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  • Nigeria: 2019 Yellow Fever

    Source: https://www.who.int/csr/don/09-janua...er-nigeria/en/
    Yellow fever – Nigeria

    Disease outbreak news
    9 January 2019

    On 22 November 2018, the World Health Organization was informed of a cluster of suspected Yellow fever (YF) cases and deaths in Edo State, Nigeria. Edo State is located less than 400km from Lagos on a dense population movement axis between Lagos and South-Eastern Nigeria. Edo State is also a known endemic area for Lassa fever – which was initially suspected as causing the outbreak. From 22 September through 31 December 2018, a total of 146 suspected, 42 presumptive positive, and 32 confirmed cases, including 26 deaths (presumptive case fatality rate: 18%), have been reported across 15 of 18 Local Government Areas (LGAs) in Edo State (figure 1).
    Blood specimens were obtained from 122 cases and sent for laboratory diagnosis; 42 (34%) samples were presumptive positive in-country based on IgM serology and sent to the regional reference laboratory, Institut Pasteur de Dakar (IPD), for confirmation. Thirty-two (76%) were confirmed by plaque reduction neutralization test (PRNT) or real-time polymerase chain reaction (RT-PCR). Males represent the majority of cases (108 of 146, 74%), and the most affected age group is 10–19 years with 48 cases (33%), followed by the age group 20–29 with 36 cases (25%). Initially, the affected LGAs were rural but since the end of November 2018, suspected cases have been reported from three urban LGAs. There has also been a report of two presumptive positive and one confirmed case in Oredo LGA, which includes the densely populated state capital Benin City, of about 1.5 million inhabitants.
    At the time of the outbreak, population immunity in Edo State was very low, (based solely on routine immunisation administrative data, with vaccine coverage estimated at less than 50% in 2018). Edo State has just concluded a seven-day YF Reactive Vaccination Campaign implementation in 13 LGAs to rapidly boost population immunity and interrupt YF transmission. As of 31 December 2018, 1.47 million people have been vaccinated.
    Entomological studies have revealed elevated indices of competent vectors, including Aedes aegypti, the mosquito species responsible for rapid amplification of arboviral disease in urban environments. Land-use practices, namely cultivation close to dwellings, may further exacerbate the spread of YF disease in this setting.
    Since September 2017, when the Nigeria Centre for Disease Control (NCDC) informed WHO of a confirmed case of YF in Kwara State, Nigeria has been responding to successive YF outbreaks. The country officially notified WHO (via the International Health Regulations, 2005) on 15 September 2017. Since then, and as of 30 December 2018, 237 specimens tested IgM positive in-country. Eighty-two cases (including 13 deaths) were confirmed by IPD; these cases were reported from 27 LGAs in 14 States and have resulted in response campaigns in selected LGAs in six states.
    The current outbreak of YF in Edo State in Nigeria is unusual in scale and severity, and the number of cases in time and place is very high in the context of the current national outbreak. The seasonal timing of the outbreak, in a period where many travellers enter the state from other states and countries for the holidays in December–January, adds to the risk for potential spread.
    Figure 1: Confirmed and suspected Yellow fever cases in Edo State outbreak, Nigeria, data as of 31 December 2018 (n=146)




