Weekly Epidemiological Report

6. GUINEA WORM DISEASE

6.1. In the reporting week, no rumour reports of Guinea Worm disease was received from any State.

6.2. Nigeria has celebrated 8 consecutive years of zero reporting of Guinea worm disease in the country. The Country has been officially certified free of Dracunculiasis transmission by the International Commission for the Certification of Dracunculiasis Eradication (ICCDE).

(For further information, contact NIGEP NC/Director: Mrs. I, Anagbogu: +2348034085607, [email protected])

1. LASSA FEVER

Please note that the data reflects the routine reports i.e. all suspected cases including the laboratory positive and negative cases

1.1. Five suspected cases of Lassa fever with one Laboratory confirmed were reported from four LGAs (three States: Bauchi – 2, Edo – 1 & Kogi – 2) in week 52, 2017 compared with eight suspected cases and one deaths (CFR, 12.50%) reported from six LGAs (five States) at the same period in 2016

1.2. Laboratory results of the five suspected cases; one positive for Lassa fever (Edo – 1), four were negative for Lassa fever & other VHFs (Bauchi – 2 & Kogi – 2)

1.3. Between weeks 1 and 52 (2017), 733 suspected Lassa fever cases with 143 laboratory confirmed cases and 71 deaths (CFR, 9.69%) from 97 LGAs (29 States) were reported compared with 921 suspected cases with 101 laboratory confirmed cases and 117 deaths (CFR, 12.70%) from 144 LGAs (29 States) during the same period in 2016 (Figure 1)

1.4. Between weeks 1 and 52 2016, 921 suspected Lassa fever cases with 109 laboratory confirmed cases and 119 deaths (CFR, 12.92%) from 144 LGAs (28 States and FCT) were reported compared with 430 suspected cases with 25 laboratory confirmed cases and 40 deaths (CFR, 9.30%) from 37 LGAs (14 States and FCT) during the same period in 2015 (Figure 2)

1.5. Investigation and active case search ongoing in affected States with coordination of response activities by the NCDC with support from partners

1.5.1. National Lassa Fever Working Group meeting and weekly National Surveillance and Outbreak Response meeting on-going at NCDC to keep abreast of the current Lassa fever situation in the country

1.5.2. Response materials for VHF provided to support States

1.5.3. National VHF guidelines (National Viral Haemorrhagic Fevers Preparedness guidelines, Infection Prevention and Control of VHF and Standard Operating Procedures for Lassa fever management) are available on the NCDC website- http://ncdc.gov.ng/diseases/guidelines

1.5.4. VHF case-based forms completed by affected States are being entered into the new VHF management system. This system allows for the creation of a VHF database for the country. Data from the VHF database is currently being analysed to inform decision making in the coming year

1.5.5. States are enjoined to intensify surveillance and promote Infection, Prevention and Control (IPC) measures in health facilities

1.5.6. NCDC Lassa fever working group visited priority States, to provide support in developing preparedness and response plans ahead of dry season

3. POLIOMYELITIS

3.1. As at December 31st, 2017, no new case of WPV was recorded

3.2. Three new cVDPV2, environmental derived and Polio compatible cases identified

3.2.1. In the reporting week, 61 cases of AFP were reported from 57 LGAs in 21 States and FCT

3.2.2. AFP Surveillance has been enhanced and outbreak response is on-going in Borno and other high-risk States

3.2.3. The 1st round of SIPDs in 2017 was conducted from 28th – 31st January 2017 in the 18 high-risk States. This was carried out using mOPV2 (2nd mOPV2 OBR). The schedule for other SIAs is as described in Table 2

3.2.4. The 2nd and 3rd round of SIPDs completed (25th-28th February and 8th – 11th July 2017) in 14 & 18 high-risk States using bOPV respectively.

3.2.5. The 1st and 2nd rounds of NIPDs completed (from 25th – 28th March 2017 and 22nd – 25th April 2017) nationwide respectively.

3.2.6. The 4th round of SIPDs completed from 14th- 17th October 2017 in 18 high-risk States using bOPV.

3.2.7. The 5th round of SIPDs completed from 9th- 12th December 2017 in 6 high-risk States using bOPV.

3.2.8. Between weeks 1 and 52 in 2016, four WPVs were isolated from Borno State compared to no WPV isolated during the same period in 2015.

3.3. No circulating Vaccine Derived Polio Virus type 2 (cVDPV2) was isolated in week 1 - 52, in both 2016 and 2015.

3.4. Between weeks 1 and 52, 2016 two (2) cVDPV2 were isolated in two LGAs (two States) while one (1) cVDPV2 was isolated from Kwali, FCT during the same period in 2015.

3.5. Six confirmed WPVs were isolated in 2014.

3.6. The SIAs were strengthened with the following events:

3.6.1. Immunisation for all vaccine-preventable diseases in some selected wards/LGAs.

7. Update on national Influenza sentinel surveillance, Nigeria week 1 - 11, 2018

7.1. From week 1- 11, 112-suspected cases were reported, of which 104 were Influenza like-illness (ILI), eight Severe Acute Respiratory Infection (SARI).

7.2 112 samples were received and all the samples were processed. Of the processed samples, 104(92.9%) were ILI cases, eight (7.1%) were Severe Acute Respiratory Infection (SARI).

