Death toll from suspected cases of meningitis has reached 438 people in Nigeria, as officials kick off a vaccination campaign aimed at controlling the outbreak.

According to a statement issued by the Nigeria Centre for Disease Control (NCDC), 3,959 suspected cases have been reported in the outbreak in 19 states across the country, 181 of which are laboratory-confirmed.

The current type C meningitis outbreak in Nigeria is a rare form of the disease, as the country had mainly experienced type A meningitis outbreaks.

The most affected group has been children aged five to 14.

On Thursday, officials started a massive vaccination campaign in the northeastern state of Zamfara, the center of the outbreak, which targets 500,000 people aged 2–29 years.

An additional stock of 800,000 doses is expected to arrive from abroad.

The vaccination campaign has been implemented with cooperation of traditional leaders and several community groups who help with mobilization of the public.

Earlier in the week, Zamfara State governor Abdulaziz Yari came under fire for attributing the outbreak of the disease to God’s anger over the sins of Nigerians.

This is the worst meningitis outbreak in Nigeria since the 2009 epidemic, which affected over 9,000 people and claimed the lives of 562.

Nigeria lies on the meningitis belt stretching from the Sahel region to the Horn of Africa.

According to Nigerian Health Ministry, the same outbreak has been reported in neighboring countries such as Niger, Chad, Cameroon, Togo and Burkina Faso.