Health
Cholera: Children worst hit as 5,260 cases, 67 deaths recorded
Deborah Tolu-Kolawole
Children under the age of five remain the most affected group in Nigeria’s worsening cholera outbreak, which has infected 5,260 people and claimed 67 lives across 128 local government areas in 33 states and the Federal Capital Territory.
This was according to the latest data from the Nigeria Centre for Disease Control and Prevention, exclusively made available to our correspondent in Abuja.
The NCDC data, covering the period up to May 31, 2026, showed that “suspected cholera cases have risen by 73 per cent compared to the same period in 2025, highlighting a significant escalation of the outbreak despite improvements in treatment outcomes.”
In Epidemiological Week 22 alone, the country recorded 1,264 new suspected cases and 13 deaths, representing an 11 per cent increase in infections compared to the previous week.
However, while infections are climbing, fatalities have declined.
“Despite the rise in cases, cumulative deaths have fallen by 37 per cent compared to 2025, reflecting stronger case management nationally,” the NCDC stated in its outbreak assessment.
The figures translate to a national case fatality rate of 1.3 per cent.
According to the NCDC, “children younger than five years remain the most affected age group nationwide, followed by children aged between five and 14 years.”
The data by the NCDC suggest that the outbreak is disproportionately affecting young children, a trend public health experts often attribute to poor access to safe drinking water, weak sanitation systems and children’s increased vulnerability to severe dehydration caused by cholera.
The outbreak is affecting males and females almost equally, with 51 per cent of cases occurring among males and 49 per cent among females.
The latest figures have raised concerns among health authorities as the country enters the peak rainy season, when flooding and contamination of water sources typically increase the risk of cholera transmission.
The NCDC said cholera cases have now been reported in “128 local government areas across 33 states and the Federal Capital Territory, underscoring the nationwide reach of the outbreak.”
Although infections have been reported across most areas in the country, the outbreak is being driven overwhelmingly by a major surge in Borno State.
Analysis of the NCDC data showed that Borno alone accounted for 4,510 of Nigeria’s 5,260 suspected cases, representing 86 per cent of the entire national caseload.
Even more striking is the concentration of cases in Maiduguri, the state capital.
According to the agency, Maiduguri Local Government Area alone has recorded 2,706 cases, accounting for 51 per cent of every cholera infection reported in Nigeria this year.
Put differently, one city is carrying more than half of the country’s cholera burden.
“Borno State accounts for 4,510 of Nigeria’s 5,260 suspected cases — 86 per cent of the entire national caseload,” the NCDC noted.
The state has recorded 27 deaths, with a case fatality rate of 0.9 per cent, below the World Health Organisation’s emergency benchmark of one per cent.
The outbreak has affected seven local government areas in Borno, including Maiduguri Metropolitan Council, Jere, Mafa, Konduga, Monguno, Magumeri and Ngala.
Health authorities noted that the addition of Ngala is particularly significant because the case detected there was imported from Maiduguri, signalling geographic spread beyond the original outbreak hotspot and raising concerns about transmission into areas with even weaker health and sanitation infrastructure.
Environmental assessments conducted across affected communities in Borno revealed conditions that continue to sustain transmission.
Investigators found contaminated shallow dams, boreholes and communal water reservoirs.
They also documented blocked drainage systems, damaged water pipelines and widespread open defecation.
Most significantly, the assessments found that free residual chlorine, a key indicator of water safety, was undetectable in all water sources tested.
According to the agency, overcrowding in densely populated communities within Maiduguri Metropolitan Council and Jere compounded the crisis, leaving large numbers of residents dependent on compromised water infrastructure.
Health officials warned that these conditions continued to drive transmission and increase the risk of further infections.
“The daily case chart is not showing a single sharp peak followed by a decline, the shape expected after a contained point-source outbreak.
“Instead, it shows sustained, elevated transmission week after week, the signature of continuous environmental contamination,” the NCDC stated.
The agency noted that the epidemic curve suggested the outbreak was no longer being driven by a single exposure event but by ongoing contamination of water sources and sanitation failures.
Health experts warned that infections could continue to rise unless urgent measures were taken to improve access to safe water, strengthen sanitation systems and eliminate environmental conditions facilitating transmission.
