Reemergence of Yellow Fever in Nigeria 2018: The Anambra state experience

Background: Yellow Fever (YF) is an acute viral hemorrhagic disease caused by the YF virus; an arthropod-borne virus of the Flaviviridae family that is transmitted by the bite of infected Aedes mosquitoes. In Nigeria, cases were last reported in 1986. However, in September 2017, the Nigeria Centre for Disease Control was notified of an outbreak of YF in Kwara state. Subsequently, cases were reported from other states including Anambra. We investigated to characterize the outbreak, assess its determinants and recommend control measures. Methods and materials: We defined a suspected case as any person with acute onset of fever and jaundice in Awka North Local Government Area (LGA) or its contiguous LGAs from 1st June, 2018 to 24th October, 2018, and a confirmed case as any suspected case with laboratory confirmation (positive IgM/IgG). We interviewed cases using a structured questionnaire, reviewed hospital records, conducted active case search; entomological survey and assessed vaccination coverage. Results: We identified 203 suspected cases from 18 LGAs out of which one case was confirmed. The confirmed case was a 7-year-old male from Awka North LGA with a positive YF vaccination history. Across the 5 LGAs surveyed, YF vaccination coverage was low (40.9%) and entomological survey showed presence of all stages of Aedes mosquitoes with high larval indices in the affected and contiguous LGAs. Conclusion: We confirmed an outbreak of YF in Anambra state. Vaccination coverage was low and high risk of transmission was established. We sensitized community leaders and members on proper environmental sanitation measures. We recommended preventive mass vaccination, strengthening of routine immunization and improvement in environmental sanitation measures.

Abstract licence: CC BY-NC-ND

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