Meningococcal disease – Nigeria
As of 19 March 2017 (epidemiological week 11), a total of 1407 suspected cases of meningitis and 211 deaths (case fatality rate: 15%) have been reported from 40 local government areas (LGAs) in five states of Nigeria since December 2016. Zamfara, Katsina and Sokoto account for 89% of these cases. Twenty-six LGAs from all five states reported 361 cases in epidemiological week 11 alone. Twenty-two wards in 15 LGAs have crossed the epidemic threshold. Three of these LGAs share borders with Niger. NmC is the predominant serotype in this outbreak.
The most affected age group is 5 to 14 year olds and they are responsible for about half of reported cases. Both sexes are almost equally affected.
Public health response
WHO and partners including National Primary Health Care Development Authority, UNICEF, Nigeria Field Epidemiology and Laboratory Training Program, eHealth Africa, Médecins Sans Frontières, Rotary International, Nigeria Centre for Disease Control, and Gavi, the Vaccine Alliance (Gavi) are providing support to this outbreak.*
The following measures are being implemented:
- Nigeria Centre for Disease Control, with support from the WHO, is taking the overall lead in coordinating the response at the national level.
- Daily coordination meetings are being held at the state and LGA levels.
- The rapid response teams are conducting active case finding, performing lumbar puncture of suspect cases and training local staff on case management.
- Case management is being carried out at the public health centres at the LGA level.
- 19 600 persons were vaccinated with the meningococcal ACWY vaccine in Gora ward in Zamfara state.
- 500 000 doses of Gavi-supported meningococcal AC PS vaccines and injection supplies were approved by the International Coordination Group (ICG) for use in Zamfara State and arrived on 27 March 2017.**
- Katsina state is preparing an ICG request for submission.
WHO risk assessment
The successful roll-out of MenA conjugate vaccine has resulted to the decreasing trend of meningitis A, however, other meningococcal serogroups are still causing epidemics. The most recent outbreak that has been reported was in Togo due to Neisseria meningitidis serogroup W (see Disease Outbreak News as published by WHO on 23 February 2017).
The outbreak response consists of appropriate case management with reactive mass vaccination of populations. Promptness of the reactive campaign is essential, ideally within four weeks of crossing the epidemic threshold.
WHO does not recommend any travel or trade restriction to Nigeria based on the current information available on this outbreak.
*Please note that an amendment was made to this sentence on 30 March 2017 to include an additional partner that is providing support to the outbreak. **Please note that an amendment was made to this sentence on 30 March 2017 to add contextual information regarding the vaccine and injection supplies.