Meningitis: Across Nigeria, a tour of death
and Australia have it in their immunisation programmes. Its outbreak in Nigeria changes things in the meningitis belt.
“Dry season is going to go. Another dry season is going to come. Every country within the meningitis belt of Africa needs to prepare effectively for Meningitis serotype C. That means campaign and vaccine,” says Bakare.
“Serotype A, we cannot say it is totally out because we are still recording portions of it. But we now know we are dealing with more of Cs, and that is a major shift in terms of our response. It is not just a country thing, it is a global phenomenon. People in public health and infectious disease are going to be taken this event very, very serious.”
Nigeria itself could being preparing for the next CSM season by October, and will “give very important consideration” to a vaccine with a wider spectrum of antigens, the federal health ministry said in a statement.
In the case of meningitis, it means a vaccine that could act against a wide range of serotypes.
At least three local governments that have crossed epidemic threshold share borders with Niger Republic-Zurmi in Zamfara, Jibia in Katsina and Gada in Sokoto.
The NCDC is concerned about risk of international border transmission. According to plans, Nigeria will arrange for crossborder surveillance locally within the country and internationally with the republics of Niger and Benin.
The surveillance includes active search for cases in affected council areas, investigating rumours of outbreaks, sensitising and training clinicians in selected areas and reviewing meningitis guidelines and laboratory protocol.
The reactive vaccination response is to target most-affected communities and reduce the risk to communities unaffected.
Starting with 500,000 doses, another batch of 823,970 doses of meningitis C vaccine is expected to scale up the reach. For now the most crucial is getting sufficient dosage to create “herd immunity”that’s when a population becomes resistant to a contagious disease after a high proportion of individuals become immune through vaccination. Immunity lasts anywhere up to 10 years.
Sokoto, with 41 deaths on record, has put up an ICG request for meningitis C vaccine. It plans to vaccinate 700,000 people.
Sokoto governor Aminu Tambuwal on a condolence visit to Danchadi village and surrounding areas in Bodinga council, said, “Health officials have been deployed to affected areas and have been working round the clock. We urge you to follow their instructions and cooperate with them as we tackle this challenge.”
In Kano, three people have died out of 36 cases reported across 13 council areas, according to the NCDC epidemiology report. Eleven people have been killed in the outbreak in Kebbi, and 33 in Niger state.
Katsina’s ICG request was for 500,000 doses. It got 50,000 doses instead for the mass vaccination it started on Thursday, targeting the five council areas where meningitis was first reportedBatsari, Jibia, Batagarawa, Faskari and Funtua.
Other states with cases of suspected or confirmed meningitis are Nasarawa, Gombe, Taraba, Cross River, Osun, Lagos, Yobe, Jigawa and Plateau. In seven of them and the FCT, no laboratory confirmation has been concluded for meningitis. In six of them, no death has been reported.
At least 216 people have been killed in the outbreak in Zamfara, the largest among states. The governor Abdulaziz Yari was driven to lament the entire consignment of vaccine was “not enough for Zamfara alone, not to talk of Katsina or Kano.”
Zamfara got 20,000 doses. But it was the governor’s comments linking meningitis C outbreak to the morality of a people-and loosely with fornication-that sparked the largest controversy yet in this outbreak.
“Because people refused to stop their nefarious activities, God now decided to send Type C virus, which has no vaccine.”
The NCDC refused to be drawn into any argument. The health ministry condemned the comments. But the Emir of Kano, HRH Sanusi Lamido Sanusi, call the comments “horrendous and Islamically incorrect.”
“Some of the examples are horrendous. Two hundred people died of meningitis in a state, the governor was asked and he said it is God’s curse on us for the sin of fornication, which apparently does not happen in America, which is why they don’t have meningitis,” he is reported to have quipped in sarcasm.
“How have we reduced ourselves, what have we done as a people, that we have placed ourselves in a situation where simple things, a medical issue… you don’t have vaccines, say you don’t have vaccines.
“These are the kinds of things that we have; and when we talk about a difficult environment, we realise that 90% of that difficulty, we can address, because it is selfinflicted.”
The Nigerian Medical Association weighed in on Friday to say “leaders should stay with the citizens to understand their plights and avoid unnecessary journeys outside the states they seek to govern.”
Long-distance journeys and numerous journeys are associated with sexually transmitted diseases, CSM is an infection caused by a bacteria and rampant with overcrowding and tramissible via the air, NMA president Dr Mike Ogirima retorted.
Even the reactive vaccination strikes a raw chord with the medical community. NMA said given research going back 1975 showing the strains involved in various epidemics, “it is embarrassing that this epidemic has taken us unawares.”
It condemn delay in immunisation once the infection was already established.
“This is ineffective based on the epidemiology of the disease,” said Ogirima.
“For immunisation to be effective, it must have been administered around three months before the period of clinical manifestation due to the latent period.”
Fifteen weeks into the epidemic, the biggest spike in number of cases occurred in week 10-nearly 450. Authorities believe the cases are tapering off, but they are still searching.
But it came too late for Bello, Abigail and the six-year-old.
Long-distance journeys and numerous journeys are associated with sexually transmitted diseases, CSM is an infection caused by a bacteria and rampant with overcrowding and tramissible via the air, NMA president Dr Mike Ogirima retorted.