Date: Fri, 15 Mar 2019 19:00:39 +0100

Niamey, March 15, 2019 (AFP) - Health authorities in Niger said Friday they had found a fake version of a meningitis vaccine after the country had launched a campaign to innoculate millions of children against the disease.   In a statement, the health ministry asked doctors to be vigilant over a "counterfeit" version of a vaccine called Mencevax ACWY.   The fake drug is marked as having been manufactured in December 2016, with an end-date for use by November 2021, it said.   Niger launched a week-long campaign on March 5 to vaccinate six million children against meningitis, which killed nearly 200 people two years ago.   The country lies in the so-called "meningitis belt" stretching from Senegal in the west to Ethiopia in the east, where outbreaks of the disease are a regular occurrence. 

The vaccination programme is against meningitis A, one of the six groups of meningitis bacteria that can cause epidemics.   The ministry's spokesman told AFP the bogus drug had been discovered during a "routine inspection" of a privately-owned pharmacy in the capital Niamey.   An investigation is underway to try to ascertain how many of the fake vaccines have been used, the spokesman said.   Health workers administering meningitis jabs are being asked to take special care about their supply source, and the public are being urged to scrutinise vaccines clearly, even if they buy them in "licensed" pharmacies.   Fake drugs -- medications that are outright counterfeits or whose active ingredients have been diluted -- are a major problem in West Africa.

In the 2017 outbreak, and in an epidemic in 2015 in which nearly 500 people died, Niger sounded the alarm over purported vials of vaccine that just contained water.   Meningitis is transmitted between people through coughs and sneezes, close contact and cramped living conditions.   The illness causes acute inflammation of the outer layers of the brain and spinal cord, with the most common symptoms being fever, headache and neck stiffness.
Date: Tue, 5 Mar 2019 21:06:15 +0100

Niamey, March 5, 2019 (AFP) - The impoverished Sahel state of Niger on Tuesday launched a campaign to vaccinate six million children against meningitis, which killed nearly 200 people two years ago.  Children aged between one and seven years will be immunised over the week-long nationwide programme, Health Minister Idi Illiassou said.   He called on parents to "massively" support the effort.

The two-billion-CFA-franc (three-million-euro, $3.4-million) cost is being mainly borne by the World Health Organization (WHO), GAVI Alliance, Rotary International and the UN children's fund, Unicef.   Niger lies in the so-called "meningitis belt" of sub-Saharan Africa, stretching from Senegal in the west to Ethiopia in the east, where outbreaks of the disease are a regular occurrence.

The vaccination programme in Niger is against meningitis A, one of the six groups of meningitis bacteria that can cause epidemics.   The disease is transmitted between people through coughs and sneezes, close contact and cramped living conditions.   The illness causes acute inflammation of the outer layers of the brain and spinal cord, with the most common symptoms being fever, headache and neck stiffness.
Date: Tue, 5 Mar 2019 20:04:12 +0100

Niamey, March 5, 2019 (AFP) - Police in Niger said Tuesday they had closed down a lab in the capital Niamey making bogus drugs and fake beauty products for sale in local markets and neighbouring Nigeria.   "We seized no less than 10 tonnes of fake medications made from local plants and other ingredients imported from abroad," police spokesman Adily Toro said on state TV.

Nine people, "none of whom had any medical knowledge," were arrested, he told AFP.   Some of the products aimed at regional tastes in beauty -- one, called "Dynawell," was supposed to help women to become obese, and another, "Bobaraba," to develop their breasts and buttocks, Toro said.   Others were supposed aphrodisiacs and anti-haemorrhoid medication.   Bogus, counterfeit or sub-standard medicines are a major health issue in developing countries, but especially so in Africa.

The American Society of Tropical Medicine and Hygiene estimated in 2015 that 122,000 children under five died due to taking poor quality anti-malaria drugs in sub-Saharan Africa.   Anti-malarials and antibiotics are the two medicines most likely to be out-of-date or cheap copies, it said.    In 2016, an operation launched by the Paris-based International Institute of Research Against Counterfeit Medicines (IRACM) and World Customs Organization (WCO) seized 113 million items of fake medication and 5,000 bogus medical devices at 16 African ports.
Date: Sat, 1 Dec 2018 17:12:59 +0100

Niamey, Dec 1, 2018 (AFP) - The number of new AIDS infections in Niger dropped by more than two thirds between 2012 and 2016, the health ministry said Saturday, in a statement marking World AIDS day.   Health Minister Idi Illiassou said new infections in the four-year period under review fell from 6,000 to 1,761, a decline of 70 percent.

