Thousands of children affected by diphtheria in Kano state, Nigeria

When Shamsiyya Abubakar Abdullahi's four-year-old daughter developed a fever and sore throat, she thought it was just a cold.

She took her daughter to a local hospital, where they were referred to the previously by MSF supported Infectious Diseases Hospital in Kano, northern Nigeria. Doctors diagnosed her daughter Fatima with diphtheria. ​

“I had heard about diphtheria before, but I did not understand what the disease was until my daughter contracted it.” says Shamsiyya. ​

“She was taken care of very well in the hospital. I was so happy and grateful when she recovered and was discharged.”

Shamsiyya’s relief was short-lived. Only two months later, Fatima fell sick with diphtheria again. This time, her symptoms were much more severe. She suffered from fever, drooling and difficult breathing. They returned to the hospital, where she was admitted to the the Intensive Care Unit (ICU) of the Infectious Diseases Hospital for life-saving treatment.

Diphtheria outbreak Nigeria

Fatima’s story reflects the experience of thousands of families in Kano State, one of the most affected states by Nigeria’s ongoing diphtheria outbreak that was officially declared in 2023. According to the Kano state MoH, more than 31,900 suspected diphtheria patients and over 1,260 deaths, most of them children, were reported between March 2022 and 22 March 2026, highlighting the devastating consequences of the disease. ​

The outbreak has mainly affected children between the ages of 5 and 14 years, many of whom were unvaccinated or partially vaccinated. Persistent gaps in routine immunisation coverage, high population density, overcrowded living conditions, delayed health-seeking behaviour, and limited access to quality healthcare have contributed to the continued transmission of the disease. ​ ​

Diphtheria disease

“Diphtheria is a vaccine- preventable infectious disease caused by a bacterial infection that affects the upper respiratory tract symptoms.” Says Khadija Usman, MSF emergency medical activity manager for Kano. “It spreads through respiratory droplets and through direct skin contact with an infected wound.”

“Diphtheria can affect most organs in the body, including the heart and kidneys. It can even cause bleedings and airway obstruction, possibly leading to death.” Says Usman.

For unvaccinated persons without proper treatment, diphtheria is fatal in around 30% of cases, with young children at higher risk of dying. ​ ​

MSF response

In response to the outbreak and overwhelming needs, MSF started an emergency intervention for diphtheria in 2023, working alongside the Kano State Ministry of Health. Between the start of the response and 30 May 2026, MSF had treated more than 14,700 children in MSF-run and supported treatment centres, including facility-based and home-based care. ​ ​

Beyond medical care, MSF strengthened referral systems, disease surveillance and data management, conducted community engagement activities, and supporting mass vaccination campaigns against diphtheria. ​

On 30 May 2026, MSF concluded its diphtheria emergency intervention in Kano State after three years of support. During the intervention, case fatality rates in MSF-supported facilities dropped from 25 per cent to less than 5 per cent. The conclusion of activities was marked by a mass vaccination campaign in Kano State, conducted by MSF in collaboration with the Kano MoH. During two rounds, over 835,000 diphtheria vaccines were administered to children. ​ Strong community engagement played a key role in the success of the vaccination campaign.

Malam Abdulhadi Abubakar, headmaster of Katibi Islamic School in Kano State, which temporarily served as one of the vaccination sites, had eight of his nine children vaccinated during the campaign and encouraged many parents to bring their children for vaccination.

“The danger of diphtheria is very real. Among the children here, two little ones caught the illness. One of them sadly passed away. This motivated us to encourage our students to get vaccinated.” said Malam Abdulhadi Abubakar.

Despite almost one million administered vaccinations, the immunisation gaps remain massive in the state with over 17 million inhabitants, leaving thousands of children vulnerable to infection.

Continued health threat

Although the number of children falling ill with diphtheria has declined in recent months - mainly due to mass vaccination campaigns - the disease remains a serious health threat to children in Kano. ​

Continued commitment from health authorities and partners to sustain high immunisation coverage, strengthen surveillance, and ensure timely access to quality treatment will be critical to prevent future outbreaks and protect the lives of children in Kano.