Epidemic hazard

Several media in Nigeria are reporting that Nigeria Centre for Disease Control CDC (NCDC) is investigating since mid-April 2024 an unidentified disease which has, based on informal reports, “killed more than 160 children in Sokoto State". According to more recent information reported by media quoting NCDC, the "disease" has now spread to Zamfara State and the authorities have urged the communities of this state and from Kaduna to report any symptoms, including fever, abdominal swelling and pain, vomiting, and weight loss to the nearest health facility, or directly to NCDC (through a toll-free phone line). Media are suggesting that the cause may be heavy metal poisoning as similar cases described in the past in some of the affected areas were actually linked to lead poisoning due to unregulated and illegal mining in communities. Considering the inconsistency of the information provided by media around this event during the latest weeks, an RFI has been sent to EpiCore members to support in the collection of more details from reliable sources. The EpiCore network has confirmed that there is currently an outbreak ongoing in Sokoto State due to an unknown disease that is affecting several children, causing mainly abdominal disorder, fever, vomiting, sudden weight loss and ascites. NCDC has confirmed the occurrence of this event and informed that the first cases have been identified in late March 2024 and as of April 18, a total of 196 suspected cases, including 7 deaths, has been documented across Isa, Sabon Birni, and Ilella Local Government Areas (LGAs). Media quoting the same sources are now reporting already over 208 cases, and 8 deaths (as of Apr 24). The Epidemiology Department of Sokoto State Ministry of Health is currently investigating the cases in collaboration with NCDC and samples of cases are currently tested in collaboration with several institutions including the National Institute for Pharmaceutical Research and Development (NIPRID), the National Agency for Food and Drug Administration and Control (NAFDAC), and the Nigerian Institute of Medical Research (NIMR). Based on the information provided by the network, so far no infectious cause has been identified however some of the cases have showed high concentration levels of lead and chromium: preliminary results are suggesting that the cause is heavy metal poisoning, most probably related to illegal mining activities, however this information has not been officially confirmed as investigation is officially still ongoing. The event is currently affecting several LGAs in Sokoto sharing fragile security issues where there have been, since a while, rumours of illegal mining and there appear to be limitations in the possibility of implementing investigation activities for security reasons. The main affected LGAs appear to be Isa and Sabon Birni. The network suggests that GIS-based solutions may play a key role in the control of this event due to the particular context. Limited diagnostic capacities at local level and the risk of spread of to neighbouring Zamfara State are reported by media as the main concerns of the response team: actually, according to some local media, similar cases have been already identified in villages bordering Sokoto state in the LGAs of Maradun and Shinkafi: here community leaders report several cases of “liver inflammation” and consider water contamination as the main causative hypothesis. The RFI has been supported by the network with valuable information collected from reliable sources, including authorities’ websites and online media directly quoting local health representatives. Despite the suspect of heavy metal poisoning due to unregulated and illegal mining activities implemented in the area being the cause of the reported cases, this information needs to be still confirmed by the national authorities. The event will be monitored closely in the coming days and this summary may be updated in case of relevant new contribution shared by the network and extracted from reliable sources. OFFICIAL SOURCES - Nigeria CDC, statement (Apr 18, 2024): https://ncdc.gov.ng/news/511/ncdc-convenes-an-emergency-meeting-with-sokoto-and-zamfara-states-to-address-unknown-illness MEDIA QUOTING LOCAL AUTHORITIES - Apr 20, 2024 (Zamfara): https://tribuneonlineng.com/zamfara-govt-discovers-unknown-illness-in-two-lgas-deploys-health-personnel/ - Apr 19. 2024 (Sokoto): https://www.vanguardngr.com/2024/04/sokoto-strange-disease-spreads-to-kaduna-as-death-toll-hits-7/ - Apr 21, 2024 (Sokoto): https://www.tvcnews.tv/2024/04/ncdc-embarks-on-emergency-response-to-sokoto-state/ - Apr 23, 2024 (Sokoto): https://www.vanguardngr.com/2024/04/strange-illness-claims-8-lives-in-sokoto-208-cases-identified/