The Ministry of Health was notified of the outbreak of a fatal febrile rash illnesses in Otodo Gbame community in Eti-Osa LGA, by the Medical Officer of Health of the LGA on 9th February,2016. The report indicated that many children died as a result of the outbreak.
The Ministry notified the FMOH and WHO and immediately constituted a team of Epidemiologists to investigate the outbreak and institute appropriate measures to prevent further spread of the disease.
The Ministry drew up an investigation plan to investigate the outbreak, verify reported deaths and report findings and recommendations.
CONFIRMATION AND DIAGNOSIS
The outbreak was confirmed as 34 cases of sick children with Febrile Rash Illnesses (FRI) have been line listed. The fatality of the outbreak was also confirmed as the graves of 20 children who died from the FRI since the day of onset of signs and symptoms in the first case on 6th January 2016, were identified by their parents.
The disease causing the outbreak is yet to be confirmed. However, the signs and symptoms are suggestive of Febrile Rash Illnesses. Blood samples (and throat swabs) from the patients and water samples from the community have been taken to the Virology Reference Laboratory at LUTH and Lagos State Drug Quality Control Laboratory (DQCL), LASUTH, Ikeja respectively.
The source of the infection is still under investigation.
Thirty-Four (34) cases have been line listed so far with 17 males and 17 females. 17 dead patients have been identified with 9 males and 8 females. All are within the age range of 8-72 months.
OTODO GBAME COMMUNITY
Otodo Gbame community is an expansive, sandy riverine, flood prone and camp-lie settlements with an estimated population of 100,000 people. The people are mainly Egun, however there are other tribes in the minority. The community is a slum with waste deposited at different spots. There are many scattered shallow wells in the community.
The water from the wells is found to be used mostly for bathing, washing and cooking. Majority of the citizen claimed it is not used for drinking but a few said they sometimes drink from the well. The community head Chief Hunpe Dansu confirmed the outbreak of the Febrile Rash Ilnesses.
INTERVENTIONS INSTITUTED BY THE STATE TO CONTROL THE DISEASE AND PREVENT FURTHER SPREAD AND AVERT ADDITIONAL DEATHS.
- Awareness Creation and Community Sensitisation: Intensive awareness creation and community mobilization and health education is ongoing through meetings and community dialogues. Continuous health education of the community on immunization, measles and personal and environmental hygiene.
- Active Case Search: House-to house search for cases is still ongoing. Forty seven (47) sick children were found, out of which 34 were line listed as Febrile Rash Illnesses.
- Local Supplemental Immunisation: Immediate immunisation of children with measles vaccine. A total of Five Hundred and Eighty-Seven (587) eligible children were immunized with measles vaccine and administered with Vitamin A.
- Laboratory investigation: Eight (8) blood samples and seven (7) throat swabs were collected from cases of FRI and sent to the laboratory for measles and other possible viral illnesses.
- Management of line listed cases: Follow up on suspected children who are undergoing treatment to monitor recovery and intervene with further medical attention if required. Seven (7) cases were already followed up as at 15th February,2016. Six (6) had recovered while one (1) who was still ill was immediately taken to the Primary Health Centre (PHC) at Ikate for further medical attention.
- Investigation: Still on-going.
NEXT STEP BY THE MINISTRY
- To conduct comprehensive supplemental immunization for all childhood preventable diseases in the community.
- To conduct a community dialogue with the community to build confidence and guarantee safety.
- To ensure continuous outreach immunization services in conjunction with the community and provide a Health centre for community considering the vast nature of community.
- To collaborate with key stakeholders in the community to ensure success of any health program in the community.
- To select three more community informants to collaborate with the Local Government and State Surveillance team for prompt disease reporting. Two of the informants should be from the TBAs in the community as it is observed that many people in the community patronize TBAs regularly.
- Involving the Office of the Civic Engagement in the settlement of the conflict between the two communities.
The government is presently intensifying efforts to conduct mapping of all slums and blighted areas in the State towards reducing the health hazards associated with such areas. The people are hereby enjoined to join hands with the government in the identification of slums and in ensuring environmental sanitation at all times.
I wish to emphasise the need for the citizenry to continue to practice health promotion and disease prevention measures highlighted below:
- Basic environmental sanitation, including proper disposal of refuse, avoiding open defecation etc.
- Regular hand washing with soap and water
- Maintaining personal hygiene
- Adequate nutrition
- Antenatal care for pregnant women
- Immunisation of children against deadly vaccine preventable childhood diseases
- Regular check-ups towards ensuring early diagnosis and prompt treatment of both communicable and non-communicable diseases.
Members of the public and health workers are to report any strange illness to the nearest health facility or call the following lines: 08037170614, 08055281442 and 08023169485