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YOBE STATE MINISTRY OF HEALTH Situation Report

TITLE Cholera Outbreak Situation Report

SERIAL NUMBER 04

EPI- WEEK 44 DATE 7 November 2021

Highlights: • One Hundred and forty-three (143) suspected cases, and four (4) deaths were reported in week 44

• This represents a 57% increase in the number of cases compared to the preceding week (91 cases were

reported in week 43)

• The cumulative number of suspected cholera cases is now 3,893 with 90 cholera-associated deaths (CFR- 2.3%),

reported from 15 out of 17 LGAs of the state.

• The SMOH, SPHCMB, with support from partners, continuous preparations for the 2nd round of OCV campaign

targeting 141,556 people in the 11 political wards of Damaturu LGA. The SPHCMB vaccinated up to 141,555

people in the first round of the campaign.

• The SPHCMB, with support from WHO and partners, continues Active Case Search and referral in 6 high-burden LGAs. The teams identified 143 suspected cholera cases and reached up to 6,369 households with cholera prevention messages

• Yobe SMOH and SPHCMB, with support from WHO and partners, continues weekly multi-sectoral cholera

response coordination meetings in the State Emergency Operations Center (EOC) with the Ministry of Water

Resources, relevant agencies, health and WASH partners, and other stakeholders

• The SMWR is mapping water points, conducting water sample analysis, and chlorinating water sources in high-

burden LGAs.

Epidemiological Summary: As of week 44, the total number of suspected cholera cases in Yobe is 3,893, and 90 associated deaths (CFR 2.3%):

From the beginning of the outbreak in week 22 to the end of week 44 (7 November 2021), 894 cases were reported

in Damaturu (10 affected wards), 320 cases in Potiskum (8 affected wards), 660 cases in Nguru (9 affected wards)

and 395 cases in Jakusko (10 affected wards). 223 cases were reported in Nangere (8 affected wards), 201 cases in

Bade (9 affected wards), 156 cases in Machina (2 affected wards), and 153 cases in Bursari (6 affected wards).

Furthermore, 160 cases were reported in Fune (10 affected wards), 155 cases in Yunusari (1 affected ward), 130

cases in Gujba (9 affected wards), and 109 cases were reported in Karasuwa (6 affected wards). In Geidam LGA,

104 cases were reported (in 5 affected wards), 89 cases were reported in Fika (6 affected wards) and 144 cases

were reported in Gulani (8 affected wards).

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Figure 1: Epi-curve of Suspected Cholera Cases in Yobe State @ week 44

Table1: Summary of suspected cholera cases in Yobe State from May to 7 November 2021

Figure 2: Trend in number of cases per LGAs

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Bade Bursari Damaturu Fune Geidam Jakusko Karasuwa Machina Nangere Nguru Potiskum Yunusari Fika Gulani Gujba Total

New suspected cholera cases 4 0 11 0 0 7 0 0 0 67 0 0 6 35 13 143

Cumulative suspected cholera

cases201 153 894 160 104 395 109 156 223 660 320 155 89 130 144 3,893

New deaths 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 4

Cumulative deaths 10 8 13 1 4 8 1 5 4 18 4 4 2 0 4 90

Number of specimen tested

(RDT) 9 11 75 0 8 10 2 4 95 3 10 3 14 7 4 255

Specimen Positive RDT 5 11 60 0 3 9 2 3 41 3 9 1 13 4 3 167

Number of samples cultured 9 11 77 0 8 10 2 4 95 3 10 3 14 7 4 257

Specimen Positive Culture 5 11 62 0 3 9 2 3 41 3 9 1 13 4 3 169

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Figure 2a | Sex Distribution of Suspected Cholera Cases Figure 2b | Age Distribution of Suspected Cholera Cases

Figure 3: Map of Yobe State Showing the Number of suspected cholera cases reported by LGA

54%46% F

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Figure 4: Risk Mapping of Yobe LGAs

Figure 5: Epi-curve of suspected cholera cases in Bade LGA. Figure 6: Epi-curve of suspected cholera cases in Bursari LGA.

