Weekly Epidemiological Report

November Week 46

Editoral

Working with States to prepare for 2020/2021 Lassa Fever Season

Lassa fever(LF) is endemic in Nigeria, with cases recorded all year round. However, there is an increase in cases in thein dry season especially between November and May. Within this, the peak period is usually from January to May. One possible reason for this is that during dry season, the rat vectors that infect humans with the virus, migrate from its primary habitat in the bush towards human settlement.

With the urgent need to reduce the number of cases, deaths and disabilities during this outbreak season, the Nigeria Centre for Disease Control (NCDC) has been working closely with all states to ensure adequate measures are put in place. In the with this, NCDC has recently developed and shared a letter of alert with all the 36 states plus the Federal Capital Territory. This highlights key expectations from states as the NCDC continues to provide necessary support.

As part of the preparedness activities for 2020/2021 peak season, NCDC has continued to work with the states to ensure reduced transmission and mitigate impacts of such. In line with the above, states are kindly requested to prioritise the following key activities:

1. Resuscitate and train State Epidemic Preparedness and Response (EPR) Committee and Rapid Response Teams (RRT)

2. Intensify risk communication activities by airing radio jingles and disseminating IEC materials

3. Continuously sensitise all health care workers to have a high index of suspicion and adhere strictly to standard precautions while providing care

4. Allocate a dedicated budget line for disease surveillance (Lassa fever), risk communications/public awareness, other preparedness and response activities

5. Designate Isolation/Treatment Centres for clinical management of infectious disease cases

6. Procure and preposition response commodities and medicines

7. Establish/strengthen a State funded robust sample transporting system health facilities

8. Intensify surveillance activities including active case search and contact tracing

9. Adopt one health approach by involving the Ministry of Agriculture, Ministry of Environment, and other relevant agencies and partners in the Lassa fever response

10. Provide comprehensive aftercare services for survivors

11. Activate Emergency Operation Centre (EOC) based on the protocol to declare an emergency

We urge the States’ Governments to fully support their respective epidemiology units and maximise the investments on the COVID-19 response to implement the above listed activities. This is especially important to reduce the risk of spread of cases. We also urge members of the public to take preventive measures to prevent Lassa fever disease including regular handwashing with soap and water, proper storage of food, ensuring clean environment to prevent breeding of rats among others.

The National Lassa fever Technical Working Group coordinated by NCDC will continue to work closely with states to monitor and coordinate situations across the country as well as support states in improving preparedness and response activities.


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 91 suspected cases, two were laboratory confirmed and one death was recorded from two LGAs in one State

Actions

To date:

• National Lassa fever multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate response activities at all levels

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

• No new Healthcare worker was affected in the reporting week 46.

Planned:

• Continue mobilisation of resources


Cerebrospinal Meningitis (CSM)

Key points

There were 5 suspected cases of Cerebrospinal Meningitis (CSM) reported from four LGAs in two States (Katsina – 3 & Plateau – 2). None was laboratory confirmed and no death was recorded

Actions

To date:

• National CSM TWG meets weekly to review reports from States and plan appropriately

• Enhanced surveillance in all States

Planned:

• Continue harmonisation of the national line list and SORMAS data

• Continue to ensure that States reporting cases send their line lists and collect CSM samples


Yellow Fever

Key points

• There were 98 suspected cases of Yellow Fever (YF) reported from 37 LGAs in 16 States. None

• was laboratory confirmed and one death was recorded

Actions

To date:

• National Yellow Fever (YF) Emergency Operations Centre (EOC) continues to coordinate response activities across states

Planned:

• Finalise ICG request for reactive mass vaccination in Enugu and Bauchi States

• Print IEC materials and distribute to states to sensitise communities and increase awareness for YF

• Continue to support affected states across all pillars of response

• Continue harmonisation of surveillance and laboratory data


Cholera

Key points

There were 14 suspected cases of Cholera reported from four LGAs in two States (Kebbi – 11 & Kwara – 3). None was laboratory confirmed and no death was recorded

Actions

To date

• National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all States and supporting affected States

Planned:

• Continue follow up and monitoring of non-reporting States

• Continue harmonisation of the national line list and SORMAS data


Measles

Key points

• There were 167 suspected cases of measles reported from 64 LGAs in 19 States. None was laboratory confirmed and one death was recorded

Actions

To date

• National Measles TWG is closely monitoring measles surveillance data and providing feedback to relevant agencies and development partners

• Weekly surveillance and laboratory data harmonisation ongoing

Planned:

• Intensify follow up with States to update and transmit line list

• Continue monthly measles surveillance data review


Acute Flaccid Paralysis (AFP)

Key points

• There were 99 suspected cases of AFP reported from 82 LGAs in 27 States and FCT. None was laboratory confirmed and no death was recorded


National Influenza Sentinel Surveillance

Key points

• The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 0(0.0%), 17(31.5%) and 37(68.5%) of the total influenza A positive samples respectively. The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 3(27.3%), 8(72.7%) and 0(0.0%) of the total Influenza B positive samples respectively

• The percentage Influenza positive was highest in week 7 with 37.5%.


Coronavirus Disease (COVID-19)

Actions

To date:

• National COVID-19 multi-partner Emergency Operations Centre (EOC) continues to coordinate response activities across States

• Conducting active case search in hotspots LGAs supported by partners

• Trained health workers on infection prevention and control (IPC) across 31 secondary health care facilities in Kaduna State supported by partners

• Conducted online training on infection prevention and control (IPC) for Adamawa State community health workers

• Provided support during the step-down IPC training of 672community healthcare workers in Taraba State

• Supporting States to conduct Risk Communication needs assessment to guide review of plan for increasing testing demand and protocol compliance to prevent second wave of COVID-19 in Nigeria

Planned:

• Conduct e-fresher courses training for IPC trainers

• Develop plan routine testing for COVID-19

• Follow up and assessment of hand hygiene facilities under the Orange Network programme

• Finalise laboratory quality assurance plan


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
  • Acute Flaccid Paralysis (AFP)
  • National Influenza Sentinel Surveillance
  • Coronavirus Disease (COVID-19)
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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