    Public health response

    The response to the outbreak is being coordinated through a multi-agency, multi-partner Incident Management System (IMS). A national Emergency Operations Centre (EOC) has been activated to monitor the outbreak at the NCDC. Rapid response teams continue to support Edo State in ongoing outbreak investigation and response. YF surveillance has been intensified and active case finding is ongoing in affected LGAs and neighbouring states. Supervisory visits to the YF laboratory network are ongoing to strengthen laboratory capacity.
    The WHO Country Office and State Office have been actively monitoring and responding to the YF outbreak since the start of the outbreak. From 15 December 2018, three YF experts from WHO (WHO Regional Office for Africa and WHO headquarters) were deployed to support local authorities in investigating this event, assessing the risk of further amplification, and assisting in conducting reactive vaccination campaigns, among other activities. Entomological surveys were conducted in Anambra, Benue, Ekiti, Kano, Katsina, Kebbi, Kwara, Rivers, and Zamfara states by entomologists from the National Arbovirus Research Institute (NARI). A vector control strategy, tailored to the local context, is being developed with the support of WHO regional and global vector control experts.
    Routine YF vaccination was introduced to Nigeria’s Expanded Programme on Immunization (EPI) in 2004, but the overall population immunity in areas affected by the current outbreak remains below herd immunity thresholds. National preventive and reactive mass vaccination campaigns have been conducted in the country since 2017 (~33 million doses). A proposal has been submitted to Gavi, the Vaccine Alliance to vaccinate twelve states over the next three years (~23 million doses).
    The International Coordination Group (ICG) on Vaccine Provision, funded by Gavi, the Vaccine Alliance approved release of 3.1 million doses of YF vaccines. The country initiated a large scale reactive yellow fever vaccination campaign in Edo State on 18 December, initially using in-country vaccine stocks which were mobilised to facilitate a timely response before the holidays.
    WHO risk assessment

    YF is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care to treat dehydration, respiratory failure and fever and antibiotic treatment for associated bacterial infections is recommended.
    The YF outbreak has been active in Nigeria since September 2017. Cases are reported from 36 states and the Federal Capital Territory. The recent confirmation by the regional reference laboratory of the YF outbreak in Edo State, with the probable epicentre in Uhunmwonde LGA, represents an unprecedented outbreak in Nigeria. Given the rapid evolution of the situation in Edo State, the national risk is assessed as high due to: the high presumptive case fatality rate (33%) in Edo State; the potential for ongoing local transmission and amplification due to low vaccination coverage; presence of competent vectors including Aedes sp.; the proximity of a case to Benin City (major urban centre and capital of Edo State); and the potential spread to new LGAs.
    There is currently a moderate risk at regional level due to the possible movement of the individuals of affected states to adjacent areas and neighbouring countries and particularly if there is arrival of unvaccinated visitors over the festive end of year season. The current overall risk is low at the global level.
    Nigeria is facing several concurrent public health emergencies, including cholera, circulating vaccine-derived poliovirus, monkey pox, measles, and Lassa fever outbreaks in other states, and a humanitarian crisis in the northeast of the country.
    WHO advice

    Nigeria is a high priority country for the Eliminate Yellow Fever Epidemic (EYE) strategy. Phased preventive YF vaccination campaigns are planned to cover the entire country by 2024. Vaccination is the primary intervention for prevention and control of YF. In urban centres, targeted vector control measures are also helpful to interrupt transmission. WHO and partners will continue to support local authorities to implement these interventions to control the current outbreak.
    WHO recommends vaccination against YF for all international travellers more than nine months of age going to Nigeria, as there is evidence of persistent or periodic YF virus transmission. Nigeria also requires a YF vaccination certificate for travellers over one year of age arriving from countries with risk of yellow fever transmission.
    YF vaccines recommended by WHO are safe, highly effective and provide life-long protection against infection. In accordance with the IHR (2005), Third edition, the validity of the international certificate of vaccination against YF extends to the life of the person vaccinated with a WHO approved vaccine. A booster dose of approved YF vaccine cannot be required of international travellers as a condition of entry.
    WHO encourages its Member States to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination. Travellers should also be made aware of YF symptoms and signs and instructed to seek rapid medical advice should they develop signs of illness. Viraemic returning travellers may pose a risk for the establishment of local cycles of YF transmission in areas where the competent vector is present.
    WHO does not recommend any restrictions on travel or trade to Nigeria on the basis of the information available on this outbreak.
    For more information on yellow fever please see:

  • #2
    Source: https://tvcnews.tv/edo-confirms-nine...-yellow-fever/

    Edo confirms nine deaths from outbreak of yellow fever
    December 6, 2018
    TVCN

    The Edo State Government wednesday said nine lives were lost to the outbreak of yellow fever that ravaged parts of the state a few weeks ago.

    The state Commissioner for Health, Dr. David Osifo, disclosed this during an audience participatory programme on a Benin-based radio station.