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Figure 7: Epi-curve of suspected cholera cases in Damaturu LGA. Figure 8: Epi-curve of suspected cholera cases in Fune LGA.

Figure 9: Epi-curve of suspected cholera cases in Potiskum LGA. Figure 10: Epi-curve of suspected cholera cases in Geidam LGA.

Figure 11: Epi-curve of suspected cholera cases in Jakusko LGA Figure 12: Epi-curve of suspected cholera cases in Karasuwa LGA

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Figure 13: Epi-curve of suspected cholera cases in Machina LGA Figure 14: Epi-curve of suspected cholera cases in Nangere LGA

Figure 15: Epi-curve of suspected cholera cases in Nguru LGA Figure 16: Epi-curve of suspected cholera cases in Yunusari LGA

Figure 17: Epi-curve of suspected cholera cases in Gulani LGA Figure 18: Epi-curve of suspected cholera cases in Fika LGA

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Response Activities Leadership and Coordination:

Yobe SMOH and SPHCMB, with support from WHO and partners, are conducting regular weekly multi-sectoral

cholera response coordination meetings in the State Emergency Operations Center (EOC) with the Ministry of

Water Resources, relevant agencies, health and WASH partners, and other stakeholders in attendance

Supported regular LGA level cholera coordination meetings and scale-up community-based response with

partners and community stakeholders

Conducted supervisory and monitoring visits to support LGA RRTs and CTUs in high-burden LGAs

Yobe SMOH strengthens the linkage between the policy-making and operational aspects of the response.

Yobe SMOH, in collaboration with YOSEMA and UNOCHA, is strengthening the participation of Civil Society

Organizations (CSOs) and community groups in the Cholera response through the network of CSOs in the state.

Surveillance:

The SPHCMB, with support from WHO and partners, conducted Active Case Search and contact tracing in 6 high-burden LGAs. The teams identified 143 suspected cholera cases and reached up to 6,369 households with cholera prevention messages.

The State surveillance team, with support from WHO, CDC-AFENET, ALIMA, and other partners, is conducting outbreak investigation and referral in settlements and wards in the 15 affected LGAs.

The SPCHMB is supporting LGA RRTs and mobile Hard-To-Reach (HTR) teams to undertake rapid response and investigations of alerts in remote and partially accessible communities and settlements.

The SMOH, SMOH, and WHO deployed 55 volunteers to support enhanced surveillance in 6 high-burden LGAs

The identified priority areas were communicated to WASH and risk communication teams to scale up the

response.

• Conducting regular analysis and dissemination of epidemiologic data to guide WASH and other sectoral

interventions.

Laboratory and Diagnostic Support:

The SMOH, SPHCMB, and WHO are supporting sample collection and transportation from LGAs to the State

Molecular Laboratory

Two hundred and fifty-five (255) samples were tested with cholera RDT, and one hundred and sixty-seven (167)

samples returned positive, representing 65.5% of the samples tested

Two hundred and fifty-seven (257) samples were cultured, one hundred sixty-nine (169) samples were positive

for Vibro cholerae sp., representing 65.8% of the samples tested.

The State Laboratory Technical Working Group (TWG) is conducting regular meetings to review activities and

commodity stock management practices.

Case Management and Infection Prevention and Control (IPC):

Nguru Jakusko Damaturu Bade Potiskum

# of New Admission 46 7 11 4 0

# of New Discharge 21 6 10 1 0

# of Patient(s) on Admission 25 1 1 3 0

In week 44, 68 patients were admitted, 38 were discharged, and 30 remained on admission in CTCs/CTUs across the

state.

The SMOH distributed case management commodities- IVF, ORS, drugs, and consumables to CTCs/CTU.

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The SMOH and SPHCMB distributed case management drugs and commodities to Bursari, Damaturu, Nangere,

Potiskum, Jakusko, Nguru, and Machina LGAs.

