WHO

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, and Nigeria Centers for Disease Control and Prevention are providing support to this outbreak.

The following measures are being implemented:

• Nigeria Centers for Disease Control and Prevention, 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 meningococcal AC PS vaccines and injection supplies was approved by the International Coordination Group (ICG) for utilization in Zamfara State which are planned to arrive 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).

WHO advice

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.