WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 26: 24 to 30 June 2024
Data as reported by: 17:00; 30 June 2024
...
Diphtheria
6 028 Cases
101 Deaths
1.7 % CFR
EVENT DESCRIPTION
The Nigeria Centre for Disease Control and Prevention
(NCDC) reported a significant and widespread diphtheria
outbreak nationwide.
The protracted outbreak began in
epidemiological week 19 of 2022 and has persisted into
2024, causing a substantial public health concern.
As of epidemiological week 23, 2024, the outbreak has
affected 16 states and 129 Local Government Areas (LGAs),
with a total of 8 827 suspected cases reported. Of these,
6 028 (68.3%) cases have been confirmed, of which, (371
cases) were through laboratory testing, epidemiological
linkage (515 cases), and 5 142 clinical compatibility. A total
of 1883 cases were negative and have been discarded,
while 916 cases remain pending or unknown.
The outbreak has resulted in 101 confirmed deaths, yielding
a case fatality rate (CFR) of 1.6%. The states with the
highest number of confirmed deaths are Kano (66 deaths)
representing 65.0% CFR, Borno 13.0% CFR (13 deaths),
and Jigawa 2.0% CFR (2 deaths). Other affected states
include Bauchi, Katsina, Yobe, and the Federal Capital
Territory.
From epidemiological week 19 of 2022 to week 23 of 2024,
32 869 suspected cases and 20 256 confirmed cases were
recorded. The CFR for the reporting period is 4.4%, with 884
confirmed deaths.
Nearly half (49.5%) of the confirmed cases were
unvaccinated, which indicates a substantial vulnerability
within the population.Additionally, 6.9% had received only
partial vaccination.
Conversely, 24.9% of the confirmed
cases were fully vaccinated, suggesting potential
challenges in vaccine efficacy or the need for booster
doses. Furthermore, 10.7% of the cases had an unknown
vaccination status, pointing to gaps in vaccination recordkeeping
and tracking. These figures underscore the urgent
need for enhanced vaccination campaigns, complete
immunization schedules, and better tracking systems to
control the outbreak effectively.
PUBLIC HEALTH ACTIONS
In response to the outbreak, the NCDC, in collaboration
with partners, has implemented several key public
health interventions:
Investments in surveillance infrastructure are
being made to ensure timely detection, reporting,
and response to diphtheria cases. This includes
continuous monitoring and reporting of cases across
affected states, data harmonization and analysis for
the development of situation reports, and follow-up
with states for updates and provision of technical
support.
Ongoing laboratory support and testing efforts
include both preliminary and confirmatory testing
at sub-national and national levels, validation of
PCR on clinical samples with support from the
US Centers for Disease Control and Prevention,
and the distribution of necessary reagents
and consumables to testing sites. Additionally,
refresher training is being conducted for
laboratory personnel to enhance diagnostic
capacities and ensure accurate and efficient
testing.
Efforts are underway to enhance routine
immunization services and conduct targeted
vaccination campaigns in high-risk areas.
This includes implementing vaccination drives
aimed at reaching unvaccinated and partially
vaccinated populations within these regions.
Additionally, routine immunization is being
promoted to increase overall vaccine coverage
and prevent future outbreaks.
Efforts to foster strong community engagement
and communication strategies are in progress
to raise awareness about diphtheria prevention
and the importance of vaccination. This includes
conducting public awareness campaigns
to educate communities and engaging with
community leaders and stakeholders to
support public health initiatives and encourage
community participation.
Collaboration with international partners such
as the WHO, Médecins Sans Frontiers, UNICEF,
and others to support outbreak response efforts
and coordination with local health authorities to
ensure a unified response to the outbreak.
SITUATION INTERPRETATION
The ongoing diphtheria outbreak in Nigeria underscores
the critical need for robust public health infrastructure
and effective disease surveillance systems. Despite
significant efforts to control the outbreak, the high
number of cases and widespread geographical
distribution highlight persistent challenges in achieving
comprehensive vaccination coverage and rapid
response capabilities.
The large number of suspected
and confirmed cases, coupled with the significant
number of deaths, indicates a severe public health
threat that requires sustained intervention. Finally, the
data on vaccination status reveal that a substantial
proportion of confirmed cases are either unvaccinated
or partially vaccinated, emphasizing
https://www.afro.who.int/publications/outbreak-and-other-emergencies-week-26-24-30-june-2024
