As Nigeria moves deeper into the height of the rainy season, health authorities are once again grappling with a recurring but dangerous public health threat: cholera.
The waterborne disease has re-emerged in parts of Northern Nigeria, resulting in deaths and thousands of infections, particularly in Plateau and Borno states, while other states are stepping up surveillance and preparedness efforts to avert outbreaks within their jurisdictions.
Health professionals say the outbreaks highlight the country’s longstanding problems with access to clean water, poor sanitation, inadequate hygiene practices, population displacement and fragile public health systems.
They caution that unless preventive interventions are sustained, additional states may experience increasing infections in the coming weeks.
While Plateau State is managing a relatively limited outbreak in Mangu Local Government Area, Borno is confronting one of its worst cholera crises in recent years, with thousands of cases reported within a few weeks.
Figures released by Médecins Sans Frontières (MSF) revealed that the state recorded 35 deaths and 3,646 new cholera infections within one week.
The latest statistics show that between early May and June 9, Borno registered 74 deaths and 7,850 suspected cholera cases across 12 local government areas.
MSF disclosed that more than 500 suspected cholera patients were admitted into treatment centres on June 5 alone, marking the highest single-day admission since emergency response activities commenced.
Maiduguri metropolis remains the centre of the outbreak and accounts for more than half of all reported cases.
Borno IDP camp records nearly 300 cases within three days
The cholera outbreak worsened at the Internally Displaced Persons (IDPs) camp in Monguno, Borno State, with 296 suspected cases reported over three days, raising alarm among health workers and residents.
According to media reports on Monday, health officials and community volunteers said the increasing number of patients arriving at Cholera Treatment Centres (CTCs) in the town is placing pressure on available resources and complicating containment efforts.
One health worker, who requested anonymity, said the influx of patients from the IDP camp has generated fear within the community.
Data cited in media reports showed that the treatment centre admitted 296 suspected cholera patients, mainly women and children, between June 11 and June 13.
According to the data, 48 cases were recorded on June 11, 68 on June 12, and 180 on June 13 alone.
Another health worker said about 90 per cent of the patients came from IDP camps in the area.
He added that most people who sought treatment survived, but several fatalities occurred at home because some patients delayed seeking medical attention.
“Some infected persons refused to come to the treatment centre and died at home. They initially treated the diarrhoea with drugs such as Flagyl and tetracycline before eventually succumbing to the disease,” he said.
The source explained that the outbreak has continued in the town for more than a month despite interventions by the state government and development partners.
A resident, Yagana Lawan, said her child suddenly developed symptoms.
“He started vomiting and became very weak. Later, diarrhoea followed. We rushed him to General Hospital Monguno, where he was referred to the cholera treatment centre,” she said.
In Plateau State, Commissioner for Health, Dr Nicholas Baamlong, confirmed that at least five people had died following a cholera outbreak in Mangu Local Government Area.
Baamlong stated that 52 suspected cases had been documented, with 11 patients currently receiving treatment in health facilities.
According to the commissioner, the outbreak affected communities including Pushit, Mangu I and Mangu II.
Although the number of confirmed cases remains significantly lower than those recorded in Borno, authorities are responding swiftly to prevent wider transmission.
Factors driving vulnerability in Plateau, Borno
According to media reports, public health specialists said the outbreaks in Plateau and Borno were driven by a combination of preventable factors.
According to them, environmental, social and infrastructural challenges have made both states especially susceptible to cholera outbreaks.
Public health expert, Dr Aliyu Isah, said cholera outbreaks are usually linked to weaknesses in water and sanitation systems.
“Cholera is not a mysterious disease. It thrives where people lack access to safe drinking water and adequate sanitation facilities. When communities depend on contaminated streams, wells or poorly maintained water sources, the risk increases significantly,” Isah said.
According to him, the outbreak in Plateau reflects deeper sanitation problems in rural communities.
“In many rural settlements, access to potable water remains poor. Open defecation is still common in several areas and these factors create pathways for contamination during the rainy season,” he added.
Godwin Ekuwke, a medical practitioner at the Kubwa General Hospital in Abuja, said conditions created by conflict and displacement have significantly increased Borno’s vulnerability.
“In emergency and humanitarian settings, cholera spreads very quickly because many people live in crowded environments with limited access to clean water and sanitation facilities,” he said.
Ekuwke explained that displaced populations often depend on shared water points, temporary shelters and overstretched sanitation facilities.
“Those conditions create the perfect environment for transmission. Once cholera enters such communities, it can spread rapidly if not detected early,” he said.
Grace Jegede, another expert, said climate-related factors are increasingly influencing cholera outbreaks across Northern Nigeria.
“During the rainy season, floodwaters frequently contaminate drinking water sources with human waste. Communities relying on untreated water become highly vulnerable,” she said.
According to her, climate change is making outbreaks more frequent and increasingly difficult to anticipate.
“Extreme weather events are increasing and this means governments must strengthen preparedness mechanisms before outbreaks occur,” she said, adding that prevention must go beyond emergency response.
States intensify preventive measures
As concern grows over the spread of cholera across Northern states, several state governments are strengthening preventive strategies.
Although Benue State has not recorded any unusual rise in cholera cases, State Commissioner for Health and Human Resources, Dr Nicholas Baamlong, told media reports on Monday that preparations are already ongoing.
Ogwuche said the state government had activated several preventive interventions.
Rapid Response Teams have been placed on standby, while essential medical supplies have been strategically positioned for emergency deployment.
The state has also expanded public awareness campaigns focusing on handwashing, environmental sanitation and safe water consumption.
“In addition, we maintain regular communication with the Nigeria Centre for Disease Control and Prevention and other stakeholders to monitor developments and ensure that Benue remains prepared for any eventuality,” Ogwuche added.
In Taraba State, checks across the 16 local government areas revealed no officially reported cholera outbreak as of the time of filing this report.
However, health authorities remain vigilant because the state recorded a cholera outbreak last year at an internally displaced persons camp in Chanchangi, Takum Local Government Area.
Bauchi State said it is reasonably prepared to respond to any cholera outbreak, having established critical systems and structures for disease detection, coordination and emergency management.
According to media reports, State Epidemiologist, Dr Ahmad M. Sambo, said the state has a functional disease surveillance system, trained Rapid Response Teams (RRTs), a Public Health Emergency Operations Centre (PHEOC), and experienced healthcare personnel who have handled previous cholera outbreaks.
According to him, Cholera Treatment Units (CTUs) have also been designated in hotspot local government areas, while coordination mechanisms involving government agencies, development partners and local communities have been established to ensure a rapid response whenever cases are identified.
Sambo, however, noted that additional improvements can still be made to strengthen the state’s preparedness efforts.
The Kebbi State Government said that despite not recording any cholera case in any part of the state, it has activated preparedness measures to ensure a prompt response if an outbreak occurs.
According to media reports, a senior official of the state Ministry of Health, Yakubu Ahmed, said that the ministry’s epidemiology department has been placed on alert and all necessary measures have been implemented to prevent and contain any outbreak.
“We are educating the people on the importance of proper hygiene and environmental sanitation to prevent the disease,” he said.
