Nigeria: Cholera Outbreak - Jun 2017Ongoing
On 7 June 2017, the Nigeria Federal Ministry of Health notified WHO of an outbreak of cholera in Kwara State in the western part of the country. The initial cases of acute watery diarrhoea (AWD) started insidiously during the last week of April 2017. Seven stool samples obtained from the initial cases and analysed at the University of Ilorin Teaching Hospital (UITH) laboratory isolated Vibrio cholerae O1 as the causative agent. The number of cases and deaths subsequently increased from the first week of May 2017. As of 14 June 2017, a total of 1,178 suspected cases and nine deaths (case fatality rate 0.8%) have been reported. Four local government areas have been affected, including Ilorin West (508 cases), Ilorin East (303 cases), Ilorin South (96 cases), and Moro (37 cases). (WHO, 23 Jun 2017)
The number of new cases reported has shown a decline over the last four reporting weeks. As of 30 June 2017, a total of 1,558 suspected cases of cholera have been reported including 11 deaths (case fatality rate: 0.7%). Thirteen of these cases were confirmed by culture in laboratory. 50% of the suspected cases reported are male and 49% are female (information for gender is missing for 1% of the suspected cases)...Between 1 May and 30 June 2017, suspected cholera cases in Kwara State were reported from five local government areas; Asa (18), Ilorin East (450), Ilorin South (215), Ilorin West (780), and Moro (50) (information for local government areas is missing for 45 of the suspected cases). (WHO, 12 Jul 2017)
The Borno State Ministry of Health in northeastern Nigeria has reported suspected cholera in Muna Garage, a camp hosting about 20,000 internally displaced persons on the outskirts of the state capital Maiduguri. A total of 152 cases of suspected cholera, including 11 deaths, as of 31 August 2017, have been reported. Three of the suspected cases are in close proximity to Muna Garage, not in the camp itself. The State Ministry of Health, with the support of all humanitarian partners, is responding to the outbreak. (OCHA, 1 Sep 2017)
Over 530 suspected cases had been registered as of 5 September 2017, including 23 deaths (4.3 per cent fatality rate), mainly in Muna Garage, a camp hosting about 20,000 internally displaced persons on the outskirts of the state capital Maiduguri. (OCHA, 6 Sep 2017)
The cholera outbreak in north-east Nigeria, which started on 16 August 2017, has now claimed the lives of at least 35 individuals in Borno State. The number of suspected cases stands at 1,283, with confirmed outbreaks in Maiduguri, Dikwa and Monguno. The number is expected to rise with further assessments. Most reported cases are concentrated in the “Muna Corridor” in Maiduguri, which includes 15 sites for displaced. The World Health Organization carried out a rapid risk assessment. The risk of spread in the Borno capital is high given the congestion, poor infrastructure and water/sanitation conditions in the area. (OCHA, 12 Sep 2017)
Confirmed outbreaks have been reported from 7 states: Borno, Kebbi, Zamfara, Kano, Lagos, Oyo, Kwara and Kaduna States. The outbreak was recently confirmed in Kaduna State (40 cases, 2 confirmed). Apart from Kwara where the outbreak has been controlled for an extended period, outbreaks are continuing or being sustained at low levels in other states. (WHO, 27 Oct 2017)
On 21 December 2017, Borno State Ministry of Health announced the end of the outbreak after two weeks had passed with no new cases.(WHO, 22 Dec 2017)
Between weeks 1 and 49, 3 714 cases were reported from 20 states compared to 727 suspected cases from 14 states during the same period in 2016. The cumulative total of cases and deaths in 2017 surpasses that observed during the same period in 2016 (727 suspected cases, 32 deaths) (WHO, 12 Jan 2018.)
121 suspected cases of Cholera were reported from 18 LGAs in Kano State. Of these, five were laboratory confirmed and nine deaths were recorded (Gov't of Nigeria, 12 Jan 2018.)
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This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 56 events in the region. This week’s edition covers key new and ongoing events, including:
Botulism in Nigeria
Lassa fever in Benin
Lassa fever in Nigeria
Humanitarian crisis in Central African Republic
Suspected Rift Valley fever in South Sudan
Cholera in Angola
Suspected Rift Valley fever in The Gambia
Performance indicators (Epi Week 02):
In Epidemiological Week 02 - 2018, a total of 21 out of 21 LGAs (including 06 IDP camps) submitted their weekly reports as timeliness and completeness of reporting were 100% and 100% respectively at LGA level (target 80%).
Measles: 19 cases of suspected measles reported with cumulative case count of 021 and No deaths
AFP: 02 cases of AFP reported with cumulative case count of 006.
• UN reports uptick in Boko Haram related insecurity across Lake Chad Basin during the second half of 2017
• Military operations, insecurity displace populations in northern Borno State
• Food analysis projects continued food insecurity for vulnerable populations in Cameroon
Direct attacks by Boko Haram resulted in violence against local communities (village chiefs, civilians, including young boys and girls reported to have been attacked or abducted).
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 State of Food Security and Nutrition in the World 2017 (SOFI) has revealed that global hunger is on the rise again after declining for more than two decades. Global hunger rose from 777 million in 2015 to 815 million people in 2016.
*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.
General situation: No cholera cases have been officially reported in West Africa during the previous two weeks. An overview of the 2017 situation will be shared in the next bulletin. A reduction in the number of reported cases is noted in the costal zones of West Africa (mainly in Ghana and Benin). However, the Lake Chad basin experienced a greater number of cases in 2017 than in the two previous years, 2016 and 2015. This was due to two distinct outbreaks in Borno State (Nigeria) and Eastern Chad. In 2017, D.R.
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 54 events in the region. This week’s edition covers key ongoing events, including:
- Chikungunya in Kenya
- Cholera in Malawi
- Cholera in Zambia
- Suspected Rift Valley fever in South Sudan
- Humanitarian crisis in the Democratic Republic of the Congo
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.
While conflict continues to rage and despite numerous challenges, humanitarian aid reached more people in more places across the north-east.
Borno officials announce end of the state’s cholera outbreak following GoN and humanitarian interventions
Nearly 60 civilian fatalities reported in recent attacks in northeastern Nigeria, Cameroon’s Far North
Food insecurity across the Lake Chad Basin projected to continue through mid-2018
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 53 events in the region. This week’s edition covers key new and ongoing events, including:
Faits saillants :
Tchad : L’épidémie est maintenant sous contrôle. Les derniers cas suspects ont été enregistrés en semaine 48 dans la délégation sanitaire régionale du Salamat. Malgré de nombreux challenges tous les acteurs se sont largement mobilisés pour répondre avec succès à cette épidémie.