Yobe State Cholera Outbreak Situation Report No. 45: 3Rd November 2018 Yobe State Ministry of Health

Yobe State Cholera Outbreak Situation Report No. 45: 3rd November 2018 Yobe State Ministry of Health

Highlights:  7 new cases were reported on 3rd November 2018 from 2 LGA (Gulani and Damaturu)  7 additional samples were collected and tested using RDT. All the 07 samples were positive  0 death was reported.

Epidemiological Summary: The total number of suspected cholera cases reported in Yobe state is 1,741 with 61 associated deaths (CFR 3.50%). In the state, up to 567 cases have been reported in Gulani LGA, 485 cases in Gujba LGA and 441 cases in Damaturu LGA. In Fune LGA, 181 cases were reported and 67 cases were reported in Potiskum LGA. Out of 94 samples collected and tested using cholera RDTs, 79 (84.0%) were positive and 15 (16%) were negative. Again, 9 (47%) out of 19 samples cultured were positive for Vibrio Cholerae. However, the 9 positive samples were taken to national reference laboratory for quality checks and further analysis samples and Vibrio Cholerae O1 (Inaba) serotype was isolated in 4 out of the 9 samples.

Table 1: Summaries of suspected cholera cases in Yobe State from July to 3rd November 2018. Gulani Gujba Damaturu Fune Potiskum Total

Cases

New suspected cholera cases 1 0 6 0 0 7

Cumulative suspected cholera 567 485 441 181 67 1741 cases Number of wards in the LGA 12 10 11 13 10 56 Number of wards affected 10 8 11 9 10 48 Deaths New deaths 0 0 0 0 0 0 Cumulative deaths 20 19 6 12 4 61

Laboratory

Number of specimen tested (RDT) 24 13 45 12 0 94 Specimen Positive RDT 21 12 37 9 0 79 Pending result for RDT 0 0 0 0 0 0 Number of samples cultured 5 8 5 1 0 19 Specimen Positive Culture 2 4 2 1 0 9 Pending result for 0 0 0 0 0 0 Culture

7 new suspected cholera cases reported in Yobe state on 3rd November 2018, showing a 71% increase in the number of cases reported compared to that of the previous day (Fig. 2). Only 1 case was reported from Gulani (Fig 4) and 6 suspected cases were reported from Damaturu (Fig 10). No case was reported from Gujba (Fig 6). Also no case was reported from Fune (Fig 8) in 13 days while Potiskum has not reported any case in 5 weeks (Fig. 12).

Figure 1: Map of Yobe State showing number of suspected cholera cases in affected wards and LGAs

60 350 300 50 250 40 200

30 150 state 20 100

Yobes Yobes tate 50 10 0

number of suspected cholera cases in in Yobe cases cholera suspected of number

7-Jul

number suspected of choleracases in

5-Oct

8-Sep

3-Aug

16-Jul 25-Jul

1-Nov

14-Oct 23-Oct

17-Sep 26-Sep

12-Aug 21-Aug 30-Aug

Cases Deaths Cases Deaths

Figure 2: Epi-curve of suspected cholera cases in Yobe state. Figure 3: Epi-curve of suspected cholera cases in Yobe state. 2

25 90 80 20 70 60 50 15 40 30 20 10

Gulani 10 0

3-9 Sep 3-9

1-7 Oct 1-7

27-2 Sep 27-2

6-12 Aug 6-12

16-22 Jul 16-22 23-29 Jul 23-29

0 Oct 8-14

10-16 Sep 10-16 Sep 17-23

13-19 Aug 13-19 Aug 20-26

15-21 Oct 15-21 Oct 22-28

24-30 Sep 24-30

30-5th Aug 30-5th

number of suspected in cholera suspected number cases of

number of Suspected Cholera cases in in Gulani cases Cholera Suspected of number

5-Oct

7-Sep

3-Aug

20-Jul 27-Jul

2-Nov

12-Oct 19-Oct 26-Oct

14-Sep 21-Sep 28-Sep

10-Aug 17-Aug 24-Aug 31-Aug 29 Oct-4 Nov ** Nov Oct-4 29

Cases Deaths Cases Deaths

Figure 4: Epi-curve of suspected cholera cases in Gulani LGA. Figure 5: Weekly Epi-curve of suspected cholera cases in Gulani LGA.

35 140 30 120 25 100 80 20 60 15 40 10 Gujba 20 0

inGujba 5

0 8 Jul

2 Sep

9 Sep

15 Jul

22 Jul 29 Jul

7 Oct

16 Sep 23 Sep 30 Sep

- -

12 Aug 19 Aug 26 Aug

14 Oct

21 Oct 28 Oct

- - -

5th Aug

1 -

- -

number of suspected in cholera suspected number cases of

4 Nov **

16 23

7-Jul

10 17 24

6-Oct

1-Sep 8-Sep 13 20

4-Aug

14-Jul 21-Jul 28-Jul

3-Nov

15 22

13-Oct 20-Oct 27-Oct

15-Sep 22-Sep 29-Sep

18-Aug 11-Aug 25-Aug

27 Aug number suspected of choleracases Cases Deaths 30 Jul Cases Deaths 29 Oct

Figure 6: Epi-curve of suspected cholera cases in Gujba LGA. Figure 7: Weekly Epi-curve of suspected cholera cases in Gujba LGA.

