Nigeria: Meningitis Outbreak - Mar 2017
As of 19 March 2017, a total of 1,407 suspected cases of meningitis and 211 deaths have been reported from 40 local government areas in five states of Nigeria since December 2016. Zamfara, Katsina and Sokoto account for 89% of these cases. (WHO, 24 Mar 2017)
As at April 3, 2017, a total of 2,997 suspected cases of CSM have been reported in 16 States in Nigeria, of which 146 have been laboratory-confirmed. Unfortunately, 336 deaths have also been recorded...A total of 500,000 doses of Meningitis C vaccines have been distributed to some of the affected States for immediate outbreak response vaccination. An additional 823,970 doses of Meningitis C vaccines are expected from the UK to support vaccination activities in other affected States. The Emergency Operations Centre will support State-wide vaccination campaign which starts in Zamfara State on Wednesday the 5th of April, 2017. (Govt, 4 Apr 2017)
The number of new cases of suspected meningitis being reported has begun to decline as outbreak control measures take effect. A total of 628 new cases were reported in week 16 versus 1,935 in week 15 and 2,127 in week 14. The cumulative number of suspected cases recorded in Nigeria throughout the outbreak period is now 9,646 and 839 deaths from 43 Local Government Areas in 23 states. (Govt, 26 Apr 2017)
Health sector is supporting the State Ministry of Health and State Primary Health Care Agency in Adamawa, Borno and Yobe states to lead the preparedness process for cerebro-spinal meningitis epidemic, which is a looming threat in the region. A draft epidemic preparedness and response plan has been prepared for North-East Nigeria. As of April 13, 2017, a total of 5,695 suspected cases have been reported; included 221 (4%) laboratory confirmed cases; and 611 deaths (WHO, Gov't Nigeria, Health Cluster, 30 Apr 2017.)
The meningitis outbreak situation in Nigeria is gradually improving. During week 18 (week ending 7 May 2017), the four most affected states of Zamfara, Sokoto, Katsina and Kebbi observed reduction in the weekly caseload and deaths. (WHO, 12 May 2017)
The Nigeria Federal Ministry of Health has, on 23 June 2017, officially declared the end of the 2016/2017 meningitis outbreak in the country. This declaration comes four weeks after the number of new meningitis cases reported each week fell below the epidemic and alert thresholds in all Local Government Areas. Since onset of the outbreak on 18 December 2016, a total of 14,518 suspected / confirmed cases of meningitis were reported from 25 states, with 1,166 deaths, giving a case fatality rate of 8%. (WHO, 23 Jun 2017)
ROLE OF EMERGENCY OPERATIONS CENTRES IN OUTBREAK COORDINATION
The response to outbreaks usually involve multiple activities, many of which occur concurrently. In most situations, resources are scarce and few personnel are involved or available to respond to an outbreak. For effective outbreak management, a well-defined structure needs to be established.
*The reporting of health facility level IDSR data is currently being rolled out across Borno State. Whilst this is taking place, some LGAs are continuing to report only at the level of local government area (LGA). Therefore, completenss and timeliness of reporting is displayed at both levels in this bulletin.
*Alerts are based on 7 weekly reportable diseases in the national IDSR reporting format (IDSR 002) and 8 additional diseases/health events of public health importance in the IDP camps and IDP hosting areas.
PREVENTING CHOLERA OUTBREAKS IN THE DRY SEASON
Historic Epidemiological reports show that the cholera outbreak season in Nigeria has two peak periods. The first peak period is seen during the rainy season when the sewage and drainage systems are overwhelmed due to heavy rains with an attendant contamination of sources of drinking water. The second peak period is seen during the dry season particularly in areas where wells and bodies of waters have dried up and people in the communities are made to travel far in search of water, albeit non-potable water.
ESTABLISHING LABORATORY SUPPORT FOR PUBLIC HEALTH SURVEILLANCE
This week, we round up our series on laboratory and its role in surveillance and disease control by focusing on establishing laboratory support for public health surveillance.
It is important to note that at every level of laboratory service delivery, certain activities are important in strengthening and driving the activities of the laboratory in public health surveillance. Below is a summary of some important outbreak preparedness and response activities, where laboratory support is essential.
BUILDING LABORATORY SYSTEMS TO ENHANCE DISEASE SURVEILLANCE
BUILDING CAPACITY FOR INTEGRATED DISEASE SURVEILLANCE AND RESPONSE IN PREPARATION FOR CEREBROSPINAL MENINGITIS SEASON
The Integrated Disease Surveillance and Response (IDSR) strategy was adopted in Nigeria in 2001 as the strategy for public health surveillance in the country. However, experience from recent outbreaks shows that the surveillance capacity for early detection of outbreaks and other public health events needs to be further strengthened.
PREPAREDNESS FOR LASSA FEVER SEASON
As the dry season begins, we are strengthening preparedness for disease outbreaks especially for diseases with more cases recorded during this time of the year. With a focus on Cerebrospinal Meningitis last week, we discuss outbreak preparedness activities specific for Lassa fever and what is expected at each level of Government, in this week’s report. These are discussed under six pillars: Surveillance, Case management, Laboratory, Logistics, Risk Communication/Social Mobilisation and Coordination
PREPARING FOR THE DISEASE OUTBREAK SEASON
Epidemiological data shows an increase in the number of cases of some infectious diseases at the end of the year (when the dry season starts) in Nigeria. This is most relevant for diseases like Lassa fever and Cerebrospinal Meningitis (CSM). As we work to improve on our outbreak response system, it is important for all levels to commence preparedness activities. This week’s editorial focuses on very essential preparedness activities that the LGA, State and National should embark on.
WHO Health Emergencies programme in the African Region: Compendium of short reports on selected outbreaks
It is our sincere pleasure to share with you a compendium of short reports on selected outbreaks in the WHO African Region. This compendium covers the following outbreaks:
Ebola in the Democratic Republic of the Congo,
Meningococcal septicaemia in Liberia,
Cholera in Malawi,
Meningitis in Nigeria,
Crimean-Congo haemorrhagic fever in Namibia,
WHO was notified of an outbreak of meningitis by the Government of Nigeria on 20 February 2017. The first case was reported in Zamfara state during epidemiology week 50 (December 12-18, 2016). On 23 June 2017, the Nigeria Federal Ministry of Health officially declared the end of the 2016/2017 meningitis outbreak in the country. This declaration was made almost 8 weeks after the number of new meningitis cases reported each week during this outbreak fell below the epidemic and alert thresholds in all Local Government Areas.