In a recent development, the Nigeria Centre for Disease Control and Prevention (NCDC) has been apprised of the emergence of a dengue fever outbreak in Sokoto State, with the first cases reported in November 2023. The Director-General of the NCDC, Dr Ifedayo Adetifa, officially disclosed that, to date, there have been 71 suspected cases, 13 confirmed cases, and thankfully, no reported fatalities in the state.
Dr Adetifa revealed that the outbreak is concentrated in three local government areas (LGAs): Sokoto South (60 cases), Wamako (3 cases), and Dange Shuni (1 case). Notably, the majority of the suspected cases fall within the age range of 21 to 40 years.
The NCDC, in collaboration with the National Emerging Viral Haemorrhagic Diseases Technical Working Group (NEVHD-TWG), is actively engaged with partners and stakeholders to conduct a comprehensive risk assessment, guiding the formulation of preparedness activities within the country. The NEVHD-TWG, overseeing preparedness for various viral haemorrhagic fever diseases, has employed a dynamic risk assessment approach, categorizing the current risk level of the dengue outbreak as MODERATE. Several factors contribute to this assessment:
The outbreak has been confined to Sokoto State.
Only three out of the 23 LGAs in the state are affected.
No severe cases or fatalities have been reported.
Sokoto State has the capacity to respond based on lessons learned from previous dengue virus outbreaks in 2016 and 2019.
No infections or fatalities among healthcare workers have been documented, although a low index of suspicion persists among them.
The nation possesses adequate in-country capacity, encompassing technical expertise, health workforce, and diagnostic resources, to effectively respond to a potential large-scale outbreak. Drawing from experience in managing viral haemorrhagic fevers such as the Ebola outbreak in 2014 and subsequent instances of Lassa fever, Nigeria has fortified its preparedness and response capabilities over the years.
Currently, diagnostic capabilities for the dengue virus (DENV) exist 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). To enhance preparedness, the NCDC plans to optimize existing Lassa fever testing laboratories and others within its national laboratory network for DENV diagnosis.
In Sokoto State, public health measures have been implemented to control the outbreak, including the dissemination of a Public Health Advisory, clinician sensitization, enhanced surveillance, media engagements, sanitation initiatives, and collaboration with the Malaria Control Agency for fumigation in metropolitan areas.
At the national level, the NEVHD-TWG has initiated several measures:
Activation of the NCDC Incident Coordination Centre (ICC) in alert mode.
Commencement of an emergency incident action plan for DENV.
Review of case definitions for DENV.
Issuance of warning notifications to Subnational Public Health Emergency Operations Centres (PHEOCs).
Initiation of follow-up procedures for suspected cases.
Readiness of trained Rapid Response Teams for deployment.
Development of a medical countermeasures plan.
Formulation of a risk communication and engagement strategy to bolster preparedness activities.
Proposal for a research project in collaboration with the National Arbovirus and Vectors Research Centre across the 6 Geopolitical zones to better understand the disease vector.
Nationwide active infection prevention and control (IPC) programme with established guidelines and training packages for healthcare workers.
The NCDC continues to monitor the situation closely, ensuring a swift and coordinated response to mitigate the risk of further spread.
