ACAPS Briefing Note – Nigeria Meningitis, 11 April 2017
3,959 cases of meningitis, 181 laboratory confirmed, resulting in 438 deaths have been reported as of 5 April. While 19 states have reported outbreaks, 97% of reported cases are in six states: Katsina, Kebbi, Niger, Sokoto, Yobe, and Zamfara. Meningitis serotype C, or NmC, is responsible for 83% of laboratory confirmed cases and is severely undervaccinated in the affected areas. Additionally, vaccines for NmC is very costly at USD 50 per dose. Both this cost and local health capacity has limited response thus far.
As of 5 April, 3,959 suspected cases of Meningitis have been reported and 438 deaths - an overall case fatality rate (CFR) of 11.1%. This caseload includes 1,172 suspected cases between 1-5 April, 313 in the week ending 1 April, and 755 in the week ending 25 March. The first cases were reported in the week ending December 18, 2016. However, the apparent increase in case numbers is due to an increased response and casefinding in affected areas. 19 states have reported outbreaks, although 97% of reported cases are in Katsina, Kebbi, Niger, Sokoto, Yobe, and Zamfara states (NCDC 09/04/2017).
The meningitis outbreak crossed the epidemic threshold in Kebbe local government agency (LGA) in Sokoto state in the week ending 5 March (WHO 05/03/2017). A meningitis epidemic is defined as case rate of 10 reported cases per 100,000 population (WHO 2015).
The most common strain of the virus in this outbreak is the meningitis serotype C (NmC), for which there is a severe vaccine deficit. NmC accounts for 83% of laboratory confirmed cases as of 5 April (NCDC 09/04/2017). 500,000 NmC vaccines were available. Over 800,000 NmC vaccine cases had to be imported from the United Kingdom to assist in the response (BBC 03/04/2017). An estimated 3 million vaccines are needed in Zamfara state alone (Al Jazeera 01/04/2017). The outbreak is placing considerable strain on northern Nigeria’s already limited health system.