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‘we are working to halt transmission, prevent future occurrences’

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Dr Chikwe Ihekweazu

Dr. Chikwe Ihekweazu is the Chief Executive Officer (CEO), Nigeria Centre for Disease Control (NCDC). The epidemiologist and consultant public health physician told The Guardian what the Federal Government led team is doing to stop the ongoing epidemic of Cerebro Spinal Meningitis (CSM). CHUKWUMA MUANYA writes. Excerpts

But given the fact that CSM is perennial, more or less, how come we didn’t prepare for this year’s outbreak? What went wrong?
There are countries in the meningitis belt, which stretches from Senegal to Ethiopia, including a majority of states in Nigeria. These regions experience increase in meningitis cases during the dry hot months of the year. Usually, a certain strain—the Neisseria meningitidis serotype A— is commonly the cause of these number of cases. This year, we are observing a different strain that requires different control approaches, specifically a different type of vaccine to control. The Federal Ministry of Health (FMoH) and the relevant agencies that is the NCDC and the National Primary Healthcare Development Agency (NPHCDA), as well as development partners are working round the clock to rapidly find and treat new cases, halt transmission of this disease and prevent future occurrences.

Was there neglect somewhere?
We continue to focus on the hard work of implementing a successful outbreak control and response at this time. At the same time, we believe it is important for us to learn lessons on how we can prepare and respond to potential outbreaks in the country, from the community level, all the way up to the Local Government Area (LGA), state and national levels. We are simultaneously working on all these angles.

What were the states involved doing?
I have just returned from Zamfara State, which has been hard hit by this outbreak. From what I observed in the State, I believe a lot of progress has been made. The State has established treatment centres, is finding and reporting cases promptly and reactive vaccination exercises is ongoing in the State. NCDC will continue to coordinate outbreak response activities in Zamfara and all other states that have been affected in this outbreak.

Why should government always resort to crash programmes to deal with familiar issues?
Preparedness is a key issue the country continues to deal with across several sectors in Nigeria. This outbreak is yet another pointer to the fact that we need to plan and execute better as a country. That said, we continue to witness progress in this area, however slow.

In those days, children were vaccinated round the clock against killer diseases, but it appears government has not been investing in CSM vaccines. Why?
This is an important observation. The government of Nigeria through the NPHCDA and its development partner agencies have continued to invest in routine immunization in the country. We are working closely with them and encourage parents to fully vaccinate their children. However, we continue to emphasize that the Neisseria Menigitidis C, has not been a common cause of meningitis in our environment and therefore not a disease we routinely vaccinated against in the country. NPHCDA will carefully examine the situation and will decide on a future approach after we have controlled this outbreak.

That also touches on local capacity to develop vaccines against tropical diseases that are here with us. Any plans on that?
A long-term vision of the government of Nigeria is to increase domestic capacity in vaccine production.

What should Nigerians be doing to protect themselves since the vaccines may not get to most people?
There are established and effective measures that could limit the spread of cerebrospinal meningitis. This would include keeping your household well-aired, regular hand washing, avoiding coughing and sneezing openly, especially in crowded settings and visiting a health care facility if a person has symptoms that may be related to meningitis, which may include sensitivity to sunlight, neck stiffness and fever.

At the cost of $50 per dose, do you think that the government can afford to vaccinate up to 22 million people that need to be vaccinated to protect the country?
We continue to focus on mobilizing resources to ensure that our citizens receive the care they need during this outbreak. This includes not only vaccinating populations at immediate risk for the disease, but also treating cases that present to health facilities. We are increasingly making progress in this direction and the NCDC, NPHCDA and other agencies of the Federal Ministry of Health, working with our international partners are confident that we will get the job done.

It is predicted that the mortality may get to over 1,000 persons and over 10,000 cases because of the delay in deploying the vaccines to critical areas. How true or possible is this?
We have one singular focus at this time. That is making sure that the outbreak response and containment measures we have put in place are effectively and rapidly detecting cases, preventing further spread of this disease and treating cases that we find. We have set up a Meningitis Emergency Operations Center (EOC) to coordinate outbreak control and response activities. Our activities are focused on three key areas including surveillance to rapidly detect and report all new cases of the disease, provide effective treatment for everyone with the disease and to rapidly vaccinate at-risk populations to prevent further spread of the outbreak.

We continue to provide updates on our progress, including number of reported and suspected cases, through the official NCDC weekly situation reports that we make available on our website.

Are there other things Nigerians should do or that we should know?
We want to assure citizens of the country that Ministry of Health and all its relevant agencies are working with international experts to ensure we quickly bring the outbreak under control.

We advise our communities and other members of the public to adopt good hygiene practices, such as regular hand washing and avoid overcrowding when possible. Persons who experience signs of meningitis including fevers, neck stiffness and sensitivity to light should immediately report to their health care providers. We encourage people to report suspected cases to local health authorities for follow up and appropriate action.


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Chikwe IhekweazuNCDC
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