By DIANA CHUKWUKA

Diphtheria Returns With a Vengeance: Inside Nigeria’s Vaccination Gaps & Rising Death Toll

A Preventable Disease Finds Room to Spread

FOR families in parts of Northern Nigeria, what initially looks like an ordinary sore throat, cough or fever can quickly become a medical emergency.

That is the danger now confronting communities in Plateau, Katsina, Kano and Nasarawa states, where fresh outbreaks of diphtheria have placed children and already stretched health systems under renewed pressure.

The disease is not new. Nigeria has battled a prolonged diphtheria outbreak since 2022. Yet its persistence remains troubling because diphtheria is vaccine-preventable and effective treatment can significantly improve survival when patients present early.

Recent reports from affected states reveal a familiar chain of vulnerabilities: children who missed routine immunisation, families that initially mistake symptoms for malaria or catarrh, patients who arrive at hospitals late, shortages of diphtheria antitoxin and diagnostic materials, and health facilities struggling with manpower and other resources.

The result is a disease that should be largely preventable continuing to claim lives.

Plateau Counts Deaths as Communities Panic

In Jos North Local Government Area of Plateau State, health authorities reported a sharp rise in suspected diphtheria cases.

State Commissioner for Health Nicholas Baamlong said 143 people were suspected to have contracted the disease, while 23 deaths had been recorded, with most of the casualties occurring within the preceding three weeks.

Nine patients were receiving treatment at Jos University Teaching Hospital and Plateau Specialist Hospital isolation centres.

Earlier figures from the Jos North Disease Surveillance and Notification Officer, Baks Bulus, put suspected cases at 117 and deaths at 15.

The difference between the figures illustrates one of the difficulties confronting outbreak response: health authorities need timely, reliable and harmonised data to know the true scale of an epidemic and direct scarce resources to the places of greatest need.

Bulus warned that the disease spreads readily among close contacts, including people who share household items such as utensils and towels.

He also stressed the importance of vaccination, noting that vaccinated children generally experience milder disease than those who are unvaccinated or have incomplete doses.

Families Discover the Cost of Late Recognition

Behind the statistics are families whose first encounter with diphtheria often begins with a symptom that seems too ordinary to trigger alarm.

Lubatu Abdullahi, a resident of Jos North, said her son Umar Mukta initially complained of a sore throat after attending an Islamic school with his sister.

The family initially treated him for what they believed was an ordinary illness and later suspected malaria.

When his condition deteriorated, they sought herbal treatment. The boy eventually died before the family understood that diphtheria was responsible.

Another parent, Shafi’u Abdullahi, described a similar tragedy involving his daughter Hauwa.

She initially had a sore throat and difficulty eating. After medication failed, the family took her to hospital, where she was diagnosed and isolated.

But treatment came too late.

The family later discovered that another relative had also died after experiencing similar symptoms.

These accounts expose a critical weakness in outbreak control: recognising the disease early enough.

The Disease Can Move Quickly From Throat to Vital Organs

Diphtheria is caused by toxin-producing strains of Corynebacterium diphtheriae. It commonly affects the nose and throat and spreads through respiratory droplets and close contact.

Dr. Aminu Mato Jitandutse of Aminu Kano Teaching Hospital explained that the toxin produced by the bacteria can damage the heart, nerves and other organs.

Initial symptoms can include sore throat, fever, weakness, swollen glands and painful swallowing.

As the disease progresses, patients may develop a thick grey or whitish membrane in the throat, hoarseness, breathing difficulty and swelling around the neck.

Severe infection can lead to airway obstruction, myocarditis, abnormal heart rhythms, nerve damage, paralysis, kidney complications and death.

That progression makes early treatment critical.

Professor Sabo Ahmed of the University of Jos similarly warned that the disease can produce systemic complications even after the bacteria begin to die because the toxins may continue damaging organs.

Katsina Faces a Wider Outbreak

In Katsina State, the geographical spread has raised another alarm.

The state government said diphtheria had reached 30 of the state’s 34 local government areas.

Yet the authorities and Federal Teaching Hospital Katsina have reported markedly different figures for the current surge.

The state government put confirmed cases at 31 during the latest increase, while officials at the teaching hospital said approximately 150 confirmed patients had been admitted within the same period, with 29 deaths.

The government reported 1,837 suspected cases in 2026 and said 719 people had presented with symptoms associated with diphtheria.

Three additional isolation centres were established in Daura, Funtua and Katsina to expand treatment capacity.

The hospital has also reported patients returning after initial treatment with serious complications involving organs such as the heart and kidneys.

One of them is nine-year-old Hafsat, who was readmitted after developing swelling in her face and legs. Her mother said the child’s speech had also been affected.

Such cases demonstrate that surviving the initial infection does not necessarily mean the medical danger has ended.

