Cholera Outbreak Investigation in Sokoto State – Nigeria, 2013

Cholera remains a global threat to public health and a key indicator of lack of social development. According to the World Health Organization, the burden of cholera is estimated to be 3–5 million cases and 100 000–120 000 deaths annually. In November, 2013, suspected cases of cholera were reported in Kebbe, Shagari and Tambuwal Local Government Areas (LGAs), Sokoto State, Nigeria. We investigated to confirm and characterize the outbreak. Suspected cholera case was defined as any resident of Kebbe, Shagari and Tambuwal LGAs with th acute watery stool with or without vomiting from 6 October and 9 November, 2013. A cross-sectional descriptive study design was used. Stool specimens were collected and tested using rapid test kit. The outbreak was described in terms of person, place and time. We identified 170 cases with 24 deaths among 10,282 persons (Attack rate: 1.7%, case fatality rate: 14.1%). The attack rate was highest among 15 – 29 years age group (2.3%). The median age of the cases was 22 years. All four specimens tested positive to Vibrio cholera serogroup O1. Of the 170 cases, 108 (63.5%) occurred in Kebbe LGA. Environmental assessment revealed widespread refuse, animal dung, uncovered wells and unsafe drinking water from streams. This study revealed that the outbreak was caused by Vibrio cholera serogroup O1. We strengthened case management and conducted health education focussing on personal hygiene and environmental sanitation. It was recommended that local authorities should intensify health education messages and provide potable water supply to affected communities.