The SMOH, HMB, and the WHO teams conducted supportive supervision in CTCs/CTUs where 30 clinicians (doctors

and nurses) were trained on Cholera Case Management and Infection Prevention and Control (IPC).

WASH Interventions: The SMWR, in collaboration with UNICEF and AAH, distributed Aquatabs in affected settlements and households.

The SMWR, with support from IRC, UNICEF, Mercy Corps, and AAH, has trained and deployed 124 hygiene promoters

to improve hygiene practices in eight affected LGAs.

The SMWR and LGA teams, with support from Solidarites International (SI) and AAH, are conducting house-to-house

sensitization on environmental sanitation and chlorinating water sources in affected settlements.

The LGA IPC and Sanitation teams are conducting decontamination and disinfection activities in affected households

and CTCs.

The State Ministry of Environment and Yobe State Environmental Protection Agency (YOSEPA) have commenced

house-to-house inspections by Environmental Health Officers (EHO) and community leaders.

The SMWR is mapping water points, conducting water sample analysis, and chlorinating water sources in high-

burden LGAs.

Oral Cholera Vaccination (OCV): The SMOH, SPHCMB, with support from partners, continuous preparations for the 2nd round of OCV campaign

targeting 141,556 people in the 11 political wards of Damaturu LGA. The SPHCMB vaccinated up to 141,555 people

in the first round of the campaign.

The 2nd phase of vaccination would be implemented by 189 teams and supported by seven (7) state supervisory teams and four (4) independent monitors.

Risk Communication and Community Engagement (RCCE):

The SPHCMB, with support from UNICEF, has deployed IEC materials (flipcharts) for house-house sensitization.

The State and LGA teams have conducted advocacy and sensitization visits to traditional and religious leaders to

scale up community sensitization and adherence to preventive measures by their populace.

The SPHCMB, with support from WHO, UNICEF, and IRC, has deployed HTR teams, VCMs, field volunteers to scale up

house-house sensitization and hygiene promotion in remote and security-compromised communities.

The SPHCMB and NOA, with support from WHO Community Health Champions and UNICEF VCMS, have conducted

house-to-house sensitization in high-burden LGAs

IRC, ALIMA, and SI have distributed cholera prevention materials to health facilities, schools, and motor parks in

Damaturu, Gujba, Potiskum, Bade, and Nguru LGAs

The SMOH, with support from UNICEF and Mercy Corps, is facilitating the airing of jingles and phone-in programs by

Yobe State Broadcasting Cooperation (YBC) and Sunshine FM in Potiskum.

The LGA teams, with support from UNICEF, WHO, and IRC, are conducting motorized sensitization campaigns in high-

burden LGAs

Challenges: Insecurity and bad geographical terrain affecting contact tracing and surveillance in remote and security-compromised

communities and LGAs

Inadequate support to scale-up Active Case Search in the nine (9) remaining affected LGAs

Inadequate commodities and resources to sustain high-level IPC in communities and health facilities

Inadequate support to build the capacity of health workers at primary and secondary levels on Cholera case detection,

case management, and IPC. Inadequate cholera RDT kits in the state.

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Inadequate resources and partners to sustain high-level WASH interventions across the 15 affected LGAs

Next Steps: Strengthen inter-ministerial coordination and collaboration between health, WASH, and related sector partners.

Strengthen the integration of response activities at LGA and community levels

Strengthen LGA RRTs to lead and sustain cholera response interventions with partners and community stakeholders at

the LGA and community levels

Strengthen community engagement and sensitization, and other risk communication activities in all high-burden LGAs

Procure additional RDTs, drugs, and commodities for case management and IPC, and ensure an efficient supply chain

for the cholera outbreak response

Provide more capacity-building support for CTC clinicians, frontline health workers, and partners to sustain quality case

management and IPC

SMOH and partners to engage additional ACS teams to enhance surveillance in the remaining nine affected LGAs