The scarcity of the needed vaccines to stem the growing epidemic of cerebrospinal meningitis (CSM) is causing more deaths and spread of the disease to more states.

The new outbreaks are caused by new strains of CSM, Neisseria meningitidis serogroup C (NmC), the vaccines for which are not commercially available and need to be acquired through a special process managed by the World Health Organisation (WHO).

As the country does not have enough vaccine doses to deal with the deadly meningitis outbreak, and the drugs are too expensive at the cost of $50 (N18,000) per dose, more Nigerians may die from the disease. This is especially so since the means of livelihood of the majority of the citizens have been eroded by the current economic recession and the $50 which is the cost of the meningitis drugs per dose is the national minimum wage.

This means that the country needs to spend not less than $65 million (N23.4 billion) to meet its needs.

Ihekweazu said the coordinating agencies would be meeting Monday afternoon to assess the situation and official statement would be released later in the evening.

The last official figures from the Federal Government through the Federal Ministry of Health (FMoH) and NCDC put the death toll in the current meningitis epidemic at 328 ( as at Saturday) from 278 on Thursday last week even as 2,524 persons were affected (as at Saturday) from 1,966 people on Thursday. Also, the epidemic had spread from six states on Tuesday last week to 16 states by Saturday, four days later.

There is the fear that the epidemic might have spread to more states and killed many more Nigerians because of the delay in deploying the vaccines and the conditions of living in most communities in the country that encourage the transmission of the disease.

According to the WHO, the bacteria are transmitted from person-to-person through droplets of respiratory or throat secretions from carriers. Close and prolonged contact – such as kissing, sneezing or coughing on someone, or living in close quarters (such as a dormitory, sharing eating or drinking utensils) with an infected person (a carrier) – facilitates the spread of the disease. The average incubation period is four days, but can range between two and 10 days.

Neisseria meningitidis infects only humans; there is no animal reservoir. The bacteria 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 per cent to 20 per cent of the population carries Neisseria meningitidis in their throat at any given time. However, the carriage rate may be higher in epidemic situations.

The most common symptoms are a stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting. Even when the disease is diagnosed early and adequate treatment is started, five per cent to 10 per cent of patients die, typically within 24 to 48 hours after the onset of symptoms. Bacterial meningitis may result in brain damage, hearing loss or a learning disability in 10 per cent to 20 per cent of survivors. A less common but even more severe (often fatal) form of meningococcal disease is meningococcal septicaemia, which is characterised by a haemorrhagic rash and rapid circulatory collapse.

Acting Director-General of the National Primary Health Care Development Agency (NPHCDA), Dr. Emmanuel Odu, said $1.1 billion was required for the vaccination of 22 million persons in the states affected.

Odu who briefed the Senate Committee on Primary Healthcare and Communicable Diseases on efforts being made to contain the outbreak, said each vaccine could cost between $30 and $50.

The committee declared that the spread across the country was caused by poor awareness campaigns of relevant government agencies. It promised to provide the necessary support to the Ministry of Health to contain and end the outbreak.

At another meeting with Ihekweazu, the Senate committee chairman, Mao Ohuabunwa (Abia North) lamented that awareness remained low across the country.
“If this had been detected early, then we would have had rounds of vaccinations and would not be having this epidemic,” he said.

Senate President Bukola Saraki has assured that the upper chamber would provide the necessary support to the Ministry of Health to end the outbreak.

Saraki, in a series of tweets on his twitter handle, said he had spoken with the Minister of Health, Prof. Isaac Adewole, to assure him of the Senate’s commitment to help end the epidemic.

Commissioner for Health, Dr. Jide Idris, said that no case of CSM has been recorded in the state contrary to media report. “However as a responsive government, we deem it fit to alert the public,” he said.

In a statement, Idris noted that though, seasonal meningitis outbreak usually affects the mainly Northern states that fall within the meningitis belt of the country, it is not impossible that outbreaks can occur in any part of the country, Lagos inclusive, in view of the phenomenal climatic change as well as the high human migration.

The Kwara State government has deplored epidemiologists to all its local government areas in readiness for any outbreak of the Meningitis in any part of the state.

At least two epidemiologists were sent to each council just as the government has rejigged its Notifications and Surveillance Unit in Ilorin, which at present is headed by the Commissioner for Health Alhaji Atolagbe Alege.

Source: The Guardian

The Nigeria Centre for Disease Control, NCDC, has confirmed the outbreak of Cerebro Spinal Meningitis, CSM, in five states with at least 282 deaths related to the disease.

Chikwe Ihekweazu, the Chief Executive Officer of the centre, made this known to the News Agency of Nigeria on Thursday in Abuja.

