Weekly Epidemiological Report

January Week 1

Editoral

Rising to the Challenge: Lassa Fever International Conference

The Nigeria Centre for Disease Control (NCDC) and partners hosted the first Lassa fever International Conference in Abuja from the 16th - 17th of January, 2019. The conference was in commemoration of the 50th year of discovery of the Lassa fever virus in a town in Nigeria. Fifty years after, cases have continued to be recorded yearly in Nigeria and other countries in West Africa.

The conference had 588 people from 14 countries in attendance including researchers, field epidemiologists, public health physicians, surveillance officers, public health laboratory scientists, high- level political office holders etc. both nationally and internationally. With the theme as “Rising to the challenge”, discussions were held across vaccine development, improved therapeutics and diagnostics, policy and coordination response, risk communications, animal and environmental health.

The conference provided a great opportunity for researchers, academia, field epidemiologists, clinicians and epidemiologists as well as collaborating treatment/research centres/universities to showcase some of the excellent work (including best practices and lessons learnt) that have been done over the years.

The Federal Government of Nigeria represented by the Honourable Minister of State for Health, acknowledged the initiative and promised that the Government will continue to support the country’s strategy to control Lassa fever.

In concluding the conference, the Director General of NCDC provided a charge to every health worker present, to utilize the lessons from the conference in improving the approach to control the disease. In his words, ‘we may find more Lassa fever cases, but we will rise to the challenge’.


SUMMARY OF REPORTS

In the reporting week ending January 6, 2019:

o There were 51 new cases of Acute Flaccid Paralysis (AFP) reported. None was confirmed as polio. The last reported case of polio in Nigeria was in August 2016. Active case search for AFP is being intensified with the goal to eliminate polio in Nigeria.

o There was one suspected case of cholera reported from Dass LGA in Bauchi State. There was no laboratory confirmed case and no death.

o There were 57 suspected cases of Lassa fever reported from 16 LGAs in nine States (Adamawa – 2, Bauchi –7, Edo –13, Nasarawa – 4, Ebonyi – 5, Ondo – 16, Plateau – 3, FCT - 3 & Taraba - 4). 25 were laboratory confirmed and seven deaths were recorded.

o There were six suspected cases of Cerebrospinal Meningitis (CSM) reported from five LGAs in four States (Bauchi – 1, Kano – 1, Katsina – 2 & Ondo – 2). Of these, none was laboratory confirmed and two deaths were recorded.

o There were 181 suspected cases of measles reported from 27 States. None was laboratory confirmed and no death was recorded.

In the reporting week, all States sent in their reports except Cross River State. Timeliness of reporting remains 89% in the current week (01) while completeness is 97% at the same period. It is very important for all States to ensure timely and complete reporting at all times, especially during an outbreak.


REPORT ANALYSIS AND INTERPRETATION

1. AFP

1.1. As at January 6 2019, no new case of WPV was recorded

1.2. In the reporting week, 51 suspected cases of AFP were reported from 48 LGAs in 28 States


2. CEREBROSPINAL MENINGITIS (CSM)

2.1 In the reporting week, six suspected Cerebrospinal Meningitis (CSM) cases with one Laboratory confirmed and two deaths (CFR, 33.3%) were reported from five LGAs in four states(Bauchi – 1, Kano – 1, Katsina – 2 & Ondo – 2) compared with 86 suspected cases with 17 laboratory confirmed and six deaths (CFR, 6.98%) reported across 36 LGAs (13 states) at the same period in 2018 (Figure 1)

2.2 Timeliness/completeness of CSM case-reporting from states to the national level (2019 versus 2018): on average, 89.2% of the 26 endemic States sent CSM reports in a timely manner while 97.3% were complete in week 1, 2019 as against 86.5% timeliness and 88.5% completeness recorded within the same period in 2018

2.3 The CSM National Emergency Operations Centre (EOC) is on alert mode and meets weekly to review the situation


3. CHOLERA

3.1 One suspected case of cholera was reported from Dass LGA in Bauchi state in week 1, 2019 compared with 88 suspected cases with one Lab confirmed and eight deaths (CFR, 9.1%) reported from 16 LGAs (six states) during the same period in 2018 (Figure 2).

