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Nigeria

Cerebrospinal Meningitis (CSM) outbreak in Nigeira: A public advisory from the Federal Ministry of Health

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Friday, March 31, 2017 Nigeria is currently experiencing an outbreak of Cerebrospinal Meningitis (CSM) that has spread across the country and mostly affecting States in the upper parts of the country which fall within the African Meningitis Belt. Other Countries that are facing similar outbreaks at the moment include our West-African Neighbours like Niger, Chad, Cameroun, Togo, and Burkina Faso. The larger African Meningitis Belt consists of 26 Countries that stretch from Senegal, Gambia and Guinea Bissau in the west coast to eastern countries of Eritrea and Ethiopia Although this is not the first time or the worst Epidemic ever faced by Nigeria, this round of the epidemic has come with a difference, as all previous epidemics were caused by Neisseria Meningitides type ‘A’ but this year we are recording Neisseria Meningitides type C in epidemic proportion for the first time.

Historically, the worst CSM epidemics experienced in Nigeria occurred in 1996 when about 109,580 cases and 11,717 deaths were recorded, followed by the one in 2003 (4,130 cases and 401 deaths) then in 2008 (9,086 cases and 562 deaths) and in 2009, when 9086 cases and 562 deaths were recorded.

These historical records and past experiences influenced Health Authorities in Africa (especially countries within the African Meningitis Belt), the World health Organization and Many Development Partners to roll out a strategic intervention for the effective prevention of such epidemics. This gave birth the mass vaccination campaign using a new conjugate vaccine the MenAfriVac-A in about 16 out of the 26 Vulnerable countries (including Nigeria). It resulted in a reduction of over 94% incidence of the disease in most countries, thus significantly reducing the risk of type A.

Some key lessons learnt from the MenAfriVac-A mass vaccination campaign and the recent happenings across the sub-region, are that, although type A was successfully displaced, other strains which were hitherto less significant can actually assume epidemic proportions. Thus Efforts must continue towards preventing a rebound of the type-A and also preventing a potential replacement by all other strains.

The Current Situation in Nigeria (Friday, 31st March, 2017):

Ninety (90) Local Government Areas (LGAs) in Sixteen (16) States of the Federation are so far affected including Zamfara, Katsina, Sokoto, Kebbi, Niger, Nassarawa, Jigawa, FCT, Gombe, Taraba , Yobe, Kano, Osun, Cross Rivers, Lagos and Plateau. The total number of people affected across these States is 2524 with 328 Deaths. So far, a total 131 samples have been confirmed in the Laboratory, out of which a majority are Neisseria Meningitides type C. This current outbreak started in Zamfara State in the 50th week of 2016 (i.e. November 2016)

Actions taken so far (Friday, 31st March 2017):

Response Coordination:

  • CSM outbreak control team constituted to coordinate all responses aimed at controlling the outbreak. Membership include FMOH, NCDC,
    NPHCDA, WHO and other partners (MSF, UNICEF, CDC and EHealth Africa)

  • Coordination meetings hold regularly

  • All initial five States have commenced Emergency Operation Center EOC/EPR meetings

  • Mapping of resources at State level to identify ongoing activities.