    He also confirmed that the yellow fever epidemic spread to 10 local government areas of the State.

    “Already, nine persons have been reported dead so far since the epidemic was first reported,” Osifo said...

    Comment


    • #3
      Source: https://wwwnc.cdc.gov/travel/notices...-fever-nigeria Yellow Fever in Nigeria

      Key Points

      • A large, ongoing outbreak of yellow fever in Nigeria began in September 2017. The outbreak is now spread throughout the country. The Nigerian Ministry of Health has reported cases of the disease in all 36 states and the Federal Capital Territory.
      • Travelers going to Nigeria should receive vaccination against yellow fever at least 10 days before travel and should take steps to prevent mosquito bites while there.
      • Those never vaccinated against yellow fever should avoid travel to Nigeria during the outbreak.

      What is yellow fever?

      Yellow fever is caused by a virus. The virus is spread to people by mosquito bites. Symptoms of yellow fever include fever, chills, headache, backache, and muscle aches. Symptoms take 3–6 days to develop after infection. About 15% of people who get yellow fever develop serious illness including bleeding, shock, organ failure, and sometimes death.

      What is the current situation?

      The Nigeria Centers for Disease Control has reported an ongoing outbreak of yellow fever beginning in September 2017. Since then, the outbreak has expanded throughout the country.
      By the end of November 2018:
      • Fourteen states had reported more than 55 laboratory-confirmed cases of yellow fever.
      • All 36 states and the Federal Capital Territory had reported more than 3,500 suspected cases and a number of deaths.
      • Edo State had reported a large number of suspected cases, several of them laboratory-confirmed as yellow fever.

      In response to this outbreak, Nigerian health authorities have conducted several mass vaccination campaigns.
      What can you do to prevent yellow fever?...


      Comment


      • #4
        Source: http://leadership.ng/2019/08/09/yell...-16-in-2weeks/

        Yellow Fever Outbreak In Ebonyi Claims 16 In 2weeks
        Published 57 mins ago
        on August 9, 2019
        By Obinna Ogbonnaya

        The Ebonyi State government has confirmed the death of 16 persons following current outbreak of Yellow Fever in Ndungele community in Izzi Local government are of the state.

        Confirming the incident, the Permanent Secretary Ministry of Health, Dr. Chris Achi stated that he got a distress call from a villager who raised the alarm over the incessant deaths in the community who prompted him to send some rapid response ream to the village.

        He noted that the outbreak is coming 21 years after the State had the last experience.

        He noted that the response team immediately moved to the place and conducted case search on some of the people who has the symptom adding that initially some of them where moved to Ndungele health facility but when the case became critical, we had to move them to the Virology Center in Abakaliki...

        Comment


        • #5
          Source: https://www.dailytrust.com.ng/ebonyi...or-months.html

          Ebonyi Yellow fever outbreak undetected for months By Judd-Leonard Okafor | Published Date Aug 11, 2019 17:04 PM

          It has emerged that the recent outbreak of Yellow fever in Ebonyi State “may have been going on for a few months undetected” by local health authorities.
          At least, 20 people have since died from a disease that can be prevented with a single shot of free vaccine in the routine immunisation schedule.
          A recent investigation by the Nigeria Centre for Disease Control found cases that fit the definition of Yellow fever from as far as May 1 to August 7.
          The 20 people who died within the period were in Izzi council area of Ebonyi state...

          Comment


          • #6
            Source: https://www.dailytrust.com.ng/inside...-outbreak.html

            Inside Ebonyi Yellow fever outbreak
            By Judd-Leonard Okafor, Abuja & Nabob Ogbonna, Abakaliki | Published Date Aug 17, 2019 8:06 AM

            The panic call came from someone in one of the villages in Izzi Local Government Area of Ebonyi. Chris Achi, permanent secretary at the state health ministry, took the call.

            It said “there is a way people are dying in the village, that he is suspecting something may be wrong,” Achi recalls.

            “On getting the call, I immediately called health workers in the area who said no such case came to their clinic.”

