Weekly Epidemiological Report

January Week 4

Editoral

Review of Nigeria’s Pandemic Influenza Preparedness and Response Plan

Given the inevitable human-animal-environment interface, countries across the world are at risk of zoonotic diseases. In the past, the world has witnessed large-scale public health events including severe respiratory diseases such as Spanish flu (1918), Swine flu (2009), Severe Acute Respiratory Syndrome (2002) and Middle East Respiratory Syndrome (2012). The ongoing novel coronavirus outbreak has now been declared a public health emergency of international concern due to its high transmissibility and increasing spread across countries.

In 2013, Nigeria developed its first national Pandemic Influenza Preparedness and Response Plan. In view of the current epidemiology and scope of global influenza outbreaks, the Nigeria Centre for Disease Control (NCDC) is working with stakeholders to review the country’s pandemic influenza plan.

In line with this, the Influenza Technical Working Group conducted the 2nd Pandemic Influenza Preparedness (PIP) stakeholders’ workshop from 28th - 29th January 2020. The objectives of the workshop were to:

1. Review the existing national Pandemic Influenza Preparedness and Response Plan

2. Ensure strong leadership and multi-sectoral government engagement in the pandemic preparedness planning at national and sub-national levels

The workshop was attended by the representatives from relevant ministries, departments and agencies, as well as multilateral and bilateral organisations.

At the end of the workshop, the objectives were achieved including the review of all the phases (Prevent, Prepare, Response and Recover) of the PIP plan.

Upon completion, the reviewed Pandemic Influenza Preparedness and Response Plan will guide and provide a high level, unifying, cross-sectoral, strategic preparedness and response framework for pandemic influenza in Nigeria.


Summary of Incidents

Notes

1. Information for this disease was retrieved from the Technical Working Group and Situation Reports

2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only

3. Information for this disease was retrieved from IDSR 002 data

4. CFR for this disease is reported for total cases i.e. suspected + confirmed

5. Information for sentinel influenza was retrieved from the laboratory


Lassa Fever

Key points

• There were 318 suspected cases of Lassa Fever (LF) reported from 56 LGAs in 19 states (Edo – 135, Ondo – 52, Ebonyi - 15, Enugu - 6, Kano – 7, Borno – 8, Nasarawa – 4, Kogi – 10, Rivers – 3, Abia – 8, Adamawa – 4, Benue – 1, Kaduna – 8, Bauchi – 11, Taraba – 11, Plateau – 10, Delta – 9, Osun – 8 & Ogun – 8). There were 95 confirmed cases and 19 deaths were recorded

• No health care worker was infected

Actions

To date:

• The National EOC continue to coordinate response activities

• NCDC Rapid Response Team (RRT) deployed to Ondo, Ebonyi, Enugu, Delta, Kano, Katsina and Borno states

• Emergency Operations Centres activated in Ondo and Ebonyi states

• Confirmed cases are being treated at the designated treatment centres

• Enhanced surveillance (contact tracing and active case finding) in affected states

• Diagnosis of all samples in the five Lassa fever testing laboratories across the country

Planned:

• Pilot indigent patient treatment scheme through the Basic Healthcare Provision Funds

• Conduct LF mortality review


Cerebrospinal Meningitis (CSM)

Key points

There were 14 suspected cases of Cerebrospinal Meningitis (CSM) reported from nine LGAs in six states (Borno – 1, Benue – 4, Ebonyi – 2, Edo – 2, Katsina – 3 & Kebbi – 2). None was laboratory confirmed and no death was recorded

Actions

To date:

• Conducted CSM risk assessment in 24 states and FCT

• Continue to follow up and monitor non-reporting states and get updated line lists

• Follow up with State Epidemiologists of Kebbi, Bayelsa, Ebonyi, and Ogun states for updates on recent reported cases


Yellow Fever

Key points

• There were 32 suspected cases of yellow fever (YF) reported from 28 LGAs in 14 states. None was laboratory confirmed and no death was recorded

Actions

To date:

• Updating and cleaning the 2019 YF line list for detailed analysis to guide future response

• National multi-agency YF TWG is coordinating response activities

• National YF guideline made available on NCDC website

Planned:

• Surveillance and laboratory data harmonisation is ongoing


Cholera

Key points

• There were 74 suspected cases of cholera reported from four LGAs in three states (Bayelsa – 3, Ebonyi – 69 & Kebbi – 2). None was laboratory confirmed and four deaths were recorded

Actions

To date

• Development of the 2020 cholera preparedness and response plan ongoing

• National cholera multi-sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states

Planned:

• Ensure that reporting states conduct rapid diagnostic test/culture test and send line list of all reported cases to the national level

• Train staff of water resources laboratories across the six geopolitical zones on Vibrio cholerae isolation

• Continue to follow up and monitor non-reporting states and get updated line lists

• Follow up with State Epidemiologists of Kebbi, Bayelsa, Ebonyi, and Ogun states for updates on recent reported cases


Measles

Key points

• There were 591 suspected cases of measles reported from 171 LGAs in 29 states. None was laboratory confirmed and two deaths were recorded

Actions

To date

• Developed weekly analysis dashboard for real time monitoring of measles surveillance data to improve data visibility to guide programmes

• National Measles TWG is closely monitoring surveillance data and response activities across the country

• Reactive vaccination in Zamfara state

Planned:

• Continue the review of measles surveillance data across the country

• Continue harmonisation of the national line list and SORMAS data

• Conduct a risk assessment of outbreaks in affected states


Monkeypox

Key points

• There were no suspected cases of monkeypox reported this week

Actions

• National Monkeypox TWG is monitoring activities in all states

• New monkeypox guideline published in December 2019

Planned:

• Enhance surveillance for monkeypox in high burden states, working with the animal health colleagues


Acute Flaccid Paralysis (AFP)

Key points

• There were 90 suspected cases of AFP reported from 79 LGAs in 27 states and FCT. None was laboratory confirmed and no death was recorded


National Influenza Sentinel Surveillance

Key points

• There were 71 processed samples positive for influenza with 2 for influenza A & 5 for influenza B.


Timeliness and Completeness of Reports


Timeliness and Completeness of Reports by State

Highlight of the week

  • Summary of Incidents
  • Lassa Fever
  • Cerebrospinal Meningitis (CSM)
  • Yellow Fever
  • Cholera
  • Measles
  • Monkeypox
  • Acute Flaccid Paralysis (AFP)
  • National Influenza Sentinel Surveillance
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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