAVI has announced support for countries to implement diphtheria vaccines into their health programs.

In conclusion, the diphtheria outbreak in Nigeria and neighboring countries underscores the urgent need for improved vaccination coverage, production of essential medical supplies, and long-term prevention strategies to mitigate the impact of such outbreaks in the future.

Piers Potter


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