            A rapid response team was dispatched. It was a Yellow fever outbreak, and 16 people had died. The death toll is controversial. Ebonyi health commissioner Daniel Umezurike says only two out of nine who tested positive for yellow fever died. Until then, it wasn’t certain what caused the deaths.

            The Nigeria Centre for Disease Control had reported deaths from “fever of unknown origin”. It found cases that fit the definition for yellow fever in an investigation that spanned May 1 to August 7. The death toll climbed to 20, it said, but it was too late to collect samples for confirmation.

            It concluded the outbreak had been going on for months undetected.
            It is uncertain how it started, but propositions have sought to explain why it went on undetected for long.

            “The problem about the outbreak was that our people did not believe that they will go to the hospital when they experience this yellowness of the eyes, they believe that it can be treated with local herbs, that is why we recorded this high casualties which should not have been,” explains Achi.

            Ndungele community in Izzi is hardest hit. Seven patients are hospitalised at the local clinic. Others are at the General Hospital Iboko. Patients in critical condition are at the Alex Ekwueme Federal Teaching Hospital in the state capital....

            Comment


            • #7
              Yellow fever – Nigeria

              Disease outbreak news
              26 September 2019


              On 16 July 2019, the Ebonyi State Ministry of Health received information about suspected yellow fever cases in Ndingele ward, Izzi Local Government Area (LGA), Nigeria. The cases had symptoms of fever and jaundice, reported with onset since May 2019. As of 30 August 2019, a total of 84 suspected yellow fever cases, including 26 deaths (case fatality ratio: 31 %), have been reported across nine LGAs within Ebonyi State. Of the suspected yellow fever cases, fifty-five per cent (46/84) are male. The most affected age group is 0-9 years (28 cases, 33%), followed by age groups 20-29 years and above 30 years each with 20 cases (24%). The 10-19 year age group has the least number of cases (16 cases, 19%). Seventy-nine per cent of suspected cases (66/84), including seven confirmed cases positive by real-time polymerase chain reaction (RT-PCR) are reported from Izzi LGA which is located in the north-eastern part of the State, bordered with Cross River State in the east, and Benue State in the north. One case has been confirmed in an international worker involved in the extractive industry in Izzi LGA, and residing in adjacent Abakiliki LGA (an urban centre in the State).

              The assessment conducted by the LGA rapid response team (RRT) and national agencies found low vaccination coverage and poor routine immunization documentation. Community surveys were conducted and yellow fever vaccination coverage was estimated to be 56% (64% for children aged less than 5 years and 48% for those older than 5 years of age). Though Nigeria introduced routine vaccination for yellow fever into the immunization schedule in 2004, most adults remain susceptible and overall population immunity is low. Although no entomological studies were conducted at the time, the geography and vegetation of the affected state is compatible with the presence of the Aedes mosquitoes, as illustrated by the transmission patterns.

              Since September 2017, when the Nigeria Centre for Disease Control (NCDC) informed WHO of a confirmed case of yellow fever in Kwara State, Nigeria has been responding to successive yellow fever outbreaks over a wide geographic area. Following the country’s official notification to WHO (via the International Health Regulations, 2005) on 15 September 2017 of the resurgence in yellow fever outbreaks, suspect cases have been reported from all States and the Federal Capital Territory (FCT), and outbreak responses to protect over 10 million people have occurred in select areas in 13 States. Efforts to strengthen surveillance are ongoing.

              From 1 January through 31 July 2019, over 2,000 suspected yellow fever cases have been reported in 506 LGAs from all 36 States including the Federal Capital Territory (FCT) of Nigeria.

              Public health response

              The response to the ongoing outbreak is being coordinated by the Nigerian Centre for Disease Control (NCDC) at the national level through a multi-agency, multi-partner Incident Management System (IMS). The public health emergency operations centre (PHEOC) located at the Ebonyi State Ministry of Health has been activated to monitor the outbreak. Active case finding, case management, risk communication and community engagement have been implemented in affected LGAs. An International Coordination Group (ICG) request for reactive vaccination in the affected area has been approved covering three LGAs in Ebonyi, two LGAs in Benue State and one LGA in Cross River State targeting a population of about 1.64 million people aged 9 months to 44 years in Ebonyi and Benue States, and aged 1-6 years in Yala LGA of Cross River State.

