Date: Tue 30 Apr 2019
Source: Nigeria CDC monthly yellow fever situation report [edited]
In this reporting month of April 2019:
- 332 suspected cases were recorded
- 3 new presumptive positive cases were recorded
- NCDC Central Public Health Laboratory (CPHL) reported 1 new presumptive positive case from Imo State - (Orsu LGA)
- Yusuf Danshoho Memorial Hospital (YDMH) Kaduna reported 1 presumptive case - case from Kebbi - (Arewa Dandi LGA)
- Gombe Specialist Hospital (GSH) Gombe reported 1 presumptive case from Gombe LGA
- 3 new confirmed cases from the Institute Pasteur (IP) Dakar from Edo State - (Uhunmwode -2, Ikpoba-Okha -1).
- Last IP Dakar confirmed cases were reported 18 Apr 2019
- 19 states have recorded at least one confirmed case from Institute Pasteur (IP) Dakar since the onset of the outbreak in 2017
- Yellow fever response activities are being coordinated by the Yellow Fever Technical Working Group (YF TWG).
- From 1 Jan - 30 Apr 2019:
- 930 suspected cases have been reported in 447 (57.8%) LGAs
- All suspected cases reported had blood samples collected
- 35 presumptive positive and 12 inconclusive cases from 12 states in 32 LGAs: Table 1
- 12 confirmed cases were reported from 2019 samples sent to Institute Dakar [Edo (7) confirmed and 1 inconclusive) Ondo (2), Imo (1) and Osun (1)]
- One death of a suspected yellow fever case has been recorded from Adamawa
- Case fatality rate (CFR) is 0.11%
- Rapid response teams have been deployed to Abia, Imo and Osun States
Summary of outbreak 2017-2018
A yellow fever outbreak has been active in Nigeria since September 2017:
- From 2017 to 2018, 163 cases were confirmed in 17 states: Kwara (8), Kogi (12), Kano (1), Zamfara (19), Kebbi (7), Nasarawa (3), Niger (1), Katsina (2), Edo (90), Ekiti (2), Rivers (1), Anambra (1), FCT (11), Benue (1), Delta (1), Ondo (2) and Abia (1): in 52 Local Government areas (LGAs).
- From September 2017 to December 2018, 283 samples (presumptive positive - 246 and inconclusive - 37) were sent to IP Dakar for re-confirmation.
- All Nigerian states (36 + FCT) reported 4132 suspected cases in 616 (79.6%) LGAs.
- Of all suspected, probable and confirmed cases, 90 deaths were recorded with 31 deaths among confirmed cases.
- The case fatality ratio (CFR) for all cases (suspected, probable and confirmed) is 2.2%, and 19.0% for confirmed cases
- Yellow fever preventive mass vaccination campaigns (PMVC) have been completed in 12 states, led by NPHCDA:
- 2013 PMVC phase 1 Nasarawa, Cross River, Akwa Ibom.
- 2018 Phase 2a: Kogi, Kwara and Zamfara and in 58 political wards in 25 LGAs in Borno State.
- 2018 phase 2b PMVC: Sokoto, Kebbi, Niger, FCT, Plateau and Borno (3 LGAs (Askira/Uba, Chibok, Konduga) States.
- Yellow fever Reactive vaccination campaigns were implemented in Katsina (Danja LGA), Edo (13) LGAs and Benue (Vandekeiya)
- 2019 phase 3 PMVC will be implemented in all LGAs where no YF campaigns have been implemented in Edo, Ekiti, Katsina and Rivers States.
[Table] 1: Showing All Affected States and Cases with Yellow Fever as at Week 18, 30 Apr 2019 [with data for categories that interested readers can see at the source URL]:
- Total number of cases in the line list
- Attack rate per 100 000 population
- Number of LGAs with suspected cases
- Number of LGAs with presumptive/inconclusive cases
- Number of LGAs with confirmed cases from IP Dakar
- Number suspected cases with blood sample collected in Nigeria
- Number of presumptive positives in Nigeria
- Number with inconclusive results in Nigeria
- Total number of samples sent to IP Dakar
- Number positive cases from IP Dakar
- Total number negative in IP Dakar
- Number awaiting result from IP Dakar
- Number of deaths from all cases
- Number of deaths from IP Dakar confirmed
Figure 1: Epidemic Curve of All Cases of Yellow Fever in Nigeria as at Week 18, 30 Apr 2019 [graph not shown]
Figure 2: Trend of Confirmed Cases of Yellow Fever in Nigeria 2017-2019
Figure 3: Map of Nigeria Showing States with
Suspected/Presumptive/Confirmed Cases as at Week 18, 30 Apr 2019 [Figure 4 not shown]
Figure 5: Map showing states that implemented PMVC/proposed PMVC from 2019-2021.
[The above report indicates that 930 suspected cases have been reported this year (2019) from 1 Jan - 30 Apr 2019. There are 332 suspected cases during the April 2019 reporting period, up from 254 suspected cases on 19 Feb 2019. There are 3 new presumptive and 3 new confirmed yellow fever cases during the April 2019 reporting period. The YF virus is endemic in Nigeria, and cases occur there sporadically. Because the 2019 outbreak that began in Edo state may have started as sylvatic (forest) yellow fever spread by various _Aedes_ species with subsequent rapid development suggesting urban yellow fever transmission spread by _Ae. aegypti_, it is reassuring to learn that the Edo state outbreak was declared over with a reported vaccination coverage of 120%. This startling level of coverage may have occurred as a result of individuals vaccinated outside the state being vaccinated in the state as well, and/or by individuals having been vaccinated twice within the state. It is encouraging to learn that phase 3 vaccination will be implemented in all LGAs where no YF campaigns have been implemented thus far in Edo, Ekiti, Katsina and Rivers States. - ProMED Mod.TY]
[HealthMap/ProMED map available at: