…PROTECTINGTHEHEALTHOFNIGERIANS

TITLE: 2017/2018CEREBRO-SPINALMENINGITISOUTBREAKINNIGERIASERIALNUMBER: 5

EPI-WEEK: 3DATE: January25,2018

HIGHLIGHTS

• NCDCandpartnersarecurrentlyimplementingthe2017/2018preparednessandresponseplanthroughthemulti-agencyCSMEmergencyOperationsCentre(EOC).Thisisthefifthsituationreport.

• IsolatedcasesweredetectedfromSeptember2017,andeachfollowedup.• Giventheknownepidemicseasonandincreasingnumberofreportedcases,amulti-agencyCSM

EmergencyOperationsCentre(EOC)wasactivatedtoalertmodeonthe4thofDecember,2017(Week49)toproactivelycoordinateresponse.

• BeginningfromSeptember1,2017toJanuary25,2018,atotalof481suspectedcaseshavebeen reported from twelve States –Zamfara(257), Katsina (86), Sokoto (41), Jigawa (29),Bauchi(20),CrossRiver(17),Kebbi(12),Yobe(9), Kano (4), Borno (3), Adamawa (2) andKaduna(1).

• Of the 481 suspected cases, 176 (36.6%)samples have been collected and tested. Ofthe 176 samples tested, 79 (44.9%) werepositiveforbacterialmeningitis.

• NeisseriameningitidesC(NmC)accountedfor63.3%(50)ofthepositivecases.

• ThefirstLGAthatcrossedthealertthresholdwasBunguduinZamfarastateinEpi-week51,2017.

• Sofar,82deaths(CFR=17.0%)havebeenrecordedamongallsuspectedcases.• In the last fourweeks (EpiWk52 to EpiWk3), fourwards in Zamfara State (Wonaka inGusau LGA,

SankalawaandKotorkoshiinBunguduLGAandZurmiinZurmiLGA),onewardinBauchiState(MadaraWardinKatagumLGA),onewardinKatsinaState(AbadauKagarainBatsariLGA)andTakwasainBaburaLGAinJigawaStatereachedtheepidemicthreshold.

• ReactivevaccinationinKagarawardinTalataMafaraLGA,ZamfaraStateendedon22ndJanuary,2018attainingfullcoverageofthetargetpopulation.

• Mediamessageshavebeendevelopedanddisseminatedbyconventionalmediaandsocialmedia.• TheNationalReferenceLaboratorycontinuesconfirmatorytestingusingPCRand isstoringsamples in

itsBiorepository.• NPHCDAhascompletedafirst ICGrequestforthewards inZamfarastatethathavecrossedepidemic

threshold.

KeyIndicators Number

Totalcasesreported 481

TotalDeaths 82

Confirmedcases 79

Totalsamplestested 176Statesthathavereportedatleastonesuspectedcase 12

LGAsinAlertinthelastfourweeks(wk52,2017towk3,2018) 2

LGAsinEpidemicinthelastfourweeks(wk51,2017towk2,2018) 0

CumulativeLGAseverinEpidemic 0

…PROTECTINGTHEHEALTHOFNIGERIANS

Outbreaksummary• BetweenSeptember,2017(Epi-Wk36)andJanuary,2018(Epi-Wk3),atotalof481caseswith82

deaths(CFR=17.0%)havebeenreported.• Ofthereportedcases,176(36.6%)werelaboratorytested;ofwhich79(44.9%)wereconfirmed

positiveforbacterialmeningitis.• NmCisthemaincirculatingstrain50(63.3%)amongstpositivecases.• Themostaffectedgroupis1-15years(74.0%)withmaletofemaleratioof1.5:1.• Inthelastfourweeks,eightwardsfromsevenLGAsinZamfaraState,threewardsfromthreeLGAsin

SokotoState,twowardsfromtwoLGAsinKatsinaState,onewardeachinBornoStateandYobeStatesreachedthealertthreshold.

• NoLGAiscurrentlyinepidemicthreshold.• Outbreakinvestigationandcontrolmeasuresarebeingimplementedintheaffectedstates.

CSMOutbreakEpidemicCurvesasatJanuary25,2018,Nigeria

0102030405060708090100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

National

Alive Dead

0102030405060708090100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Zamfara

Alive Dead

…PROTECTINGTHEHEALTHOFNIGERIANS

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Katsina

Alive Dead

0102030405060708090100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Sokoto

Alive Dead

…PROTECTINGTHEHEALTHOFNIGERIANS

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Jigawa

Alive Dead

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Bauchi

Alive Dead

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

CrossRiver

Alive Dead

…PROTECTINGTHEHEALTHOFNIGERIANS

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Kebbi

Alive Dead

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Yobe

Alive Dead

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Kano

Alive Dead

…PROTECTINGTHEHEALTHOFNIGERIANS

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Borno

Alive Dead

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4

2017 2018

Numberofcases

Weekofonset

Adamawa

Alive Dead

0

20

40

60

80

100

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3

2017 2018

Numberofcases

Weekofonset

Kaduna

Alive Dead

…PROTECTINGTHEHEALTHOFNIGERIANS

DistributionofcerebrospinalmeningitiscasesinNigeriaasat25thJanuary,2018

020406080100120140160

Lessthan1 1-5 6-10 11-15 16-20 21-25 >25

Numberofcases

Agegroupinyears

AgedistributionofCSMcasesinNigeriaasat25thJanuary,2018

…PROTECTINGTHEHEALTHOFNIGERIANS

Distributionofcerebrospinalmeningitiscasesatwardlevelshowingcumulativethresholdsfromepiweek52,2017toepiweek3,2018inNigeria