NIGERIA -YELLOW FEVER OUTBREAK

Nigeria (Yellow Fever Outbreak)

9 January 2019
The current outbreak of YF in Edo State in Nigeria is unusual in scale and severity, and the number of cases in time and place is very high in the context of the current national outbreak. The seasonal timing of the outbreak, in a period where many travellers enter the state from other states and countries for the holidays in December–January, adds to the risk for potential spread. 
On 22 November 2018, the World Health Organization was informed of a cluster of suspected Yellow fever (YF) cases and deaths in Edo State, Nigeria. Edo State is located less than 400km from Lagos on a dense population movement axis between Lagos and South-Eastern Nigeria. Edo State is also a known endemic area for Lassa fever – which was initially suspected as causing the outbreak. From 22 September through 31 December 2018, a total of 146 suspected, 42 presumptive positive, and 32 confirmed cases, including 26 deaths (presumptive case fatality rate: 18%), have been reported across 15 of 18 Local Government Areas (LGAs) in Edo State (figure 1).
Blood specimens were obtained from 122 cases and sent for laboratory diagnosis; 42 (34%) samples were presumptive positive in-country based on IgM serology and sent to the regional reference laboratory, Institut Pasteur de Dakar (IPD), for confirmation. Thirty-two (76%) were confirmed by plaque reduction neutralization test (PRNT) or real-time polymerase chain reaction (RT-PCR). Males represent the majority of cases (108 of 146, 74%), and the most affected age group is 10–19 years with 48 cases (33%), followed by the age group 20–29 with 36 cases (25%). Initially, the affected LGAs were rural but since the end of November 2018, suspected cases have been reported from three urban LGAs. There has also been a report of two presumptive positive and one confirmed case in Oredo LGA, which includes the densely populated state capital Benin City, of about 1.5 million inhabitants.
(source WHO)

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