Nigeria has recorded more than 65,000 suspected cases of cholera in 35 states and about 195 local government areas (LGAs) in 2026, Director-General of the Nigeria Center for Disease Control and Prevention (NCDC), Dr. Jide Idris, has revealed.
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However, Idris, who spoke at a news conference on the current cholera and diphtheria outbreaks on Friday, said weekly cholera cases had dropped substantially from the peak recorded earlier in the year, while the proportion of cases resulting in death was significantly lower than during the corresponding period last year.
He cautioned that the decline should not be interpreted as the end of the outbreak, warning that cholera transmission remains active and could worsen as the rainy season continues.
“Our experience in recent years shows that cholera transmission can peak between late August and October. Furthermore, we are still in the rainy season and flooding remains a major risk because it can contaminate water sources and overwhelm sanitation systems,” Idris said.
He said that the country must consolidate the progress made so far and avoid a resurgence of cases.
According to him, one of the clearest lessons from the outbreak was the importance of early access to treatment, noting that outcomes had improved in Borno State, which recorded the most cases, where treatment was brought closer to affected communities.
“But the data tells us something equally important: while treatment saves lives, we cannot treat our way out of cholera,” said the NCDC Director General.
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It identified contaminated water, open defecation, damaged water distribution systems, poor hygiene infrastructure and inadequate sanitation in schools, markets and other public institutions as persistent factors of cholera transmission.
Idris said sustained interventions in water, sanitation and hygiene, environmental health and community behavior are therefore required to prevent recurrent outbreaks.
Regarding diphtheria, he revealed that Nigeria had recorded more than 10,000 confirmed cases this year, although the case fatality rate had decreased considerably compared to the same period in 2025.
He said the majority of confirmed diphtheria cases were concentrated in Kano, Borno and Bauchi states, and attributed the continued burden largely to inadequate vaccination coverage.
“The central issue is that too many children remain unvaccinated or not fully vaccinated. Vaccine hesitancy, insecurity, hard-to-reach communities, displacement and population movements make it more difficult to reach all the children who need protection,” he said.
Idris emphasized that diphtheria can be prevented with vaccines and urged intensified efforts to identify and vaccinate children who had missed recommended doses.
The DG said the NCDC was coordinating the national response with state governments and partners through enhanced surveillance and laboratory capacity, case management and infection prevention and control support, community engagement and deployment of national rapid response teams in affected states.
He said oral cholera vaccination had been implemented in the most affected areas, while water chlorination, rehabilitation of water sources and hygiene promotion continued in affected communities.
In Borno, he said, NCDC teams had investigated sources of transmission and assessed water supply points to identify gaps in water quality, sanitation and chlorination, while in Bauchi oral rehydration points had been established, treatment capacity strengthened and active case finding intensified.
For diphtheria, he said, reactive vaccination was being carried out in the affected areas, along with the provision of essential treatment and laboratory products.
Idris, however, stressed that the federal government alone could not end the outbreaks, and urged state and local governments to provide the human, material and financial resources necessary to sustain interventions.
It called for better access to drinking water and sanitation, water quality monitoring, repair of critical water infrastructure, elimination of open defecation, and functional treatment and rapid response capacity in high-risk LGAs.
Regarding vaccination, he urged states to strengthen routine immunization and targeted vaccination, particularly in affected, underserved and hard-to-reach communities.
‘Enugu is the only state without reported cases of cholera’
Responding to a question on states reporting cholera cases, Idris clarified that Enugu State was, for now, the only state without a reported case of cholera, but cautioned against interpreting the absence of reported cases as evidence that cholera does not occur sporadically in other states.
He said the NCDC did not rank states based on disease burden but instead focused attention on states where cases had reached outbreak or epidemic levels.
“Just because they are not reporting cholera does not mean they are hiding information,” Idris said, adding that he had visited Enugu state about three weeks earlier and found the state government to be proactive in its response to public health issues.
He explained that cholera can occur throughout the year but is worse during the rainy season.
“Virtually every state has cholera. It may not be at the level of an outbreak,” he said.
According to him, some states may register a small number of cases that are treated in health centers without reaching the threshold that would justify classification as an outbreak.
Idris said the NCDC instead concentrated resources on critical states where the number of illnesses was considered unacceptable.
“We have not classified the states yet, but we have classified those states where the numbers are unacceptable, and that is why I mentioned cholera, those states, because they are responsible for a very, very high number of cases, and that is why we must focus on reducing the number,” he said.
He also attributed the detection of diphtheria cases in more states in part to better surveillance of the disease.
“Diphtheria used to affect three or four northern states. Now it has spread to one or two in this way. And the new spread is just a reflection of the increase in surveillance systems. More cases are being detected than before,” Idris said.
He described the increase in detection as a positive development, but stressed that identified cases must be followed by effective monitoring and response.
The NCDC Director General also rejected the argument that poverty should be used to explain poor hygiene practices that contribute to the transmission of cholera.
“Just because you’re poor doesn’t mean you can’t express your personal hygiene. Just because you’re poor doesn’t mean you should just defecate in the open, defecate anyway,” he said.
Idris acknowledged that governments had responsibilities to provide water and sanitation infrastructure, but argued that individuals and communities also had responsibilities.
It said communities could reduce their risk by ensuring drinking water is safe, maintaining a clean environment, using adequate sanitation facilities, avoiding open defecation, washing hands regularly with soap and clean running water, and properly preparing and protecting food from contamination.
He urged Nigerians who develop frequent watery diarrhea, with or without vomiting, to immediately begin oral rehydration and seek treatment at the nearest health facility.
“Don’t wait until the illness gets worse,” he said.
Idris also urged parents and caregivers to ensure that children were fully vaccinated against diphtheria, emphasizing that the vaccines were safe, effective and available free of charge through routine immunization services and vaccination campaigns.
He attributed the decline in cholera cases in some states partly to better responses by state governments, saying the NCDC had been engaging states and demanding accountability for resources deployed to combat the outbreak.
“States are getting more money. And when it comes, we say, ‘What have you done?’ So you understand me. So some states have addressed it and said they are actively working on it,” he said.
He warned that leadership and governance gaps in some states could undermine the national response, and stressed that such failures must not be allowed to persist.
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