The NCDC said its preparedness efforts in Borno began months before the first case was reported.
According to the agency, Borno had previously conducted a multi-hazard risk assessment that identified cholera as a priority public health threat and mapped seasonal patterns of transmission.
Working with the Nigerian Meteorological Agency, the Nigeria Hydrological Services Agency and the National Emergency Management Agency, the NCDC issued preparedness advisories and early warning guidance to states considered at high risk.
The agency also pre-positioned cholera response commodities, including oral rehydration salts, intravenous fluids and rapid diagnostic test kits, in Borno and other vulnerable states ahead of the rainy season.
Healthcare workers in affected states were also trained on cholera management, including the establishment of oral rehydration points and cholera treatment centres.
Since the outbreak began, the NCDC said its State Liaison Officer in Borno had provided continuous technical support and coordinated response activities between state and national authorities.
“NCDC’s State Liaison Officer, permanently stationed in Borno, has provided continuous on-ground technical support and coordinates the interface between state and national response structures from day one,” the agency said.
The National Incident Coordination Centre in Abuja has also been analysing epidemiological trends and providing technical guidance to the state response team.
On May 15, the NCDC deployed additional emergency response commodities to Borno, including Ringer’s Lactate, intravenous fluids, oral rehydration salts, rapid diagnostic kits and infection prevention and control materials.
The Borno State Public Health Emergency Operations Centre, established with NCDC support, is operating in full response mode and holding regular coordination meetings involving health, water and sanitation agencies, humanitarian partners and development organisations.
The national multi-sectoral Cholera Emergency Operations Centre is also coordinating activities with the Federal Ministry of Health and Social Welfare, the Federal Ministry of Water Resources, the National Primary Health Care Development Agency and international partners.
The NCDC disclosed that a National Rapid Response Team was being finalised for deployment to Borno to conduct a detailed epidemiological investigation, including a case-control study aimed at identifying the precise transmission pathways and risk factors driving the outbreak.
The agency added that additional emergency supplies of Ringer’s Lactate and critical intravenous fluids were being processed to address shortages in treatment centres.
Three cholera treatment centres are currently operational in Borno State with a combined capacity of 290 beds.
The facilities are supported by Médecins Sans Frontières Belgium, Save the Children and FHI360.
Eleven oral rehydration points had also been established in hotspot communities to ensure patients receive treatment before developing severe illness.
According to the NCDC, ambulance and referral services were operating across affected local government areas to facilitate rapid access to care.
“The overall case fatality rate of 0.9 per cent in Borno, below the WHO emergency benchmark of one per cent, is a meaningful indicator that case management, where patients are reaching it, is working,” the agency said.
It, however, noted that many patients continued to present late at treatment facilities, increasing the risk of severe illness and death.
The response also includes active case-finding teams deployed across all seven affected local government areas, supported by community mobilisers and partners, including the WHO and United Nations Children’s Fund.
As of May 25, response teams had disinfected 1,148 households, reached 2,915 individuals with hygiene promotion messages and conducted water quality testing in Shehuri South, Gamboru, Bulabulin and Mashamari communities.
The Borno State Government and its Water, Sanitation and Hygiene agencies are also working with partners to chlorinate water sources, repair damaged pipelines, clear blocked drainage systems and improve sanitation infrastructure.
In addition, cholera awareness jingles are being aired on radio stations, while traditional and religious leaders, including the Shehu of Borno, have been mobilised to support risk communication efforts.
The NCDC added that house-to-house distribution of water purification tablets was ongoing, while in collaboration with the National Primary Health Care Development Agency, it was implementing an oral cholera vaccination campaign in affected communities.
Cholera is an acute diarrhoeal infection caused by the bacterium Vibrio cholerae, usually transmitted through contaminated water or food.
The disease can cause severe dehydration and death within hours if untreated, but prompt administration of oral rehydration salts, intravenous fluids and antibiotics can dramatically reduce mortality.
Nigeria experiences recurrent cholera outbreaks, particularly during the rainy season, when flooding, poor sanitation, open defecation and inadequate access to safe drinking water heighten the risk of transmission.
Public health experts have repeatedly linked the country’s recurring outbreaks to long-standing deficiencies in water, sanitation and hygiene infrastructure, especially in densely populated communities and humanitarian settings.
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