BY CHIKA OKEKE, Abuja
The Nigeria Centre for Disease Control and Prevention (NCDC) has confirmed 13 cases of Dengue Fever outbreak in Sokoto State.
This followed the reported cases of the fever in November 2023, with 71 suspected cases and zero deaths in the state.
Currently, the virus has been reported in three Local Government Areas (LGAs) in the state such as Sokoto South (60 cases), Wamako (3 cases) and Dange Shuni (1 case).
The majority of the suspected reported cases fell between the age range of 21- 40 years, according to the alert issued by the Director General of NCDC, Dr Ifedayo Adetifa on Sunday in Abuja.
Dengue fever is a viral infection caused by the dengue virus (DENV) and transmitted to humans through the infected mosquito bite.
Human-to-human transmission of the virus has not been established but DENV is found in tropical and sub-tropical climates, mostly in urban and semi-urban areas worldwide.
Adetifa informed that Sokoto state could respond to the outbreak by emulating the lessons learnt from prior dengue virus outbreaks in 2016 and 2019.
He said that though no healthcare worker infections or deaths have been reported in the state, that dengue remains a low index of suspicion among Healthcare Workers (HCWs).
The DG maintained that the NCDC-led multisectoral National Emerging Viral Haemorrhagic Diseases Technical Working Group (NEVHD-TWG) in collaboration with partners and relevant stakeholders has conducted a rapid risk assessment to guide in-country preparedness activities.
He said that the NEVHD TWG coordinates preparedness efforts for Ebola virus disease and other emerging viral haemorrhagic fever diseases.
Adetifa stated that based on a dynamic risk assessment, the current risk level of the dengue outbreak has been determined to be moderate as only Sokoto state has reported confirmed cases.
Response Mechanism
Most people with dengue have mild or no symptoms and will get better in one to two weeks. It can be severe but rarely leads to death.
However, the symptoms usually begin between four to 10 days after infection and last for two to seven days.
Symptoms may include high fever (40°C/104°F), severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands, and rash. Individuals who are infected for the second time are at greater risk of severe dengue.
The DG added: "There is currently adequate in-country capacity including technical, health workforce and diagnostic to respond effectively in the event of a large-scale outbreak.
"Nigeria has also responded to viral haemorrhagic fever epidemics like the Ebola Outbreak in 2014 and subsequently lassa fever. This has built our preparedness and response capabilities for viral haemorrhagic fevers like dengue virus (DENV) over the years.
"Currently, there is a diagnostics capacity for the dengue virus (DENV) at the NCDC National Reference Laboratory (NRL) in Abuja and the Usman Dan Fodio University Sokoto Teaching Hospital Laboratory Centre for Human and Zoonotic Virology (UDUTH).
"However, the NCDC will proceed to optimise existing lassa fever testing laboratories and others within the NCDC national laboratory network for DENV diagnosis to improve preparedness and readiness in the event of a large-scale outbreak.
"An effective response system is in place with the availability of control capacities including trained rapid response teams, and an effective infection, prevention, and control programme to limit the risk of spread to other states."
Control Measures
In Sokoto, NCDC embarked on certain public health actions to control the spread of the outbreak. This includes dissemination of a public health advisory to the public and media by the Sokoto State Commissioner for Health (HCH).
Others are sensitisation of clinicians across the state on dengue fever, sensitisation of LGA surveillance officers to enhance surveillance of dengue fever, and media engagements including phone-in programs to ensure public awareness of dengue fever.
Also, collaboration with the Ministry of Environment to improve sanitation and clearing of mosquito breeding sites in the metropolitan LGAs, and partnership with Malaria Control Agency for a Reactive Fumigation in the Metropolitan LGAs.
But at the national level, NEVHD-TWG adopted drastic measures following input from arbovirus institute and review of entomological surveillance data to inform action and strengthen preparedness for a large-scale DENV outbreak in Nigeria.
Adetifa listed the measures as activation of NCDC Incident Coordination Centre (ICC), commencement of an emergency incident action plan for DENV and review of case definitions.
He pointed out that the National Emergency Operations Centre (EOC) has sent out warning notifications to all Subnational Public Health Emergency Operations Centres (PHEOCs).
"Follow-up of suspected cases has commenced, and Trained Rapid Response Teams (TRRTs) are on standby to be deployed in the event of a nationwide outbreak.
"A medical countermeasures plan is being developed, in addition to a risk communication and engagement strategy meant to strengthen preparedness activities which include a review of risk communication protocols, plans, and messages in the event of a wider outbreak.
"Proposed research project with the National Arbovirus and Vectors Research Centre across the six geopolitical zones to better understand the disease vector," Adetifa added.
The DG hinted that Nigeria has an active Infection Prevention and Control (IPC) programme nationwide with guidelines and training packages developed for healthcare workers.
Appeal
Available data showed that prevention and control of DENV infection depended on vector control. There is no specific treatment for dengue though early detection and prompt initiation of supportive treatment have significantly reduced fatality cases
Adetifa advised Nigerians especially people living in Sokoto to adhere strictly to preventive measures by wearing clothes that cover their body to avoid mosquito bites.
He enjoined Nigerians to sleep under insecticide-treated mosquito nets and use insect-repellent in sleeping areas, as well as ensure proper sanitation of their environment to reduce the breeding of mosquitoes.
The DG harped on the need for the residents to call 6232 or other dedicated hotlines by State Ministries of Health to ensure that all persons with suspected symptoms of dengue fever are promptly taken to designated healthcare facilities for prompt diagnosis and initiation of supportive treatment.
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