By Angela Onwuzoo originally published in Punch
As cholera rages in the country, public health physicians have stressed the need for hospital management to restrict families from visiting loved ones on admission being treated for the diarrhoeal infection, warning that it is among the factors fuelling spread.
The experts stressed that reducing such visits had become crucial as the highly infectious disease spread faster through human-to-human transmission.
The medical practitioners noted that families have to be cautious when their loved ones become infected with cholera and should allow health workers alone, who have been trained in the management of the disease to take care of them.
At the moment, no fewer than 40 deaths have been recorded in the current cholera outbreak, which has hit 30 states, including Lagos and Ogun.
The Lagos State Commissioner for Health, Prof. Akin Abayomi, as of Friday, said the cholera fatalities in the have risen from 21 to 24.
Abayomi disclosed this in a post on his Instagram handle.
He noted that the situation report, as of 19 June, shows 35 confirmed infections out of 417 suspected cases recorded across 20 Local Government Areas in the state.
On her part, the Ogun State Commissioner for Health, Dr Tomi Coker, said the state had recorded one death and 14 cases.
The Nigeria Centre for Disease Control and Prevention, in its recent report, said from January 1 to June 11, 2024, over 1,141 suspected and over 65 confirmed cases of cholera, resulting in over 30 deaths, had been reported from 96 local government areas in 30 states.
With the six additional deaths in Lagos and one death in Ogun, the fatalities are no fewer than 37.
The physicians, who spoke exclusively with PUNCH Healthwise said preventing cholera spread has to do with attitude.
The public health experts disclosed that most people infected with cholera contracted it from infected persons and not from contaminated food and drinks.
They explained that after initial contact with cholera from food or water, the mode of spread mostly becomes person-to-person transmission.
Cholera is a highly contagious food and water-borne disease. It spreads through direct transmission by eating or drinking contaminated food or water, and indirect transmission due to poor sanitation and lack of handwashing.
Symptoms of cholera include acute, painless watery diarrhea of sudden onset, with or without vomiting. It may be associated with nausea, profuse vomiting, and fever.
A Jigawa State-based public health specialist, Dr Abdullahi Namadi, cautioned relatives to stop acting as caregivers to cholera patients.
Namadi said, “Simple hygiene measures will prevent cholera outbreaks but by the time there is an outbreak, you will find out that people are not internalising the problem because they think they are protected.
“You see people rushing to the hospital to see their relatives on admission being treated for cholera.
“And by the time they try to interact with the patient as a normal person by shaking hands and sitting close to the patient, and going back home and eating their food like that without washing their hands; the next thing you see is that they are brought to hospitals as patients.
“So, preventing cholera spread has to do with attitude. You don’t visit cholera patients in the hospital. Only healthcare workers are supposed to manage them.
The public health physician advised family members not to become caregivers because the health workers have been trained to take care of them.
Namadi said, “We have this culture and tradition of trying to show care to family members that are sick but this is dangerous, particularly with cholera. Before you know it, you will also contract diarrhoeal infection.
“Most of the people that came down with cholera at one point or the other had interaction with another infected person.
“So, the source is usually from an infected person and the information you get from the first infected persons is that they got it from food or drinks. The point is that after the initial contact with food, the mode of spread is now from person to person.”
He urged the government to intensify sensitisation among the people to prevent further outbreak.
“So, you can see that we need attitudinal change to understand that we need to take care of our loved ones but with caution.
“The instructions given by health workers should be followed very well. Taking precautions does not mean you are stigmatising the person. You are only trying to protect yourself as well.
“There is a need for enlightenment and people need to be cautious and also follow instructions”, the physician added.
The NCDC has been cautioning Nigerians against self-medication in the treatment of cholera.
The health agency warned that severe cases of cholera could lead to death within hours due to dehydration from massive fluid loss.
Corroborating the statement of the public health specialist, an infectious disease expert with the Infectious Diseases Unit, Lagos University Teaching Hospital, Idi-Araba, Dr Oluwafemi Akinpeloye, said when family members of a patient are allowed into the ward and they help the patient, they could be infected.
He said, “People that have loved ones with cholera that are hospitalised should avoid entering the wards where such patients are admitted.
“They should allow the health workers tending to them to take absolute care of the patients. It is not appropriate for relatives to be in the ward taking care of patients.”
The expert emphasised that cholera could spread from human to human, adding, “Cholera is usually a disease that should be left for health workers to manage until the person is fine.
“Even the nurses that manage cholera patients are not supposed to go and manage other patients. They are supposed to manage only the cholera patients.
“So in a proper setting, when a nurse is assigned to cholera patients, if they now bring another emergency for that particular nurse or they bring another emergency to that hospital and the nurse available is the one managing cholera patients, then, such a nurse should not go and manage another patient because she is already taking care of a patient that has cholera.”
The infectious disease expert urged the government to try and provide potable water for rural communities.
He also recommended that vegetables, especially those that are eaten raw be washed properly and with salt.