3.2 The cholera National Emergency Operations Centre (EOC) is on watch mode and the Technical Working Group meets weekly to review the situation

3.3 National Preparedness and Response to Acute Watery Diarrhoea/Cholera Guidelines. Available from

http://ncdc.gov.ng/themes/common/docs/protocols/45_1507196550.pdf


4 LASSA FEVER

4.1 In the reporting Week 1 (1 – 6 January, 2019), twenty-five new confirmed I cases were reported from Edo (9), Ondo (8), Bauchi (3), FCT (1), Nasarawa (1), Ebonyi (1), Plateau (1) and Taraba (1) States with seven new deaths in Ondo (2), Edo (2), Nasarawa (1), FCT (1) and Taraba (1) States

4.2 From 1st - 6th January 2019, a total of 57 suspectedi cases have been reported from eight states. Of these, 25 were confirmed positive and 32 negative (not a case)

4.3 Since the onset of the 2019 outbreak, there have been seven deaths among confirmed cases. Case Fatality Rate in confirmed cases is 28.0%

4.4 Eight states have recorded at least one confirmed case across 14 LGAs (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Plateau, Taraba & FCT) and remain active.iv

4.5 National rapid response team deployed to Bauchi State

4.6 Lassa fever international Conference conducted on 16th to 17th January 2019

4.7 The Lassa fever national multi-partner, multi-agency Technical Working Group (TWG) continues to coordinate response activities at all levels.


5 MEASLES

5.1 In the reporting week, 181 suspected cases of measles were reported from 27 states compared with 144 suspected cases and one death (CFR, 0.69%) reported from 23 states during the same period in 2018

5.2 National rapid response tram deployed to support outbreak response in Katsina State

5.3 Response measures include immunization for all vaccine-preventable diseases in some selected/affected wards and LGAs during Supplementary Immunisation Activities (SIAs), as well as case management


6 Yellow fever

5.1 In the reporting week, 181 suspected cases of measles were reported from 27 states compared with 144 suspected cases and one death (CFR, 0.69%) reported from 23 states during the same period in 2018

5.2 National rapid response tram deployed to support outbreak response in Katsina State

5.3 Response measures include immunization for all vaccine-preventable diseases in some selected/affected wards and LGAs during Supplementary Immunisation Activities (SIAs), as well as case management


7. Update on national Influenza sentinel surveillance, Nigeria week 1 – 52, 2018

7.1. From week 1- 52, 396 suspected cases were reported, of which 356 were Influenza like-illness (ILI), 40 were Severe Acute Respiratory Infection (SARI).

7.2 A total of 396 samples were received and all the samples were processed. Of the processed samples, 356(89.8%) were ILI cases, 40 (10.1%) were Severe Acute Respiratory Infection (SARI).

7.3 Of the 356 processed ILI samples, 39 (11.0%) were positive for Influenza A; 33(9.3%) were positive for Influenza B and 284 (79.9%) were negative.

7.4 Out of the processed 40 SARI samples, 7 (17.5%) were positive for Influenza A, 2 (5.0%) were positive for Influenza B, while the remaining 31 (77.5%) were negative.

7.5 Of the 396 processed samples, 81 (21.8%) were positive for Influenza, with 46 (56.8%) of these positive for Influenza A and 35 (43.2%) positive for Influenza B.

7.6 The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 8(17.4%), 28 (60.9%) and 10 (21.7%) of the total influenza A positive samples respectively.

7.7 The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 24(70.6%), 8(20.6%) and 3(8.8%) of the total influenza B positive samples respectively

7.8 The percentage of influenza positive was highest (100.0%) in week 43, 2018

7.5 In the reporting week 1- 52, all samples were processed

FOR MORE INFORMATION CONTACT

Surveillance Unit:

Nigeria Centre for Disease Control,

801 Ebitu Ukiwe Street, Jabi, Abuja, Nigeria.

epidreport@ncdc.gov.ng

www.ncdc.gov.ng/reports

0800-970000-10

Highlight of the week

  • SUMMARY OF REPORTS
  • REPORT ANALYSIS AND INTERPRETATION
  • 2. CEREBROSPINAL MENINGITIS (CSM)
  • 3. CHOLERA
  • 4 LASSA FEVER
  • 5 MEASLES
  • 6 Yellow fever
  • 7. Update on national Influenza sentinel surveillance, Nigeria week 1 – 52, 2018

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