Following a recorded outbreak of yellow fever in Awka LGA of Anambra state, residents of the Nigeria Field Epidemiology and Laboratory Training (FELTP) were deployed as part of a rapid response team. The team comprised of residents and graduates of NFELTP as well as government staff from October 24 to November 1, 2018. The aim of the outbreak was to investigate and assess the outbreak situation and determinants of the outbreak. The response team conducted advocacy visits to government stakeholders and health facilities in the state, active case search, key informants’ interview, rapid vaccination coverage assessment, verbal autopsy and an entomological survey among others.
The index case was identified as a 7-year-old who reported to the primary healthcare facility with a history of vomiting and fever but no jaundice. The caregiver recalled that the index case was vaccinated against yellow fever a few years ago but had travelled to several places since then. Strengthening of routine immunization was recommended to increase yellow fever coverage and thereby establish herd immunity.
Yellow Fever Preventive Campaign
Following the outbreak of yellow fever in some states in Nigeria, a preventive campaign was implemented in Plateau, Niger, Borno and Sokoto states from November 22, 2018. In Plateau state, the campaign was phased into 2 with 10 LGAs implementing the the first phase while 7 LGAs implemented during the second phase. Nigeria FELTP residents were deployed to support the exercise. The NFELTP residents provided technical support and ensured coverage was wide and all eligible adults and children (aged 9months to 44 years) were immunized.
Training Of Clinicians and DNSOs
NFELTP conducted a three (3) day training for clinicians and Disease Surveillance Officers (DNSOs) on case management and sample management for optimum cerebrospinal meningitis outbreak response was conducted for Zamfara state. Thirty-four (34) clinicians (doctors and nurses) and fourteen DSNOs were in attendance. The training session which was divided into two (2) parts: theory and practical was facilitated by competent facilitators.
For better preparedness and response to an eventual cerebrospinal meningitis outbreak in the country, the training centred on case recognition, diagnosis, management (with emphasis on Lumbar Puncture (LP)) and sample packaging. LP mannequins were used as part of the experiential learning process.
With a high cerebrospinal meningitis burden in Zamfara state and a cerebrospinal fluid (CSF) collection rate of 22.5% which is below the WHO target of 50%, the attainment of the WHO standards largely depends on availability of trained skilled health workforce with the ability to identify cases, conduct lumbar puncture (LP), initiate appropriate treatment and confirm cases.