              Routine yellow fever vaccination was introduced to Nigeria’s Expanded Programme on Immunization (EPI) in 2004, but the overall population immunity in areas affected by the current outbreak remains below recognized herd immunity thresholds.

              A four-year (2018-2021) national yellow fever Preventive Mass Vaccination Campaign (PMVC) plan supported by GAVI and partners is currently being implemented. By 2024, it is anticipated that all the States in Nigeria will have undergone campaign activities to protect at-risk populations against yellow fever.

              WHO risk assessment

              Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care is required to treat dehydration, respiratory failure, and fever; and antibiotics are recommended to treat associated bacterial infections.
              The recent confirmation by the national and regional reference laboratories of the Yellow fever cases in Ebonyi State, with the probable epicentre in Izzi LGA, represents a concerning situation in Nigeria.

              Given the rapid evolution of the situation in Ebonyi State, the national risk is assessed as high due to the high CFR (36%) and the potential for ongoing local transmission and amplification. Factors considered include the low vaccination coverage; probability of the presence of competent vectors including Aedes species; the proximity of a yellow fever case to Abakiliki LGA (an urban centre in the State); and the potential spread to new LGAs.

              There is currently a moderate risk at regional level due to the possible movement of the individuals of affected States to adjacent areas and neighbouring countries, particularly if there is arrival of unvaccinated visitors to the State. There is risk to national and international workers in high-risk extractive industries like open pit mining and forestry, underscoring the importance of ensuring all international travelers and workers are vaccinated according to International Health Regulations (IHR) recommendations as emphasized in the Eliminate Yellow Fever Epidemics (EYE) strategy. The current overall risk is considered to be low at the global level.

              Nigeria is facing several concurrent public health emergencies, including circulating Vaccine Derived Polio Virus (cVDPV), measles, cholera and Lassa fever outbreaks and a humanitarian crisis in the north-east of the country.

              WHO advice

              Nigeria is a high priority country for the EYE strategy. Vaccination is the primary intervention for prevention and control of yellow fever. In urban centres, targeted vector control measures are also helpful to interrupt transmission. WHO and partners will continue to support national & state authorities to implement these interventions to control the current outbreak.

              WHO recommends vaccination against yellow fever for all international travelers more than nine months of age going to Nigeria, as there is evidence of persistent or periodic yellow fever virus transmission. This is of particular importance to temporary or international workers engaged in extractive industries. Nigeria also requires a yellow fever vaccination certificate for all arriving travelers over one year of age.

              Yellow fever vaccines recommended by WHO are safe, highly effective and provide life-long protection against infection. In accordance with the IHR (2005),
              Third edition, the validity of the international certificate of vaccination against yellow fever extends to the life of the person vaccinated with a WHO approved vaccine. A booster dose of approved yellow fever vaccine cannot be required of international travelers as a condition of entry.


              WHO encourages its Member States to take all actions necessary to keep travelers well informed of risks and preventive measures including vaccination. Travelers should also be made aware of yellow fever signs and symptoms and instructed to seek rapid medical advice should they develop signs of illness. Travelers returning to Nigeria who may be infected with possible high levels of the virus in the blood may pose a risk for the establishment of local cycles of yellow fever transmission in areas where a competent vector is present.

              WHO does not recommend any restrictions on travel or trade to Nigeria on the basis of the information available on this outbreak.
              ...


              https://www.who.int/csr/don/26-septe...er-nigeria/en/
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment


              • #8
                Source: https://www.bignewsnetwork.com/news/...fever-outbreak

                Death toll rises to 16 in northern Nigeria yellow fever outbreak
                ANI
                30th September 2019, 03:55 GMT+10

                Abuja [Nigeria], Sep. 29 (ANI): The death toll of a yellow fever outbreak in Nigeria's northern state of Bauchi has risen to 16, said local health authorities on Sunday.

                The death toll increased from seven which was recorded earlier this month due to the rejection of vaccination by some locals, Rilwanu Mohammed, head of the local Primary Healthcare Development Agency in Bauchi, told Xinhua news agency.