AIDS-related deaths in the country fell by 15 percent over the same period, according to Illiassou.   Between 2013 and 2017 patients receiving retroviral care rose from 11,182 to 17,122, he added with aid from partner states a factor in the country now boasting 73 screening centres from just one in 2003.   "The estimated annual number of deaths due to AIDS fell from 4,000 in 2012 to 3,400 in 2016  -- a drop of 15 percent," the minister also said.

HIV cases had stabilised at 0.4 percent of 15-49 year-olds since 2008 and that there were some 43,000 current sufferers nationwide.   At the same time, Illiassou regretted that "less than four percent of adults" had had voluntary screening in 2016.   Beset by widespread poverty and child malnutrition as well as a high incidence of malaria poverty-stricken Niger has generally focused on those issues first and foremost ahead of AIDS.

In October the government put nationwide malaria cases at 1,360,000 cases of malaria, with 1,584 deaths this year through to mid-September while Oxfam indicates malnutrition is the cause of almost half of all child deaths in the country.
Title:    Cluster of vaccine-derived polio type 2 cases with AFP in Niger
To:       NVRL, Travel Medicine, AFP group
Cc:       HPSC medics
From: IHR national contact point (HPSC)
Level of urgency*: For information
Date:   24/10/2018
Alert Number: New alert

Dear Colleagues,
We have been alerted to a cluster of vaccine-derived polio type 2 cases with AFP in Niger genetically linked to cases in Nigeria. Please see below for details.
                                 
Content:  
Summary of situation

Between July and September six cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) are reported from Niger, genetically linked to a cVDPV2 in Jigawa and Katsina States, Nigeria. The virus was isolated from children with acute flaccid paralysis (AFP) from Zinder region, located in the south of Niger and on the border with Nigeria, with dates of onset of paralysis ranging from 18 July until 16 of September, according to information available to date. AFP stool samples from Niger were tested at the Senegal laboratory for viral isolation and Intratypic differentiation. Isolates that need to be sequenced were sent to National Institute for Communicable Disease (NICD). Cases have been reported from Tanout, Dungass and Magaria districts.

Nigeria is also reporting a separate cVDPV2 outbreak in Sokoto district since January 2018. Nigeria is one of only three countries in the world classified as endemic for wild poliovirus, along with Afghanistan and Pakistan.

As part of the Lake Chad response, the last monovalent oral polio vaccine type 2 (mOPV2) round was implemented in Niger in January 2017. There is a large cohort lacking immunity against the type-2 poliovirus.

Public health response

The outbreak response plan is being finalized to include the outbreak zone most at risk and the exact scale and extent of the response is being determined.

WHO risk assessment

The emergence of cVDPV2 in Niger is a reminder that until polio is eradicated, polio-free countries will remain at risk of polio re-infection or re-emergence. The detection of this cVDPV2 strain underscores the importance of maintaining high levels of routine polio vaccination coverage at all levels to minimize the risk and consequences of any poliovirus circulation.

As this outbreak is linked to an ongoing cVDPV2 outbreak in Nigeria, the risk of further international spread associated with this virus remains high.

WHO advice

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP in order to rapidly detect any polio case, implement prevention measures, and speed-up the response if needed. Countries should also maintain uniformly on all their territory high polio immunization coverage through routine vaccination to minimize the consequences of any new virus introduction or emergence.

WHO’s International Travel and Health recommends that all travelers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than four weeks) from infected areas should receive an additional dose of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) within four weeks to 12 months of travel.  For travelers to Niger, IPV is recommended as it is effective against cVDPV2, whereas the type 2 component is no longer included in OPV.

All countries should report any polio case using the decision instrument in Annex 2 of the International Health Regulations (IHR). Countries affected by polio transmission should comply with the Temporary Recommendations issued by the Director General following advice from the IHR Emergency Committee concerning ongoing events and context involving transmission and international spread of poliovirus.  These recommendations include that affected countries declare a national public health emergency, and encourage departing travelers to be vaccinated.

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