Nigeria: Meningitis Ravages the North - Over 70 Reported Dead, Hundreds Infected
Damaturu
21 February 2009


Aliyu M. Hamagam — Outbreaks of Cerebro-Spinal Meningitis continue to rear their ugly heads in Northern Nigeria, even as statistics revealed continue to raise concerns. In Kano State, the disease has led to the death of 21 persons out of the 278 cases reported in the state.

The Deputy Director, Disease Control of the state's Ministry of Health Dr. Ashiru Rajab, said a total of 278 cases have been reported since the outbreak of the disease in November 2008. Then in Yobe State, many people, including children and women have been confirmed dead following an outbreak in about ten local government areas in the state.

The representative of the World Health Organization (WHO) in the state, Dr. Isa Adamu, confirmed this in Damaturu yesterday and stated that Gulani, Fune and Fika Local Government Areas have recorded more casualties. Dr. Isa said at present about 178 cases have been reported in the affected local government. "As for the deaths, I cannot give you figures now but we are trying to collate reports from the affected areas to come out with a comprehensive and up to date report on the disease," he said.

Alarmingly, in Gombe State, the disease has claimed the lives 14 people with 224 infected patients undergoing treatment in various health facilities across the state. Speaking to newsmen in his office, Gombe's Commissioner of Health, Dr. Isa Umar, said the first suspected case of the epidemic was reported from Funakaye Local Government area, where it was identified that the outbreak started from a Qur'anic school of almajiri setting. He added that the ministry swooped into action by embarking into immunization of all the Qur'nic schools in the area, saying this had become necessary for subjecting the situation of the epidemic under control in the LGA which had help in only recording the death of a single individual. The North-East's coordinator of the National Emergency Management Agency (NEMA), Hajiya Fatima Abdu Usman disclosed this to Weekly Trust in Maiduguri, Borno State.

Although Kaduna State heeded the warning of the impending epidemic, the outbreak in Ikara Local Government caught its officials napping. Dr. Everton Yarison, the Commissioner of Health, said: "Actually, we have been preparing since last year because there were warnings of an impending outbreak of Meningitis in the North. Before you embark on mass immunisation, especially when you have an epidemic, you have to determine the strain of the bacteria. There are many types of antigens, the seed of the disease. You have to be sure of the antigens that you are vaccinating against. Unfortunately, when the disease breaks out - and even when you know clinically that it is Meningitis - you have to have a laboratory back-up so as to know the antigen that you are dealing with so that you can be able to give effective vaccines. And there is only one of such laboratories in the country and it is in Lagos." Yarison said that is the main problem the healthcare officials fighting the disease are facing.

According to Dr. Rajab in Kano, "since the outbreak of the disease last November to date, we have recorded a total of 278 cases in 28 of the 44 local governments areas of the state and out of this figure, 21 people did not survive". He added that the state's health ministry is not surprised at the outbreak of the disease. "The World Health Organization has already alerted states about the anticipated outbreak therefore we have taken all control measures. This happens every ten years or so". Dr Rajab further explained that the state has also embarked on reactive immunization where only people in affected areas are immunized as against the mass immunization saying, this is as a result of shortage in the supply of the vaccine from the Federal Ministry of Health. "[Kano] state has in stock oily chloramphenicol, which is one of the strongest drugs in treating the disease in all hospitals across the state," Dr. Rajab said.

Yarison, in Kaduna, cautioned against lackadaisical approach to signs of the disease. "This is an epidemic and it has the tendency of spreading rapidly. What we are doing is to prepare to go in for treatment in those areas where the cases have been reported, since the vaccines have not arrived. People should as much as possible stay in airy environments because Meningitis thrives where there is poor ventilation and over-crowding. Also, we should boil our water before drinking." In addition, he said, personal hygiene is of utmost importance. Curiously, Yarison mentioned that even states in the country which were not hitherto in the 'Meningitis zone', like Ebonyi, Cross River and Akwa Ibom, have recorded cases. "The Meningitis belt is growing, even in Africa. It used to stop around Equitorial Guinea but it has extended down."

Gombe's Commissioner of Health, Dr. Umar said the disease was commonly found in Northern Nigeria because the region lies within what he described as the 'West African Meningitis belt'.

In Maiduguri, Usman said 824 cases of Meningitis were recorded in Jigawa and then out of this figure, 54 deaths were recorded. A laboratory analysis was carried out. Out of the analysis, 10 were negative while 25 were Positive Type A and one case was Positive Type B. Usman said even though Borno enjoys a calm weather at the moment, is very prone to attacks because there are lots of densely populated areas, while the state is famous for intense heat which is likely to be witnessed in a month to come.

In Yobe, the people of Ngalda village in Fika Local Government Area expressed disappointment with poor response from the state Ministry of Health despite an outbreak reported some days ago in Bajoga Local Government area of neighbouring Gombe, which claimed several lives. A resident of Ngalda, Mallam Musa, said: "The state authorities have no explanation to give because this has been an annual occurrence, so they should have taken measures to save the people".

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Back in Borno, Usman said that NEMA has already began campaigning to sensitise people on preventive measures as she urged that especially authorities in boarding schools and residents of crowded areas on the need to adopt preventive measures which include avoidance of sleeping in congested rooms, leaving windows opened through out, reporting symptoms such as severe headache, fever and stiffness around the neck to hospitals while those affected should be isolated to avoid spread.

With varying levels of treatment carried out across the states of the North - and the shocking inclusion of states not typically within the 'Meningitis Belt,' - varying results are bound to be recorded. But as the people of Ngalda village rightly raised alarm, will it be enough? That is the question on the lips of concerned Nigerians.