With a nearly tripling in yellow fever cases this year compared with 2018, disease activity in Nigeria seems to be intensifying, the World Health Organization (WHO) said today in an update.

In related developments, health officials are investigating a yellow fever outbreak in Mali, including at its Ivory Coast border.

Nigeria activity intensified since August

Nigeria has been battling successive yellow fever outbreaks since September 2017, but now cases are being reported in previously unaffected parts of the country, the WHO said.

Since the first of the year and through Dec 10, officials have reported 4,189 suspected yellow fever cases in 604 of Nigeria’s 774 local government areas across all 36 states and the Federal Capital Territory.

Of 3,547 samples, 207 were positive on immunoglobulin M testing at labs in Nigeria. Also, 197 samples from 19 states were positive on reverse-transcriptase polymerase chain reaction (RT-PCR) testing. The overall case fatality rate (CFR) is 5.1%, and, among confirmed cases, the CFR is 12.2%.

The hardest-hit areas are Bauchi, Katsina, Edo, and Ebonyi states, which account for 68% of the 197 RT-PCR–confirmed cases.

On Nov 5, Nigeria’s government activated its emergency operations center for yellow fever for the third time because of increasing cases in Bauchi, Benue, and Katsina states. The country has deployed a rapid response team to affected areas and has added lab capacity in Abuja, Edo, and Enugu states.

Though the response has targeted Alkaleri in Bauchi state, reports of ongoing transmission suggest that more vaccination across a wider geographic is needed, the WHO said. And in Katsina state, a mass vaccination campaign recently wrapped up, but there have been some challenges, such as lack of access to insecure areas that has resulted in pockets of undervaccinated people.

James Gathany, CDC [Public domain], via Wikimedia Commons

Elimination strategy

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