                The most recent deaths were recorded on Thursday, Mohammed said, noting they were all infected by the disease...

                Comment


                • #9
                  Source: http://www.xinhuanet.com/english/201..._138446715.htm

                  At least 43 killed by yellow fever in Nigeria
                  Source: Xinhua| 2019-10-03 23:41:12|Editor: Mu Xuequan
                  by Olatunji Saliu

                  ABUJA, Oct. 3 (Xinhua) -- At least 43 people have been killed in a yellow fever outbreak since July, following the confirmation by health authorities that another patient died in the country's northeastern state of Bauchi on Wednesday.

                  There have been cases of yellow fever in all parts of Nigeria, but local officials have recorded deaths in the southeastern state of Ebonyi and the northeastern state of Bauchi.

                  The latest death was recorded in Alkaleri, a town in Bauchi, which had earlier recorded some deaths, said Rilwanu Mohammed, head of the State Primary Healthcare Development Agency.

                  The additional death brought to 17 deaths out of the 20 yellow fever cases recently recorded in 11 local government areas of the state, Mohammed said...

                  Comment


                  • #10
                    Source: https://www.dailytrust.com.ng/yellow...ses-to-17.html

                    Yellow fever death toll rises to 17
                    By Hassan Ibrahim, Bauchi |
                    Published Date Oct 5, 2019 1:37 AM

                    The death toll of people in the Yellow Fever outbreak in Bauchi State has increased to 17 with another 19 suspected cases. The Executive Chairman of the Bauchi State Primary Health Care Development Agency, (BSPHCDA), Dr Rilwanu Muhammed, gave the update in an interview with Daily Trust Saturday in Bauchi.
                    He 333 suspected cases of Yellow Fever were recorded out of which 20 were confirmed with 17 dead and another 19 suspected cases...

                    Comment


                    • #11
                      Source: https://thenationonlineng.net/katsin...d-in-two-lgas/


                      Katsina battles yellow fever, 36 cases already reported in two LGAs
                      by Augustine Okezie, Katsina
                      October 6, 2019

                      The Katsina State government yesterday announced plans to tackle yellow fever outbreak in the state, with 36 cases already reported in two LGAs of Danmusa and Kankara.

                      The Permanent Secretary, State Ministry of Health, Dr. Kabir Mustapha, who made the above declaration at the flag-off ceremony of Yellow Fever Preventive Mass Vaccination Campaign held in the state capital, said seven million people in Katsina State are expected to be vaccinated, which translates to about 87% of the state’s population...

                      Comment


                      • #12
                        Source: https://www.who.int/csr/don/08-octob...er-nigeria/en/ Yellow fever – Nigeria

                        Disease outbreak news 8 October 2019

                        On 29 August 2019, a suspected yellow fever case was reported from Kano state with a travel history to Yankari game reserve, Alkaleri Local Government Area (LGA), Bauchi state, Nigeria.

                        From 29 August through 22 September 2019, Nigeria reported an outbreak of yellow fever with an epi-centre in the Yankari game reserve of Alkaleri LGA, Bauchi state. According to Nigeria Centre for Disease Control (NCDC), 231 suspected cases have been reported in four states including Bauchi (110), Borno (109), Gombe (10), and Kano (2), of which there have been 13 presumptive positive by IgM testing and 24 cases positive by reverse-transcriptase polymerase chain reaction (RT-PCR) at national laboratories. Of 24 cases confirmed by RT-PCR (20 cases in Bauchi, three in Gombe and one in Kano state), six deaths were reported, all from Alkaleri LGA, Bauchi state, resulting in a case fatality ratio of 25% among the confirmed cases. The vaccination history for the 231 suspected yellow fever cases is not known, and the results of follow-up testing from regional reference laboratory Institute Pasteur Dakar (IPD) are not yet available.

