Meningitis Death Toll Rises to 328  in 16 States, 90 LGAs

•  FG sets up isolation centres, issues medical advisory  
• 2,524 cases recorded so far 
• 5 neighbouring countries affected 

Senator Iroegbu and  Kuni Tyessi,  in Abuja

The Federal Government saturday said that 328 persons had died from the outbreak of Cerebrospinal Meningitis (CSM) that has affected 16 states and 90 Local Government Areas (LGAs).

The affected states are Zamfara, Katsina, Sokoto, Kebbi, Niger, Nassarawa, Jigawa, FCT, Gombe, Taraba , Yobe, Kano, Osun, Cross Rivers, Lagos and Plateau.

Government  also said about five neighbouring countries within the Meningitis belt – Niger, Chad, Cameroun, Togo, and Burkina Faso – were facing similar outbreaks at the moment.

A statement signed by the Director Media and Public Relations, Ministry of Health, Mrs. Boade Akinola, noted that to contain and effectively tackle the outbreak, functional Isolation centers/units had been identified in all states and efforts were on to strengthen them.

The ministry puts the total number of people affected across the 16 states at 2,524 with the majority of about 131 samples confirmed in the laboratory to be Neisseria Meningitides type C.

Meningitis,  an inflammation (swelling) of the protective membranes covering the brain and spinal cord known as the meninges, is usually caused by an infection of the fluid surrounding the brain and spinal cord. It is usually caused by bacteria or viruses, but could also be a result of injury, cancer, or certain drugs. Knowing the specific cause is however important because the treatment differs depending on the cause.

While assuring that government was taking appropriate measures to address the situation, Akinola noted that “although this is not the first time or the worst epidemic ever faced by Nigeria, this round of the epidemic has come with a difference, as all previous epidemics were caused by Neisseria Meningitides type ‘A’ but this year we are recording Neisseria Meningitides type C in epidemic proportion for the first time.”

 According to the health ministry, the current outbreak started in Zamfara State on November 2016.

The ministry spokesperson said: “Nigeria is currently experiencing an outbreak of Cerebrospinal Meningitis (CSM) that has spread across the country and mostly affecting states in the upper parts of the country which fall within the African Meningitis Belt. Other Countries that are facing similar outbreaks at the moment include our West-African Neighbours like Niger, Chad, Cameroun, Togo, and Burkina Faso. The larger African Meningitis Belt consists of 26 Countries that stretch from Senegal, Gambia and Guinea Bissau in the west coast to eastern countries of Eritrea and Ethiopia

“Historically, the worst CSM epidemics experienced in Nigeria occurred in 1996 when about 109,580 cases and 11,717 deaths were recorded, followed by the one in 2003 (4,130 cases and 401 deaths) then in 2008 (9,086 cases and 562 deaths) and in 2009, when 9086 cases and 562 deaths were recorded.”

“These historical records and past experiences influenced Health Authorities in Africa (especially countries within the African Meningitis Belt), the World health Organization and Many Development Partners to roll out a strategic intervention for the effective prevention of such epidemics. This gave birth the mass vaccination campaign using a new conjugate vaccine the MenAfriVac-A in about 16 out of the 26 Vulnerable countries (including Nigeria). It resulted in a reduction of over 94% incidence of the disease in most countries, thus significantly reducing the risk of type A.

“Some key lessons learnt from the MenAfriVac-A mass vaccination campaign and the recent happenings across the sub-region, are that, although type A was successfully displaced, other strains which were hitherto less significant can actually assume epidemic proportions. Thus efforts must continue towards preventing a rebound of the type-A and also preventing a potential replacement by all other strains.”

Akinola listed other actions taken so far, especially in response coordination noting that CSM outbreak control team had been constituted to coordinate all responses aimed at controlling the outbreak with membership from FMOH, NCDC, NPHCDA, WHO and other partners (MSF, UNICEF, CDC and EHealth Africa)

She said that coordination meetings were being held regularly and all initial five states had commenced Emergency Operation Center EOC/EPR meetings and mapping of resources at state level to identify ongoing activities.

Listing other measures, she said there had also been Case Management and Infection Prevention & Control (IPC). “Antibiotics and management supplies available and being used as per protocol in all states for treatment; number of cases currently on admission or treated since the onset of the outbreak are being collated across LGAs and states; and micro plan concluded in Zamfara for possible vaccination in week 14.”

In addition, she said surveillance with active case searches in the affected LGAs and register review were ongoing, including  outbreak/rumour investigations, and clinician sensitization and training proposed in selected areas. She also listed some CSM guidelines including laboratory protocol under review.

Akinola said that the ministry had embarked on communication and social mobilization through community health education as part of state team responses with support from UNICEF, while most states (especially Katsina and Zamfara) are doing radio jingles with support from UNICEF, while IEC materials were being developed by NCDC, NPHCDA and UNICEF.

As a prevention mechanism, Akinola urged members of the public to avoid overcrowding, sleep in well ventilated places, avoid close and prolonged contact with a case, proper disposal of respiratory and throat secretions, strict observance of hand hygiene and sneezing into elbow joint/sleeves.

The members of the public were also advised to reduce handshake, kissing, sharing utensils or medical interventions such as mouth resuscitation, and vaccination with relevant sero-type of the meningococcal vaccine  and elf-medication should be avoided

Akinola called for early diagnosis, treatment and isolation, saying that it’s “very important that all individuals should acquaint themselves with at least the basic knowledge/understanding of CSM and how it is transmitted and prevented; strictly adhere to the advice  of Health workers on how to protect oneself as enumerated above; and prompt seeking for medical/health care as soon as CSM or CSM-Like Illness is suspected”.

“All Hospitals to ensure that appropriate Diagnoses are made including laboratory confirmation and immediate reporting through the surveillance system; commence early treatment as soon as the diagnoses of CSM is made; restrict mingling with other people once one is diagnosed as a case of CSM; and all Secondary and Tertiary Public Health Facilities should provide free treatment to all CSM Patients,” she stated.

Calling on the general public to remain calm as Meningitis  is both preventable and curable, she noted that even though the cumulative number of people and locations affected may continue to increase, the actual rate of increase had begun to decline in some states indicating that the end of the epidemic is in sight.

Akinola further stated that all public sector hospitals (secondary and tertiary hospitals) had been directed to provide free treatment for all cases of Cerebrospinal Meningitis.

She commended national and international development partners (multilateral and bilateral) who supported the ministry  in accessing the relevant CSM vaccines which had already been deployed to Zamfara, Sokoto, Katsina and FCT.

“We are equally reassured that more doses are expected and all necessary documentation for the new vaccines arrivals have been concluded,” she stated.

She also assured that the Federal Ministry of Health would continue to provide regular feedback to the general public on the necessary steps to take, urging people to “remain calm and continue to abide by the health advisory being issued periodically”.