More than 10,000 people have been infected with Cholera in a major outbreak centred on Nigeria’s conflict-hit northeastern Borno state.

At least 46 people have died from the infection in Doctors Without Borders (MSF) medical facilities during the outbreak, which began early last month, the organisation told The Telegraph.

The French medical charity, working alongside the state ministry of health, has ​set up a cholera treatment centre in the capital, ​Maiduguri, as clinics struggle to cope with the surge in cases.

The outbreak is placing further strain on an already fragile healthcare system in a region shaped by violent extremism, mass displacement and poor water and sanitation infrastructure, raising fears of wider spread if containment efforts fail.

“When we opened our cholera treatment centre, it was with 120 beds. Right now we’re at about 151 beds… in some of the [treatment centres], there is even over occupancy,” said Stuart Alexander Zimble, MSF’s Head of Country Office in Nigeria.

“In the last couple of days, there’s [been] a stabilisation in the numbers… but it’s still a situation we’re concerned about,” he told The Telegraph.

Nigeria’s ministry of health has requested more than three million oral cholera vaccine doses through the The International Coordinating Group (ICG) on Vaccine Provision in a bid to contain the outbreak, Mr Zimble said.

Cholera is spread when food or water contaminated with the bacterium Vibrio cholerae is ingested.

The bacteria infects the intestines and makes them produce large quantities of fluid, leading to severe diarrhoea and vomiting.

Without treatment, death can occur rapidly. However, the disease can be treated by replacing lost fluids and electrolytes through oral rehydration solutions or intravenous fluids in severe cases.

The waterborne disease spreads rapidly in areas with limited access to safe drinking water and sanitation facilities.

Most of the cases are concentrated in Maiduguri, the state capital, which is home to about two million people, including large numbers of people displaced by a 17-year insurgency by Boko Haram, the terror group which gained global notoriety for kidnapping hundreds of schoolgirls.

Mr Zimble said cholera had become a recurring problem in the city, with outbreaks driven by overcrowding, displacement and inadequate sanitation.

“Every night I go to sleep thinking about the numbers of people that are suffering from this,” said Mr Zimble.

“One cholera case is too many… it’s such a dastardly disease, and yet it’s so simple to treat… It’s a matter of making sure that our teams are present and are identifying where the hot spots are so that we can save their lives.”

Protect yourself and your family by learning more about Global Health Security