Cholera Outbreak Situation Report No. 7: 26th September 2018 Yobe State Ministry of Health

Highlights:  23 new cases were reported on September 26, 2018 from 5 LGAs (, , , Fune and )  0 death was reported.

Epidemiological Summary: The total number of suspected cholera cases reported in Yobe state is 1170 with 61 associated deaths (CFR 5.2%). In the state, up to 378 cases have been reported in Gulani LGA (affecting 9 wards), 315 cases in Gujba LGA (affected 7 wards) and 293 cases in Damaturu LGA (affecting 6 wards). In Fune LGA, 117 cases were reported (from 6 wards) and 67 cases were reported in Potiskum LGA (from 4 wards). Out of 56 samples collected and tested using cholera RDTs, 44 (79%) were positive and 9 (17%) 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 26th September 2018. Gulani Gujba Damaturu Fune Potiskum Total

Cases

New suspected AWD cases 14 4 5 0 0 23

Cumulative suspected AWD 378 315 293 117 67 1170 cases Number of wards in the LGA 12 10 11 13 10 56 Number of wards affected 10 8 11 9 9 47 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 29 9 0 56 Specimen Positive RDT 7 9 21 7 0 44 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

Twenty-three (23) new suspected cholera cases were reported in Yobe state on the 26th September 2018, representing 17.4% increase in the number of cases reported the previous day (Fig. 2). Fourteen (14) of the new cases were reported from Gulani, representing 21.4% increase in number of cases reported in the previous day (Fig. 4). Five (5) cases were reported in Gujba (Fig. 6), two (2) cases were reported from Fune (Fig. 5), one (1) case is from Damaturu (Fig. 10) and no case was reported from Potiskum LGA (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 40 200 150 30 100

20 state 50

in Yobes in Yobes tate 10 0

0

2-8 Jul 2-8

9-15 Jul 9-15

3-9 Sept 3-9

6-12 Aug 6-12

16-22 Jul 16-22 Jul 23-29

27-2 Sept 27-2

13-19 Aug 13-19 20-26 Aug 20-26

10-16 Sept 10-16 Sept 17-23

30-5th Aug 30-5th

7-Jul number of suspected cholera cases in in Yobe cases cholera suspected of number

number suspected of choleracases

8-Sep

3-Aug

16-Jul 25-Jul

17-Sep 26-Sep

12-Aug 21-Aug 30-Aug 24-30 Sept ** Sept 24-30

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.

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

Gulani 20 5 10 0

0

number of suspected cholera cases in cases cholera suspected of number

2-Sep 6-Sep

1-Aug 5-Aug 9-Aug

20-Jul 24-Jul 28-Jul

number of suspected in cholera suspected number cases of

10-Sep 14-Sep 18-Sep 22-Sep 26-Sep

13-Aug 17-Aug 21-Aug 25-Aug 29-Aug

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.

140 35 120 30 100 25 80 20 60 15 40 10 5 20 0 0

2-8 Jul 16- 22 30 Jul- 13-19 27 10-16 24-30 number number ofsuspected cholera cases Gujba in

number number ofsuspected cholera cases Gujba in Jul 5th Aug Aug-2 Sep Sep ** Aug Sep 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.

14 50 45 12 40 10 35 8 30 25 6 20 4 15 10 2 5 0 0 20-26 27-2 Sep 3-9 Sep 10-16 17-23 24-30

Aug Sep Sep Sept **

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

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25 90 80 20 70 60 15 50 40 10 30 20 5 10 0

0 20-26 27-2 Sep 3-9 Sep 10-16 17-23 24-30 number number ofsuspected cholera cases Damaturu in Aug Sep Sep Sept **

number number ofsuspected cholera cases Damaturu in 22-Aug 29-Aug 5-Sep 12-Sep 19-Sep 26-Sep 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

Potiskum 1 0

0

Jul

Sep Sep Sep

Sep Sep Sep Sep

-

Aug Aug

Aug Aug Aug Aug Aug

- - -

- - - -

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

- -

- - - - -

1 5 9

4 8

31

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

13 17 21 25

12 16 20 24 28

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:  EHAs have identified 10 suspected cases during house-to-house search in various LGAs and referred them all to

CTUs/ORPs in the respective LGAs  Active case search has been intensified in all the affected communities and LGAs

 Priority areas have been identified and communicated to WASH and risk communication teams to scale-up interventions. In Gujba, the area is Buni Yadi and in Gulani LGA, they are Tetteba, Bara and Gagure settlements. In Damaturu LGA, the priority areas for interventions identified are Bindigari Fawari, One million road, and Nayinawa.

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Case Management:

Gulani Gujba Damaturu Fune Potiskum Total

Admissions

New admissions 14 4 5 0 0 23

New Discharges 9 4 2 4 0 19

On admission 17 4 4 0 0 25

 MSF-Spain has completed assessment in Gujba LGA to establish ORPs in remote peripheral health clinics  CTUs in Gulani, Gujba, Damaturu, Potiskum and Fune LGAs have been supplied with adequate quantities of intravenous fluids, drugs and commodities by SMOH, WHO, UNICEF and partners to continue proper case management  No death was recorded in all the affected LGAs for more than one week now.

Risk Communication:  UNICEF conducted orientation for 14 mosques Imams in Potiskum to scale-up hygiene promotion and cholera risk prevention message dissemination during mass Friday prayers.  WHO-supported motorized cholera awareness and prevention campaign has been expanded to cover Damagum, Shamka and Dogon-Kuka communities of Fune LGA.  UNICEF-supported VCMs sensitized 1321 persons on hygiene promotion in shamka, Jajere and kollere settlements of Fune LGA.  WHO communications team is collaborating with Yobe State Broadcasting Corporation (YBC) and Yobe State Television (YTV) to scale-up awareness creation and risk mitigation campaigns through mass media in the state  UNICEF-supported VCMs sensitized 645 persons on hygiene promotion in Mamudo and Yerimaram in Potiskum LGA.

WASH:  State Ministry of Water Resources (SMOWR) and UNICEF trained 13 newly deployed Environment Health Assistants on water chlorination and household disinfection in Gujba LGA.  Fune LGA has donated 6 Knapsack sprayers to scale-up WASH interventions such as disinfection of surfaces and latrines in affected households and CTUs  ACF-International sensitized additional 901 people in Bungai, Solar and Mutai settlements on hygiene promotion and cholera prevention during nutrition and food distribution programme  RUWASA has completed drilling of new hand pump boreholes in Mutai and Bungai communities of Gujba LGA provide safe water sources.

Coordination:  Yobe state government provided additional funding to ministries of water resources and environment to scale-up interventions in affected LGAs  Regular state and LGA RRT meetings have been conducted to sustain integrated and well-coordinated responses in all affected LGAs.

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