NIGERIA – Experts at the Aminu Kano Teaching Hospital have found an unusual manifestation of diphtheria, a deadly throat disease, in the vagina of a baby and a 17-year-old girl teenager in Kano.

Kano State Diphtheria Case Manager, Dr Salma Suwaid, disclosed this while speaking at a webinar with the theme ‘Diphtheria Outbreak in Nigeria: A Case of Re-emergence or Improved Surveillance (Second Series) by the Nigerian Centre for Disease Control (NCDC)’.

Suwaid, a consultant paediatrician, said the outbreak of diphtheria, a disease that affects young children more than adults, had claimed 61 lives in Kano State as of March 2, 2023.

“As of March 2, 2023, we had a total of 783 admissions, out of which 360 were females and 423 were males. The average hospital stay of the patients is four days and 83 percent of deaths occurred in patients with onset of symptoms greater than three days,” she said.

“On average, we have 15 admissions per day. Sixty-eight percent of patients have been discharged, 1.66 percent absconded, and 12.2 percent died.

“The vaginal diphtheria was in a 17-year-old girl that presented with sore throat, fever and cough for four days. She had two siblings with suspected diphtheria. One of the siblings’ throat swabs was confirmatory. She was placed on treatment and three days into admission she complained of vulva swelling and painful urination.

Suwaid added, “We cannot say anything for now why this is the case; we will continue to watch to see if there will be more cases and then do further investigations to find out whether there is anything predisposing a particular age group to vaginal diphtheria.”

The paediatrician said there is a need to strengthen surveillance to ensure early detection of diseases of public health importance to mitigate their propagation at early stages.

Also speaking, Dr Adejoke Oladele of the National Primary Health Care Development Agency said the majority of the confirmed diphtheria cases in the country occurred in children aged two to 14 years.

She added that the agency is responding with vaccination and routine immunisation in the states at risk.

In his remarks, the director-general of the NCDC, Dr Ifedayo Adetifa, said 90 percent of confirmed cases of the infection are either not vaccinated or under-vaccinated.

“This is a significant local experience. It is, however, important to document peculiar diphtheria cases so we can share it and it becomes a constant reference material,” he said.

NCDC was first notified of suspected diphtheria cases in Kano and Lagos states on 01 December 2022.

On 20 January 2023, the Nigeria Centre for Disease Control and Prevention (NCDC) officially declared the situation as an outbreak of Diphtheria cases in Lagos and Kano States, which were the first to confirm the outbreak. Diphtheria quickly spread to other states.

The National technical working group multi-partner, multi-sectoral Emergency Operations Centre (EOC) was activated to coordinate the response activities at all levels. With the alarming trend, Government asked for National States support for immunizations scale-up.

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