                        This is the first time that cases have been reported in relation to this area since the outbreak started in Nigeria in September 2017. This outbreak is unique in the broad geographic distribution of cases, most with linkage through travel, work or residence in, or close to, the Yankari game reserve, which is an ecological zone highly prone to yellow fever virus circulation (vectors, reservoir). Epidemiological summary for Nigeria from 1 January through 31 August 2019 (not including the cases in Bauchi)

                        Since 15 September 2017, when the Nigeria Centre for Disease Control (NCDC) officially notified a confirmed case of yellow fever in Kwara state to WHO as per the International Health Regulations (2005), the country has been responding to successive yellow fever outbreaks over a wide geographic area.

                        From 1 January to 31 August 2019, a total of 2,254 suspected yellow fever cases have been reported in 535 LGA’s. All states including Federal Capital Territory (FCT) have reported at least one suspected case of yellow fever. Samples have been collected for 2,197 suspected cases, and according to Nigerian laboratories 74 tests were presumptive positive and 29 inconclusive for yellow fever. A total of 103 (74 presumptive positive and 29 inconclusive) samples were sent to yellow fever reference laboratory Institute Pasteur in Dakar (IPD) for confirmatory testing, of which 29 tested positive. Eight additional cases were confirmed by the Nigerian laboratories including National Reference Laboratory (7), Lagos University Teaching Hospital (1). These 37 confirmed cases were from the states of Edo (13), Ebonyi (8), Ondo (4), Katsina, (3), Kebbi (2), Anambra (1), Cross River (1), Imo (1), Osun (1), Oyo (1), Kano (1), and Sokoto (1). Forty-four (44) deaths have been recorded from the states of Katsina (14), Edo (1), Adamawa (1) and Ebonyi (28) with an overall CFR of 2% among suspected cases. Public health response

                        The outbreak response activities are being coordinated by a multi-agency national yellow fever emergency operation centre (EOC) hosted at NCDC. On 5 September 2019, a national Incident Management System (IMS) was activated to coordinate the response activities. A national rapid response team (RRT), including NCDC and National Primary Health Care development Agency (NPHCDA), have been deployed to Bauchi and other affected states to support outbreak response activities such as case finding, case management and risk communication. The state, with the support of partners, has successfully conducted a reactive yellow fever vaccination campaign in Alkaleri LGA, vaccinating 407,708 people and is now planning to conduct a similar campaign in contiguous LGAs across the affected states, including submission of an International Coordination Group (ICG) request for reactive vaccination.

                        Routine yellow fever vaccination was introduced to Nigeria’s Expanded Programme on Immunization (EPI) in 2004, but the overall population immunity in areas affected by the current outbreak remains below recognized herd immunity thresholds.

                        A four-year (2018-2021) national yellow fever Preventive Mass Vaccination Campaign (PMVC) plan, supported by the Global Alliance for Vaccines and Immunization (GAVI) and partners, is currently being implemented to cover all states in the country. By 2025, it is anticipated that all states in Nigeria will have conducted PMVC activities to protect at-risk populations against yellow fever.

                        This year’s phased preventive campaigns will target the following states, Anambra, Ekiti, Katsina, and Rivers, with specialized activities in Borno. Bauchi has not yet been covered by the phased PMVCs, and the states planned for the next phase are undergoing through a review process to consider the evolving epidemiology. WHO risk assessment

                        Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care is required to treat dehydration, respiratory failure, and fever; and antibiotics are recommended to treat associated bacterial infections.

                        The recent confirmation by the national reference laboratory of the yellow fever outbreak in Bauchi states linked with cases in three other states including Borno, Kano and Gombe represents a concerning situation in Nigeria.

                        Given the scale of the outbreak in Bauchi and three other states, the national risk is assessed as high due to the potential for ongoing local transmission and amplification. Factors considered include the low vaccination coverage; probability of the presence of competent vectors including Aedes species; the potential spread to new LGAs, and the link of the outbreak to the game reserve in Alkaleri LGA, the most popular tourist destination in the country.

                        There is currently a moderate risk at regional level due to the possible movement of the individuals of affected states to adjacent areas and neighbouring countries. The current overall risk is low at the global level.

