UNICEF Nigeria Cholera Situation Report 10 February 2014

Highlights As of 31 January 2014, 855 cholera cases (17 lab confirmed) and 20 deaths (Case Fatality Rate 3.3%) were reported from 28 Local Government Areas (LGAs) in 9 States. During the same period in 2013, no cases or deaths were reported (see graph below - source: WHO, Federal Ministry of Health). In the last three weeks an upward trend of cases has been observed compared to the same period in 2012 and 2013. In week four, 288 cases and 10 deaths were reported in four LGAs from Bauchi, Ebonyi, Federal Capital Territory (FCT) and Kano States. The majority of these cases, representing 79.5% (237/298), were reported in Bauchi from Bauchi LGA. In the on-going dry season, water sources have been stretched, contributing to the already low access to water and sanition. Only 58% of Nigerias population has access to water and sanitation, which poses a high risk for the spread of cholera cases to states which have not previously reported any cases (Fedral Ministry of Water Resources). No cases of cholera have been reported in Borno and Yobe so far this year, however during week one, Adamawa state reported one case. The risk of cholera outbreak in these states remains high given their precarious humanitarian situation (a State of Emergency has been declared in these areas). UNICEF and partners continue to support the government to strengthen coordination at State and LGA level, and intensify communication to raise awareness.

General Situation Overview and Trends Kano State

In the last few weeks, there has been a notable a downward trend of cases in Kano states if compared to the first weeks of 2014 (see graph below). UNICEF, WHO and the State Ministry of Health have identified 89 high-risk wards in 21 LGAs. Community awareness in these areas, including treatment of cases, is ongoing to contain the outbreak. Weekly epidemiological trend on Cholera in Kano State

Response In Kano, UNICEF supported the State authorities, Kano State Ministry of Health (SMoH) and Rural Water and Sanitation agencies through the provision of essential supplies and dessemination of preventive messges to respond to the outbreak. In addition, 89 cholera high risk wards in 21 LGAs were identified. UNICEF is supporting Kano State to respond to cholera within polio health camps. UNICEF provided 86 cartons of Oral Rehydration Salts (ORS) and basic health kits for this response. This is in addition to supplies already provided to Kano State Ministry of Health. The Federal Ministry of Health has deployed a rapid response team from Abuja to reinforce surveillence activities. Bauchi State Bauchi state reported an upsurge of cholera cases in week four. In week two, five cases were reported and in week three, three cases were reported with no deaths (see graph below).
Weekly epidemiological trend of cholera in Bauchi State

Response The State Ministry of Health (SMOH) and partners have intesified the response. Four treatment centres have been established in Kandahar, Kofar, Dumi and Karofi. Additionally, the SMOH is planning to establish a major treatment centre at ATBU hospital. The State Emergency Management Agency has provided 10 buckets and 30 cartons of Ringers lactate to treatment centres. MSF-France has deployed a team to support the SMOH to contain the outbreak. UNICEF is working closely with the Rural Water and Sanitation Agency to identify WASH gaps for immediate response. This includes identifying contaminated water sources for chlorination and strengthening preventive measures. Inter-Agency Collaboration and Key Partnerships In all nine affected States, UNICEF is collaborating with WHO, State Emergency Management Agency, SMOH, State Rural Water Supply & Sanitation Agency, and the Nigerian Red Cross Society in coordinating response to the outbreak. The main challenge is how to strengthen the surveillance system across high risk communities as part of early warning mechanisms for immediate response. The Federal Ministry of Health and Federal Ministry of Water Resources have activated their respective sector coordination mechanisms at the centrallevel (Abuja) in order to review preparedness plans and support response at State level. UNICEF is working closely with WHO and State Health authorities to support surveillance activities. The Child Protection Network has been mobilized in Bauchi State and is contributing to community surveillence, preventive measures and information sharing to strengthen response. UNICEF Programme Response UNICEF continues to actively support State authorities to respond to the outbreak. Support has been provided in case management, WASH intervention, community awareness and

strengthening coordination in the WASH sector. In addition, UNICEF has prepositioned cholera supplies sufficient for 5,000 people for response. Next Steps UNICEF will continue to strengthen State response coordination mechanisms while intensifying preparedness and preventive measures to States that have not reported cases, particularly those under the State of Emergency rule (Borno, Yobe and Adamawa). UNICEF will strengthen community awareness through the dissemination of key messages on hand washing, safe excreta disposal, and treatment of water at source. UNICEF will continue to support the State Ministry of Health and WHO to strengthen active surveillance activities for early detection and response. Next SitRep: 17 February 2014

For further information, please contact:

Name Ms Jean Gough Representative UNICEF Nigeria Country Office Nigeria Tel: +234 (0)8034020870 Email: jgough@unicef.org Name Mr Samuel Momanyi Deputy Representative Nigeria Country Office Nigeria Tel: +234 (0)35350009 E-mail: smomanyi@unicef.org Name Mr Adili Matontu Chief Emergency Nigeria Country Office Nigeria Tel: +234 (0) 803525027 E-mail: amatontu@unicef.org Name Mr Geofrey Njoku Communication Specialist UNICEF, Nigeria Country Office Nigeria Tel: + 234 (0) 8035250288 E-mail: gnjoku@unicef.org