Yobe State Cholera Outbreak Situation Report No. 21: 10Th October 2018 Yobe State Ministry of Health

Yobe State Cholera Outbreak Situation Report No. 21: 10th October 2018 Yobe State Ministry of Health

Highlights: • 13 new cases were reported on 9th October 2018 from 4 LGAs (Gujba, Gulani, Damaturu and Fune). • 0 death was reported.

Epidemiological Summary: The total number of suspected cholera cases reported in Yobe state is 1,481 with 61 associated deaths (CFR 4.1%). In the state, up to 447 cases have been reported in Gulani LGA (affecting 10 wards), 434 cases in Gujba LGA (affected 8 wards) and 358 cases in Damaturu LGA (affecting 11 wards). In Fune LGA, 175 cases were reported (from 9 wards) and 67 cases were reported in Potiskum LGA (from 10 wards). Out of 61 samples collected and tested using cholera RDTs, 48 (79%) were positive and 13 (21%) 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 9th October2018. Gulani Gujba Damaturu Fune Potiskum Total

Cases

New suspected cholera cases 1 7 5 0 0 13

Cumulative suspected AWD 447 434 358 175 67 1481 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) 8 10 31 12 0 61 Specimen Positive RDT 7 9 23 9 0 48 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

Thirteen (13) new suspected cholera cases were reported in Yobe state on 10th October 2018, representing 13% decrease in the number of cases reported the previous day (Fig. 2). Seven (7) of the new cases were reported from Gujba, representing 30% increase in number of cases reported the previous day from Gujba (Fig. 6). One (1) case was reported from Gulani (Fig. 4). Five (5) cases were reported from Damaturu (Fig. 10). No case was reported in Fune (Fig 8). However, there was no case from Potiskum over two weeks (Fig. 12). 1

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 100 20

Yobes Yobes tate 50 10 0

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

2-8 Jul 2-8

9-15 Jul 9-15

1-7 Oct 1-7

3-9 Sept 3-9

6-12 Aug 6-12

16-22 Jul 16-22 Jul 23-29

number suspected of choleracases in

27-2 Sept 27-2

7-Jul

13-19 Aug 13-19 Aug 20-26

5-Oct

5-Sep

1-Aug 6-Aug

12-Jul 17-Jul 22-Jul 27-Jul

10-16 Sept 10-16 Sept 17-23

30-5th Aug 30-5th

24-30 Sept 24-30

10-Oct

8-13 Oct ** Oct 8-13

10-Sep 15-Sep 20-Sep 25-Sep 30-Sep

11-Aug 16-Aug 21-Aug 26-Aug 31-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.

25 90 80 20 70 60 15 50 40 30 10

Gulani 20 10 5 0

3-9 Sep 3-9

1-7 Oct 1-7

number of suspected in cholera suspected number cases of

27-2 Sep 27-2

6-12 Aug 6-12

16-22 Jul 16-22 Jul 23-29

10-16 Sep 10-16 Sep 17-23

8-Oct

6-Sep

13-19 Aug 13-19 Aug 20-26

5-Aug

20-Jul 28-Jul

24-30 Sep 24-30

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

30-5th Aug 30-5th

14-Sep 22-Sep 30-Sep

13-Aug 21-Aug 29-Aug 8-13 Oct ** Oct 8-13

Cases Deaths Cases Deaths s 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

- - -

- -

5th Aug

number of suspected in cases cholera suspected ofnumber

16 23

7-Jul

13 Oct **

10 17 24

5-Oct 13 20

5-Sep

1-Aug 6-Aug

12-Jul 17-Jul 22-Jul 27-Jul -

10-Oct

15-Sep 10-Sep 20-Sep 25-Sep 30-Sep

11-Aug 16-Aug 21-Aug 26-Aug 31-Aug

27 Aug

number suspected of choleracases 30 Jul Cases Deaths Cases Deaths

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

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

3-Oct 8-Oct

8-Sep 3-Sep

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

24-Aug 29-Aug

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 20 70 60 15 50 40

10 Damaturu 30 20 inDamaturu 5 10 0 0 in cases cholera suspected of number 20-26 27-2 3-9 10-16 17-23 24-30 1-7 8-13

Aug Sep Sep Sep Sep Sept Oct Oct

number suspected of cholera cases

1-Oct 5-Oct 9-Oct

3-Sep 7-Sep

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

11-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

7 350 6 300 5 250 200 4 150 3 100 2 state Potiskum 50 1 0

2-8 Jul 2-8

Jul

Oct Oct

Sep Sep Sep Sep Sep Sep

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

9-15 Jul 9-15

Aug

Aug Aug Aug Aug Aug

1-7 Oct 1-7

3-9 Sept 3-9

- -

------

- - - - -

6-12 Aug 6-12

16-22 Jul 16-22 Jul 23-29

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

27-2 Sept 27-2

4 9

13-19 Aug 13-19 Aug 20-26

10-16 Sept 10-16 Sept 17-23

30-5th Aug 30-5th

24-30 Sept 24-30

8-13 Oct ** Oct 8-13

14 19 24 29

10 15 20 25 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 new suspected cases from 4 LGAs (Fune, Gujba, Damaturu, Gulani) • WHO supported EHAs conducted house-house active case search and covered 1000 households in 5 affected

locations. • MSF-Spain supported Field volunteer conducted active case search in Bakin Kasuwa and Kandahar, Damaturu LGA. During the search they identify 3 cases and referrer them CTU • WHO supported EHAs have identified 5 new suspected cases during house-to-house search in 4 LGAs and referred them all to CTUs/ORPs locations. • Priority areas have been identified and communicated to WASH and risk communication teams to scale- up interventions. In Damaturu the areas are: Sumsumma, Old Market, Ali Marami extension Bakin Kasuwa 4

settlements. In Gujba the areas are Buni Yadi, Gotala and Gonori. In Gulani; Kushimaga. In Fune area is Shango settlement.

Case Management: Gulani Gujba Damaturu Fune Potiskum Total Admissions

New admissions 1 7 5 0 0 13

New Discharges 7 4 4 1 0 16

On admission 1 7 2 0 0 10

• No suspected cholera case was reported in Potiskum LGA since 24th September 2018 • No mortality was reported in all affected LGAs. • Ten patients were currently on admission at various CTU in the state while remaining 6 were manage at ORP

Risk Communication: • MSF-Spain supported field volunteer have reach out 708 households and sensitized up to 1538 in pomppmari communities and Farin Masallaci on personnel and environmental hygiene. • MSF-Spain supported field volunteers conducted sensitization in Pompomari primary school with 208 pupils in attendance. Practical demonstration of importance of good hand washing was showcase to the pupils • CRS-CGPP supported VCM conducted house-to-house sensitization reaching up to 5149 households in Fune, Potiskum and Gulani LGAs with basis hygiene promotions practice • UNICEF-supported VCMs have reach out to 1250 household and sensitized 2,838 persons on key hygiene promotion in 14 settlements across the five LGAs. • Continues sensitization of religious leaders during congregation in mosques and churches • Continues airing of radio jingles on key hygiene promotion as well as cholera prevention by Yobe state broadcasting cooperation (YBC). • WASH: • UNICEF supported Environment Health Assistants have chlorinated 3 water points in Damaturu affected communities. • UNICEF VCMs and WHO supported Environmental Health Assistants has distributed 2,800 strips of Aqua tab to 1000 household in Damaturu, Gujba, Gulani, Potiskum and Fune. • Wash Sector team have chlorinated 2 Hand dug wells in Shanga settlement of Fune LGA and trained the EHA for preparation of bucket chlorination at the water source. • 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