Kano Confronts the Immunisation Gap

Kano State, historically one of the states most heavily affected by diphtheria, is facing another vaccination challenge.

The Federal Government supplied 650,000 doses of diphtheria vaccine to the state, but the Kano State Centre for Disease Control said at least nine million doses would be required to mount an effective response across all 44 local government areas.

The disparity between available and requested vaccines underscores the scale of the challenge.

Kano authorities have intensified community surveillance and worked with district heads and traditional institutions to mobilise residents.

The state has also established a special committee involving health agencies and emirate councils to improve verification, coordination and reporting.

The urgency is heightened by the fact that some communities are also dealing with cholera, creating competing demands on the public-health system.

Nasarawa Shows What Early Treatment Can Change

Nasarawa provides a contrasting picture.

The state reported 15 confirmed cases, with 11 in Keffi, three in Lafia and one in Wamba. The affected children were between two months and 11 years old.

Public Health Director Attah Peter attributed most infections to failure to complete routine childhood immunisation.

But unlike the fatalities reported elsewhere, he said no death had occurred this year among patients who presented at health facilities.

He attributed the outcome partly to preparedness, early diagnosis and prompt treatment.

The contrast is instructive.

The difference between a fatal case and a recoverable one can depend not only on whether a child was vaccinated, but also on how quickly symptoms are recognised and appropriate care begins.

The National Picture Is Larger Than the Current Surge

Nigeria’s diphtheria crisis extends beyond the latest outbreaks.

According to an NCDC epidemiological report covering Epidemiological Week 19 of 2022 to Week 3 of 2026, the country recorded 40,460 confirmed cases and 2,151 deaths.

Kano accounted for the largest number of confirmed cases, followed by Borno, Bauchi, Yobe and Katsina.

Children aged one to 14 years accounted for about 64.8 per cent of confirmed cases.

Even more revealing was the vaccination profile: only about 14.3 per cent of confirmed cases were fully vaccinated against diphtheria.

The NCDC later reported more than 10,000 confirmed cases in 2026 as of late August, although it said the proportion of confirmed cases resulting in death had declined compared with the previous year.

Why Children Are Still Missing Protection

NCDC Director-General Jide Idris has repeatedly stressed that vaccination remains the most effective protection against diphtheria.

Children who miss or fail to complete the recommended doses are left vulnerable.

But immunisation gaps do not emerge from a single cause.

Insecurity can prevent health workers from reaching communities. Displacement and population movement can interrupt routine services. Hard-to-reach settlements may remain outside effective health campaigns.

Misinformation, limited awareness and competing household priorities can also prevent caregivers from completing vaccination schedules.

Plateau NMA chairman Andrew Shainaan identified inadequate vaccination coverage as a major contributor to outbreaks.

He urged parents not to dismiss cough, fever, breathing difficulty or throat swelling as ordinary illnesses.

The Health System Is Fighting More Than the Disease

Diphtheria is exposing weaknesses beyond vaccination.

Plateau authorities reported shortages of diphtheria antitoxin and specialised containers needed to collect and transport samples for laboratory confirmation.

The state has requested assistance from the NCDC.

In Katsina, health workers are simultaneously dealing with manpower and welfare problems.

The Medical and Health Workers’ Union has threatened industrial action over salary adjustments, allowances and working conditions.

The union says its dispute predates the current outbreak, but any disruption to healthcare delivery could further strain facilities treating infectious-disease patients.

An investigation in Katsina also found reports of doctors leaving state hospitals, with about 14 doctors said to have departed between February and June 2026.

Some remaining health workers reportedly attend to more than 60 patients in a day.

Such shortages matter during an outbreak because early diagnosis, isolation, contact tracing, treatment and follow-up all depend on sufficient trained personnel.

Prevention Remains Simpler Than Crisis Management

The medical advice is consistent across the affected states.

Vaccination remains central.

Nigeria’s routine childhood immunisation programme includes three pentavalent doses containing diphtheria protection during infancy.

But protection does not end with vaccination.

Suspected patients should receive prompt medical evaluation and avoid close contact with others while awaiting assessment.

Close contacts may require monitoring, preventive antibiotics and vaccination, while diphtheria antitoxin should be administered where indicated.

Basic hygiene, reduced overcrowding and avoidance of shared personal items can also help limit transmission.

A Test of Public-Health Preparedness

The current outbreak is therefore more than a story about isolated deaths in Northern communities.

It is a test of whether Nigeria can sustain routine immunisation, detect outbreaks early, provide essential medicines, maintain laboratory capacity and keep health workers in the system.

The experiences of Plateau, Katsina, Kano and Nasarawa show that where vaccination gaps, delayed presentation and resource shortages converge, a preventable disease can quickly become deadly.

The country has the tools to control diphtheria.

The harder question is whether those tools will consistently reach the children and communities that need them most.