                        Nigeria is facing several concurrent public health emergencies, including circulating Vaccine Derived Polio Virus (cVDPV), measles, Lassa fever, and cholera outbreaks, and a humanitarian crisis in the northeast of the country. WHO continues to monitor the epidemiological situation and will reassess the evolution of risks based on the latest available information. WHO advice

                        Nigeria is a high priority country for the Eliminate Yellow Fever Epidemic (EYE) strategy. Vaccination is the primary intervention for prevention and control of yellow fever. The early detection and investigation of yellow fever cases through strong surveillance is key to control the risk of yellow fever outbreaks. Prevention of mosquito bites (repellents, wearing long clothes) is an additional measure that limits the risk of yellow fever transmission. In urban centres, targeted vector control measures are also helpful to interrupt transmission. WHO and partners will continue to support local authorities to implement these interventions to control the current outbreak.

                        WHO recommends vaccination against yellow fever for all international travelers more than nine months of age going to Nigeria, as there is evidence of persistent or periodic yellow fever virus transmission. Nigeria also requires a yellow fever vaccination certificate for travelers older than one year of age arriving from countries with risk of yellow fever transmission.

                        Yellow fever vaccines approved by WHO are safe, highly effective and provide life-long protection against infection. In the context of international travel, the amendment to Annex 7 of the International Health Regulations (IHR 2005) changes the period of validity of the related international certificate of vaccination against yellow fever, and the protection provided by vaccination against yellow fever infection from ten (10) years to the life of the person (traveler) vaccinated. Accordingly, as of 11 July 2016, for both existing or new certificates, revaccination or a booster dose of yellow fever vaccine cannot be required of international travelers as a condition of entry into a State Party, regardless of the date their international certificate of vaccination was initially issued.

                        On 1st July 2019, WHO updated the areas at-risk of yellow fever transmission and the corresponding recommendations for vaccination of international travelers. The list of countries at-risk, and revised recommendations for vaccination against yellow fever are available on the WHO website: International travel and health (ITH).

                        WHO encourages its Member States to take all actions necessary to keep travelers well informed of risks and of preventive measures, including vaccination. Travelers should also be made aware of yellow fever signs and symptoms and instructed to seek rapid medical advice should they develop signs of illness. Travelers returning to Nigeria who may be infected with possible high levels of the virus in the blood may pose a risk for the establishment of local cycles of yellow fever transmission in areas where the competent vector is present.

                        WHO does not recommend any restrictions on travel or trade to Nigeria on the basis of the information available on this outbreak.

                        For more information on yellow fever, please see:

                        Comment


                        • #13
                          Source: https://punchng.com/yellow-fever-dea...creases-to-22/

                          Yellow Fever: Death toll in Bauchi increases to 22
                          Published October 14, 2019
                          Armstrong Bakam, Bauchi

                          The Bauchi State Primary Health Care Development Agency has confirmed six new recorded deaths in the Yellow Fever outbreak in the State which brings the total number of deaths to 22.

                          Recall that cases of yellow fever were recorded in Yankari Game Reserve in Alkaleri and Tafawa Balewa Local Government Areas of Bauchi State which led to the death of three people.

                          The first case was recorded when four students of the College of Education, Waka-Biu, in Biu Local Government Area of Borno State were confirmed dead while 12 were hospitalized after a field trip to Yankari Games Reserve in Bauchi.

                          According to the report, those who lost their lives complained of abdominal pains after which they vomited blood.

                          The Bauchi State Government on September 5th confirmed the outbreak of the killer disease in the state.

                          Speaking at a press conference on the Executive Secretary, Bauchi State Primary Health Care Development Agency, Dr Rilwan Mohammed, said the Ministry of Health had confirmed a yellow fever case that was linked to the Yankari Games Reserve.

                          Giving an update of the disease while speaking to Journalists on Monday, the Executive Chairman of the Agency in the State, Dr. Mohammed, disclosed that no fewer than 143 suspected cases of the disease were recorded out of which 24 cases were confirmed and 22 died saying all the cases were from Alkaleri Local Government Area of the state.

                          Mohammed further disclosed that 10 out of the 22 people that died of the disease were rangers working with the Yankari Games Reserve.

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