18 50 45 16 40 14 35 30 12 25 10 20 15 8 10 6 5 4 0 2

3-Oct 8-Oct

3-Sep 8-Sep

2-Nov

13-Oct 28-Oct 18-Oct 23-Oct

13-Sep 28-Sep 18-Sep 23-Sep

29-Aug 24-Aug

number of suspected cholera cases in in Fune cases cholera suspected of number number of Suspected Cholera cases in in Fune cases Cholera Suspected of number Cases Deaths Cases Deaths

Figure 8: Epi-curve of suspected cholera cases in Fune LGA. Figure 9: Weekly Epi-curve of suspected cholera cases in Fune LGA

25 90 80 70 20 60 50 15 40 30

10 Damaturu 20 10

inDamaturu 0 5

0 in cases cholera suspected of number

number suspected of cholera cases

1-Oct 5-Oct 9-Oct

3-Sep 7-Sep

2-Nov

29-Oct 13-Oct 17-Oct 21-Oct 25-Oct

11-Sep 15-Sep 19-Sep 23-Sep 27-Sep

22-Aug 26-Aug 30-Aug

Cases Death Cases Deaths

Figure 10: Epi-curve of suspected cholera cases in Damaturu LGA. Figure 11: Weekly Epi-curve of suspected cholera cases in Damaturu LGA

7 25 6 20 5 15 4 10 3 5

2 Potiskum 0 Potiskum 1

0 1-7Oct

3-9Sept

6-12Aug

8-14 Oct 8-14

27-2Sept

13-19Aug 20-26Aug

22-28Oct

number of suspected cholera cases in in cases cholera suspected of number

10-16Sept 17-23Sept

15-21Oct

30-5thAug

24-30Sept

Jul

Oct

Oct Oct Oct Oct

Sep

Sep Sep Sep Sep

Aug

Aug Aug Aug Aug

number of Suspected Cholera cases in in cases Cholera Suspected of number

- - - -

11 17 23 29

29 Oct-429Nov **

12 18 24 30

Cases Death Cases Deaths

Figure 12: Epi-curve of suspected cholera cases in Potiskum. Figure 13: Weekly Epi-curve of suspected cholera cases in Potiskum.

Response Activities

Surveillance:  Continues line listing of all suspected cholera cases within the city and neighboring communities.  Continues retroactive case search in communities and health facilities using, MSF-Volunteers, EHA, HTR and LGA RRT

team in Gulani, Gujba, Fune and Damaturu.  Conducted investigation of new suspected cases from 2 LGAs (Damaturu and Gulani)  WHO supported EHAs and MFS volunteers conducted house-house active case search in Gujba, Gulani, Fune, Potiskum and Damaturu reaching up to 615 households, 3 patients were identified and referred all to CTU  Priority areas have been identified and communicated to WASH and risk communication teams to scale-up interventions.

Case Management:

Gulani Gujba Damaturu Fune Potiskum Total Admissions

New admissions 1 0 6 0 0 7

New Discharges 1 0 3 0 4

On admission 0 0 6 0 0 6

 No suspected cholera case was reported in Potiskum LGA since 24th September 2018.  Seven additional samples were collected and tested using RDT from Gulani and Damaturu LGA.  No mortality was reported in all affected LGAs.

Risk Communication:  Continues sensitization of Islamiyya and Tsangaya school is ongoing in Galani, Gujba and Damaturu.  Airing of radio jingles by Yobe Radio Broadcasting Corporation has continued across the state.  WHO and UNICEF field volunteers distributed 854 sachets of Aqua-tabs in Gulani, Damaturu and Gujba LGAs  WHO HTR teams, CORPs, AAH, MSF, ICRC, Rescue and UNICEF supported volunteers continue to sensitized peoples on hygiene promotion and health education on hand washing, water purification and dangers on open defecation reaching up to 823 households in Damaturu, Gujba, Fune and Gulani LGAs.

WASH:  UNICEF, AHH, MWR and RUWASA continues response activities in affected location through bucket-to bucket chlorination, clearing of drainages & refuges, and disinfection of households.  Wash Teams and WHO supported volunteers have disinfected 41 households in Gulani, Gujba and Damaturu.

Coordination:  LGA RRTs in Gujba, Gulani, Damaturu and Fune LGA conducted daily local coordination meetings, and provided updates to state RRT to mobilize additional resources and technical supports Daily coordination meetings were consistently being chaired by SMOH at the state level to ensure robust and effective response activities