Mr. Ihekweazu said that 1,966 suspected cases have been recorded while 109 have been confirmed and being treated since the outbreak of the disease in February in the country.

He said that the centre had deployed a response team to the affected states to vaccinate the residents and control further spread of CSM.

According to him, Zamfara has the highest number of confirmed cases of 44, followed by Katsina with 32, Sokoto 19, Kebbi 10 and Niger 4 confirmed cases.

He also said that there is an inter-agency response supporting the states to contain the outbreak through the primary mode of vaccination.

However, Mr. Ihekweazu explained that a new strand of meningitis called “stereotype C” has emerged in place of the previous known type “stereotype A”, which has disappeared.

He regretted that there was not yet commercially available vaccine for this new stereotype “C” meningitis.

“There is a vaccine available but it is not commercially available for the stereotype involved in this specific outbreak and we have to make application to the World Health Organisation for the vaccines.

“Thankfully the vaccines have arrived and we have started vaccination campaign in Zamfara. We are in the process of starting in Sokoto and Kebbi states.

“We continue to advocate for scientists and for the global community to really try and push to develop a vaccine for meningitis `C’, on the other hand all we can do is prevention,” he said.

Ihekweazu said that prevention and early detection was key to combating the disease, if detected early, it could be treated with antibiotics.

He said that the centre was working with the states by supporting and ensuring they have the supplies to combat the disease.

“Meningitis is a tough disease especially during this period and it is associated with over-crowding, understanding the living conditions in the country, people must keep their building ventilated,” he said.

He urged Nigerians to avoid sleeping in overcrowded condition and if a lot of people must sleep together in the same room, the windows and doors must be open to allow enough ventilation.

The chief executive officer assured that the centre would work with state governments in the North West and North Central, where most cases were recorded, to ensure better preparation and avert similar outbreak next year.

The Abuja authorities had earlier confirmed five deaths in the Nigerian capital.

The Federal Capital Territory, FCT, Primary Health Care Development Board on Thursday confirmed the death of yet another person due to cerebrospinal meningitis in the territory.

The News Agency of Nigeria reported on Wednesday that the board recorded four deaths on Tuesday in Durumi area of Abuja Municipal Area Council, AMAC.

The Executive Secretary of the board, Rilwanu Mohammed, said in an interview in Abuja that another death from the disease occurred in Dakwa, a border village of Bwari Area Council and Niger State on Wednesday.

“The four suspected cases we have were all in Durumi I and II in AMAC while one confirmed case of a child that just happened yesterday (Wednesday) in Dakwa of Bwari area council.

“The four that died in Durumi showed all signs of meningitis but there was an autopsy carried out in the one at Dakwa and was confirmed to be meningitis at the University of Abuja Teaching hospital, Gwagwalada.

“We have so far immunised all residents of Durumi that are within the ages of one year and 29 years and we are going to condone off Dakwa area today (Thursday) for a similar vaccination,” he said.

According to him, the board had so far immunised 65,000 residents as against 70,000 targeted for vaccination against meningitis in FCT.

He said that since the disease broke out in Zamfara, Sokoto and Niger states, the board intensified effort to curtail its spread in the territory.

The secretary disclosed that the board focused on Internally Displaced Persons (IDPs) and barracks for the vaccination exercise because of their vulnerability.

Mr. Mohammed advised residents to avoid crowded places and ensure crossed ventilation in their homes to prevent the spread of the disease.

Meanwhile, Haruna Agwai, the Primary Health Care Coordinator of Kuje Area Council, says inadequate vaccines is hindering the progress of work at the ongoing immunisation of children against meningitis and polio in the area.

Mr. Agwai made this known to the News Agency of Nigeria on Thursday in Kuje during the immunisation of children at the Primary Health Care Centre in the area.

“Inadequate vaccines, weather condition, inadequate funding, difficult terrain, vehicles and manpower are slowing down the process of immunisation in the area,’’ Mr. Agwai said.

He said that in spite the hindrance, “the health workers are vaccinating children on Oral Polio Vaccines (OPV) from the ages 0 to 59 months and meningitis from 1 to 29 years.’’

The coordinator said the essence of the current exercise was to immunise children against the recent outbreak of meningitis in some parts of the country.

“We are vaccinating the children and taking precautions against the outbreak of meningitis in some parts of the country.’’

He said about 7,763 children had so far been immunised out of about 17,000 children, representing 40 per cent.

Mr. Agwai commended some parents for cooperating with health workers for the progress of the exercise.

According to him, Kuje Area Council Administration is determined to ensure that children in the area are healthy.

He also praised the council’s health personnel, traditional rulers and families for their support.

The News Agency of Nigeria reports that the council has 10 electoral wards while some of its communities lack adequate primary healthcare centres.

Source: NAN