School Resumption: Expert Urges Lagos, Ogun to Tighten Diphtheria Surveillance Ahead of New Term
Korede Abdullah 
Dr. Charles Adeyemo
LAGOS, Nigeria – As primary and secondary schools resume across Nigeria, an infectious disease expert has urged the Lagos and Ogun State governments to strengthen diphtheria surveillance, vaccination and school preparedness to prevent outbreaks among pupils and students.
Speaking exclusively with Africa Health Report on Monday, Consultant Pathologist and Infectious Disease Specialist, Dr. Charles Adeyemo, warned that the absence of major diphtheria outbreaks in Lagos and Ogun should not create a false sense of security.
He said both states have a unique opportunity to prevent transmission by identifying immunisation gaps, improving disease surveillance, preparing health facilities and educating schools on early detection of suspected cases.
“The fact that Lagos and Ogun have not recorded significant outbreaks gives them an advantage. They should use this period before schools fully resume to strengthen surveillance, review vaccination coverage, prepare health facilities and communicate clear guidelines to schools,” Adeyemo said.
He urged the Ministries of Health and Education in both states to establish direct communication channels with schools to ensure suspected cases are reported promptly.
According to him, teachers and school administrators should be trained to recognise symptoms, while schools should improve classroom ventilation and discourage pupils or staff with signs of illness from attending classes until medically cleared.
“They should not wait until the first confirmed case before acting. Preparedness is always more effective than emergency response,” he added.
Schools Can Accelerate Transmission
Adeyemo explained that diphtheria spreads mainly through respiratory droplets released when an infected person coughs, sneezes or talks, making schools high-risk environments because children spend long hours together in enclosed spaces. School Resumption: Expert Urges Lagos, Ogun to Tighten Diphtheria Surveillance Ahead of New Term
“One infected child can expose many others in crowded classrooms, especially where ventilation is poor,” he said.
He advised parents, teachers and school authorities to watch for symptoms including persistent sore throat, fever, weakness, swollen neck glands, difficulty swallowing or breathing, and the appearance of a thick grey or whitish membrane in the throat.
However, he cautioned against waiting for the characteristic throat membrane before seeking medical attention.
“Some patients may initially present with less obvious symptoms. Early medical evaluation is critical,” he noted.
Plateau Outbreak Highlights Need for Preparedness
His warning comes as Plateau State battles a diphtheria outbreak that has reportedly claimed 23 lives and infected more than 140 people, forcing the state government to temporarily shut public and private primary and secondary schools.
The outbreak has also raised concerns over shortages of diphtheria antitoxin and laboratory diagnostic materials in some health facilities, while the Nigeria Centre for Disease Control and Prevention (NCDC) continues response efforts.
Adeyemo said school closures may help reduce transmission in heavily affected communities but stressed that they are not a standalone solution.
“Closing schools alone cannot stop an outbreak because transmission can continue in homes, markets, public transport and places of worship. School closure should be accompanied by vaccination, case detection, treatment, contact tracing and public education,” he explained.
Low Immunisation Driving Outbreaks
According to Adeyemo, recurring outbreaks in parts of northern Nigeria are largely linked to low routine immunisation coverage, alongside poverty, insecurity, misinformation and limited access to healthcare.
He cited findings from the 2024 Nigeria Demographic and Health Survey, which showed that only about 53 per cent of Nigerian children received the third dose of the pentavalent vaccine that protects against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B.
“Vaccination remains the most effective protection against diphtheria. Governments should identify children who missed routine immunisation and ensure they receive the required doses,” he said.
He added that immunity can reduce over time, making recommended booster doses equally important.
States Must Prepare Before Cases Emerge
Adeyemo advised states currently experiencing outbreaks to intensify vaccination campaigns, strengthen surveillance, investigate suspected cases, trace contacts and ensure timely treatment.
For states without significant outbreaks, including Lagos and Ogun, he recommended preventive measures rather than reactive responses.
“Affected states need outbreak control, while unaffected states need outbreak prevention and preparedness. Lagos and Ogun should not say, ‘We have no cases.’ They should say, ‘This is the best time to prepare,'” he said.
He also urged schools to promote hand hygiene, respiratory etiquette and adequate classroom ventilation while avoiding stigma against children suspected of infection.
Parents, he added, should verify their children’s immunisation records and seek immediate medical attention whenever symptoms appear instead of relying on self-medication.
Federal Government Urged to Strengthen Response
Adeyemo called on the Federal Government to ensure states have adequate supplies of vaccines, diphtheria antitoxin, laboratory materials and trained healthcare workers to improve outbreak response nationwide.
“Diphtheria is a vaccine-preventable disease. Every outbreak should remind us to strengthen immunisation, surveillance and rapid response systems before more lives are lost,” he said.
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Mirian Gom 
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