Nigeria

Yellow Fever Outbreak in Nigeria: NCDC Situation Report #39 (5 October - 11 November 2018)

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HIGHLIGHTS

  • In this reporting week 5th October – 11th November, 2018:

o 85 suspected cases were recorded

o One inconclusive case from Bakassi Local Government Area of Cross River state – recorded from the NCDC Central Public health laboratory Lagos

o No new confirmed case from Institut Pasteur (IP) Dakar

o Last confirmed case from IP Dakar was on 18th October, 2018

o A national yellow fever Incident Management System (IMS) Level 2 Emergency Operation Centre (EOC) is active

o Phase 2b Yellow fever preventive mass vaccination campaign to commence from 22nd November, 2018

o A three year (2019-2021) Yellow fever (YF) Preventive Mass Vaccination Campaign (PMVC) proposal plan approved by global alliance for vaccine initiatives) (GAVI)

SUMMARY OF OUTBREAK

  • A yellow fever outbreak is currently active in Nigeria

  • Confirmed cases have been recorded in 14 States (Kwara, Kogi, Kano, Zamfara, Kebbi, Nasarawa, Niger, Katsina, Edo, Ekiti, Rivers, Anambra, FCT, and Benue States): in 27 Local Government areas (LGAs) [Table 1]

  • Since the beginning of the outbreak, 167 samples (presumptive positive -140 and inconclusive -27) in 82 LGAs have been sent to IP Dakar for re-confirmation [Figure 1]

  • All Nigerian states have reported suspected cases in 570 (73.6%) LGAs [Figure 4] From the onset of this outbreak in September 12, 2017, a total of 3,456 suspected yellow fever cases have been reported as at week 45 [5 th November – 11th November, 2018: (Table 1)]

  • Of the 3,456 suspected cases, 3,201 (92.6%), had blood samples collected and sent to the Nigerian testing laboratories.

  • Of the 3,201 samples collected, 140 (4.4%) tested positive for yellow fever (presumptive positive cases) and 27 (0.8%) inconclusive results in six Nigerian laboratories [Table 1]

  • Of the 167 (presumptive positive and inconclusive) samples in Nigeria, 56 (33.7%) samples have been confirmed positive by IP, Dakar. 88 (53%) samples were negative. Awaiting results of 23 (13.7%) samples from IP Dakar [Table 1]

  • Of all suspected, probable and confirmed cases, 55 deaths have been recorded with 13 deaths among confirmed cases only

  • The case fatality ratio (CFR) for all cases (suspected, probable and confirmed) is 1.6%, and 23.2% for confirmed cases.[Table 1]

  • Predominant age groups affected among the suspected cases is 20 years and below (children and younger adults) accounting for 2,164 (62.7%) [Male 1,326 (38.4%): Female 839 (24.3%)],
    However, age groups 1 - 5 years have the highest peak o Median age is 15 years (range 1 – 92 years) o Male to female ratio is 1.4 to 1 [Male 2,003 (58.0%), Female 1,453 (42.0%)] o Among the confirmed cases, male to female ratio is 1.9:1 (Male 66.1%,
    Female 33.9%)

  • Yellow fever preventive mass vaccination campaigns (PMVC) have been successfully completed in six states: o Nasarawa, Cross River, Akwa Ibom; Kogi, Kwara and Zamfara and in fiftyeight political wards in 25 LGAs in Borno State o 2018 phase 2b November PMVC to be implemented from 22nd November –st December, 2018 in Sokoto, Kebbi, Niger, FCT, Plateau and Borno [3 LGAs (Askira/Uba, Chibok, Konduga)] States. Target population 9 months to 44 years, (85% of the total population).