As the outbreak of cerebrospinal meningitis (CSM) in Northewest Nigeria continues to spread across five states, experts have cautioned other State governments to immediately take measures to protect their citizens.
The Nigeria Centre for Disease Control (NCDC) today issued statement to allay fears that together with the National Primary Health Care Development Agency (NPHCDA) are supporting Northwest States to respond to a widespread outbreak of CSM which was first noticed late 2016 in Zamfara State.
The NCDC disclosed that as at Tuesday, March 28, the number of suspected cases reported in the 2016/2017 CSM season had risen to 1,966, with the outbreak reaching epidemic proportions in five States- Zamfara, Sokoto, Kebbi, Katsina and Niger States.
The World Health Organisation (WHO) had earlier in the week reported a total of 1407 suspected cases of meningitis and 211 deaths (case fatality rate: 15%) 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. Neisseria meningitidis serogroup C NmC has been isolated asthe predominant serotype in the present outbreak.
Given the size of the outbreak and the number of States affected, the NCDC says it is leading a multi-agency CSM Outbreak Control Team to coordinate the response.
This team includes representatives from the NPHCDA, World Health Organisation, UNICEF, US Centers for Disease Control, Médecins Sans Frontières and EHealth Africa.
The Outbreak Control Team is focusing on communicating prevention messages, strengthening surveillance, case detection, verification and management as well as communication and coordination across the affected States.
According to the Director of Surveillance at the NCDC, Mrs Olubunmi Ojo, “Immunisation is key to the prevention of meningitis. Between 2011 -2014, the MenAfriVac vaccination campaign against the predominantly circulating Neisseria meningitidis serogroup A in Nigeria then, led to a major reduction in cases recorded from that strain. We now see an outbreak caused predominantly by Neisseria meningitidis serogroup C (NmC). While reactive vaccination helps to curtail outbreaks, a vaccination campaign against NmC with a long-lasting conjugate vaccine is sorely needed in the region.
Consultant and Senior Research Immunologist, Nigeria Institute of Medical Research, Dr. Adeshina Adeiga shared his thought with Healthstyleplus Online saying, “Yes, we ought to have prepared (for the disease ) but priority on little funds available prevent such preparation”.
He noted that though we still import vaccines, “SOS should be sent to possible links in unaffected states to vaccinate children in the hot spots. He called on non-governmental agencies to be on the tail lf all state governments to immediately respond to the outbreak before it gets out of hand”.
According to the Chief Executive Officer of the NCDC, Dr Chikwe Ihekweazu, “We understand meningitis peaks every year in the dry season in certain States and we must work better with these States to prevent the unnecessary loss of lives. We must work collectively to stop this outbreak and prevent outbreaks of this scale in the future”.
Technical Adviser to the Chief Executive Officer, Dr. Lawal Bakare, told Healthstyleplus Online,” While CSM vaccination is not part of routine immunization the NCDC have put out some preventive messages to the public.
“These include: avoiding overcrowded shelter (though may not be easy in very unavoidable cases), we advocate for proper ventilation. And as people ensure ventilation, they also need to be mindful of mosquitoes hence sleeping under Insecticides Treated Nets.
“We ask parents and Nigerians to be mindful of symptoms and how to respond. The most common symptoms of meningitis are stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting” adding, “anyone with these symptoms is advised to urgently seek care at the nearest health facility. Meningitis should always be viewed as medical emergency”, noted Lawal.
NPHCDA is leading a reactive vaccination in Zamfara State, while a similar response is currently being planned in Kebbi and Sokoto States. Vaccines that provide protection to Neisseria meningitidis serogroup C (NmC) are not commercially available and need to be acquired through a special process managed by WHO. Meningitis can be treated if detected early.
Nigeria is one of the fifteen countries in the hot belt of meningitis in Africa. The other countries are: Mauritania, Senegal, Guinea, Cote d’Ivoire, Guinea Bissau, Ghana, Benin, Togo, Camroon, CAR, DR Congo, Uganda, Kenya and Eritrea.
Our brains and spinal cords are covered by membranes called meninges; they help to protect these delicate organs from infection and even direct physical injury. The infection of the meninges by microorganisms such as bacteria or viruses results in the condition known as meningitis. Viral and bacterial infections are the most common cause but bacterial meningitis is much more serious due to its rapid onset and its significant risk of death.
Neisseria meningitidis can be carried in the throat and sometimes, for reasons not fully understood, can overwhelm the body’s defences allowing infection to spread through the bloodstream to the brain. It is believed that 10% to 20% of the population carries Neisseria meningitidis in their throats at any given time but the carriage rate may be higher in epidemic situations.
The most common symptoms of meningitis are stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting, and anyone with the symptoms above is advised to urgently seek care at the nearest health facility. Meningitis should always be viewed as a medical emergency.