7.4. Of the 104 processed ILI samples, 16 (15.4%) was positive for Influenza A; 26(25.0%) positive for Influenza B and 62(59.6%) were negative.

7.5 For the processed eight SARI samples, five (62.5%) were positive for Influenza A while the remaining three (37.5%).were negative.

7.6 42 (37.5%) of the processed 104 samples were positive for Influenza, with 16 (38.1%) of these positive for Influenza A and 26 (62.9%) positive for Influenza B.

7.5. The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for (0.0%), 11 (68.8%) and 5 (31.2%) of the total influenza A positive samples respectively.

7.6 The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 10(38.5%), 16(61.5%) and 0(0.0%) of the total influenza B positive samples respectively

7.7 The percentage influenza positive was highest (75.0%) in week 6, 2018

7.8 In the reporting week 1 -11, no samples was left unprocessed

FOR MORE INFORMATION CONTACT

Surveillance Unit:

Nigeria Centre for Disease Control,

801 Ebitu Ukiwe Street, Jabi, Abuja, Nigeria.

[email protected]

www.ncdc.gov.ng/reports

0800-970000-10

REPORT ANALYSIS AND INTERPRETATION

1. AFP

1.1. As at May 6th, 2018, no new case of WPV was recorded

1.2. In the reporting week, 151 cases of AFP were reported from 124 LGAs in 33 States & FCT

1.2.1. AFP Surveillance has been enhanced and outbreak response is on-going in Borno and other high-risk States

12.2 Two SIPDs and one NIPDs were conducted from January to April 2018 using bOPV in 18 high-risk States and 36 States plus FCT respectively

1.3. The SIAs were strengthened with the following events:

1.3.1. Immunisation for all vaccine-preventable diseases in some selected wards/LGAs.

1.3.2. Use of health camp facilities.

1.3.3. Field supportive supervision and monitoring.

1.3.4. Improved Enhanced Independent Monitoring (EIM) and Lots Quality Assessments (LQAs) in all Polio high-risk States.

1.3.5. High level of an accountability framework

4. LASSA FEVER

4.1 In the reporting Week 36 (3 – 9 September, 2018) seven new confirmedI cases were reported from Edo (6) and Delta (1) States with no new death recorded.

4.2 From 1st January to 9th September 2018, a total of 2515 suspectedi cases have been reported from 22 states. Of these, 504 were confirmed positive, 10 are probable, 2002 negative (not a case)

4.3 Since the onset of the 2018 outbreak, there have been 132 deaths in confirmed cases and 10 in probable cases. Case Fatality Rate in confirmed cases is 26.2%

4.4 22 states have recorded at least one confirmed case across 87 Local Government Areas (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo, Plateau, Lagos, Taraba, Delta, Osun, Rivers, FCT, Gombe, Ekiti, Kaduna, Abia, Adamawa and Enugu). Eighteen states have exited the active phase of the outbreak while four – Edo, Ebonyi, Bauchi and Delta States remain activeiv

4.5 NCDC and Partners deployed Rapid Response Team (RRT) to Enugu and Edo States

4.6 Supplies for Lassa fever management procured through UNICEF and distributed to all LF affected states

4.7 Lassa fever international Conference registration, abstract submission and sponsorship now open to the public on the conference website www.lic.ncdc.gov.ng

4.8 The Lassa fever national multi-partner, multi-agency Technical Working Group (TWG) continues to coordinate response activities at all levels. Response and laboratory supplies have been provided to priority States

4.9 National VHF guidelines (National Viral Haemorrhagic Fevers Preparedness guidelines, Infection Prevention and Control of VHF and Standard Operating Procedures for Lassa fever management) are available on the NCDC website- http://ncdc.gov.ng/diseases/guidelines

4. LASSA FEVER

4.1 In the reporting Week 36 (3 – 9 September, 2018) seven new confirmedI cases were reported from Edo (6) and Delta (1) States with no new death recorded.

4.2 From 1st January to 9th September 2018, a total of 2515 suspectedi cases have been reported from 22 states. Of these, 504 were confirmed positive, 10 are probable, 2002 negative (not a case)

4.3 Since the onset of the 2018 outbreak, there have been 132 deaths in confirmed cases and 10 in probable cases. Case Fatality Rate in confirmed cases is 26.2%

4.4 22 states have recorded at least one confirmed case across 87 Local Government Areas (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo, Plateau, Lagos, Taraba, Delta, Osun, Rivers, FCT, Gombe, Ekiti, Kaduna, Abia, Adamawa and Enugu). Eighteen states have exited the active phase of the outbreak while four – Edo, Ebonyi, Bauchi and Delta States remain activeiv

4.5 NCDC and Partners deployed Rapid Response Team (RRT) to Enugu and Edo States

4.6 Supplies for Lassa fever management procured through UNICEF and distributed to all LF affected states

4.7 Lassa fever international Conference registration, abstract submission and sponsorship now open to the public on the conference website www.lic.ncdc.gov.ng

4.8 The Lassa fever national multi-partner, multi-agency Technical Working Group (TWG) continues to coordinate response activities at all levels. Response and laboratory supplies have been provided to priority States

4.9 National VHF guidelines (National Viral Haemorrhagic Fevers Preparedness guidelines, Infection Prevention and Control of VHF and Standard Operating Procedures for Lassa fever management) are available on the NCDC website- http://ncdc.gov.ng/diseases/guidelines

National Influenza Sentinel Surveillance