Cholera Epidemiology in Nigeria: an overview

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium, Vibrio cholera. Choleragenic V. cholera O1 and O139 are the only causative agents of the disease. The two most distinguishing epidemiologic features of the disease are its tendency to appear in explosive outbreaks and its predisposition to causing pandemics that may progressively affect many countries and spread into continents. Despite efforts to control cholera, the disease continues to occur as a major public health problem in many developing countries. Numerous studies over more than a century have made advances in the understanding of the disease and ways of treating patients, but the mechanism of emergence of new epidemic strains, and the ecosystem supporting regular epidemics, remain challenging to epidemiologists. In Nigeria, since the first appearance of epidemic cholera in 1972, intermittent outbreaks have been occurring. The later part of 2010 was marked with severe outbreak which started from the northern part of Nigeria, spreading to the other parts and involving approximately 3,000 cases and 781 deaths. Sporadic cases have also been reported. Although epidemiologic surveillance constitutes an important component of the public health response, publicly available surveillance data from Nigeria have been relatively limited to date. Based on existing relevant scientific literature on features of cholera, this paper presents a synopsis of cholera epidemiology emphasising the situation in Nigeria.