Weekly Epidemiological Report

November Week 45

Editoral

Responding to Yellow Fever Outbreak in Nigeria

The Nigeria Centre for Disease Control (NCDC) has the mandate to lead the preparedness, detection and response to infectious disease outbreaks and public health emergencies. In line with this, NCDC has been leading the public health response to the ongoing COVID-19 outbreak in Nigeria as well as maintaining continued epidemic intelligence around other epidemic-prone diseases such as yellow fever (YF), cholera, Lassa fever (including other viral haemorrhagic fevers), measles, cholera etc.

On the 1st and 2nd of November, the Delta and Enugu State Ministries of Health, respectively, notified the NCDC of clusters of cases and deaths - with cases having symptoms such as fever, bloodshot eyes, convulsions etc. In a swift response to this, samples from the states were sent to the NCDC National Reference Laboratory (NRL) and confirmed positive for yellow fever. This was followed by the immediate deployment of rapid response teams (RRTs) and activation of a national multi-sectoral emergency operations centres (EOCs) to support outbreak investigations and response activities in the affected states. The EOCs in affected states have also been activated for state-level coordination and synergy with the national EOC.

As of 22nd November 2020, a total of 40 cases have been confirmed with 10 deaths recorded in Delta, Enugu, Bauchi, Benue and Ebonyi States. The NCDC is currently supporting affected state to:

1. Enhance active case search and other surveillance activities

2. Intensify risk communication and sensitise the public on preventive measures for yellow fever

3. Transport samples from the affected states to the six in-country laboratories for YF serology testing

4. Support infection prevention and control activities and provide case management guidelines

Following further risk assessments, alerts have been sent to states sharing boundaries with the outbreak LGAs i.e. Edo, Kogi, Jigawa and Gombe States. These States are strongly advised to intensify surveillance and risk communication activities towards curtailing further spread of the disease.

Yellow fever is a vaccine-preventable disease and the YF vaccine is available for free in all primary healthcare centres in Nigeria as part of the routine childhood immunisation schedule. It is very important that Nigerians ensure their children receive the yellow fever vaccine which provides safety against the disease for life. NCDC is working collaboratively with NPHCDA to conduct reactive and accelerated yellow fever mass campaign. If you are unsure of your vaccination status, please visit a health facility and request for the yellow fever vaccine. The virus is spread by mosquito bites, so it is important to protect yourself from mosquito bites.

Finally, please protect yourself and your families by keeping your environment clean, covering your food to prevent contact with rodents, washing your hands regularly and adhering to public health guidance. If you feel ill, please avoid self-medication and visit a health facility.


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 98 suspected cases, five were laboratory confirmed and one death was recorded from two LGAs in two States

Actions

To date:

• National Lassa fever multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate the 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 45.

Planned:

• Continue mobilisation of resources


Cerebrospinal Meningitis (CSM)

Key points

There were 10 suspected cases of Cerebrospinal Meningitis (CSM) reported from five LGAs in four States (Adamawa – 2, Borno – 1, Ebonyi - 1 & Katsina – 6). 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 48 suspected cases of Yellow Fever (YF) reported from 25 LGAs in 11 States and FCT. There were ten laboratory confirmed cases and no death was recorded

Actions

To date:

• National COVID-19 multi-partner 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 ongoing


Cholera

Key points

• There was no suspected case of cholera in the reporting week

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 139 suspected cases of measles reported from 52 LGAs in 14 states. Two were laboratory confirmed and no 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


Monkeypox

Key points

• There was no suspected case of Monkeypox in the reporting week.

Actions

To date

• National Monkeypox Technical Working Group (TWG) is monitoring activities in all States

Planned:

• Enhance surveillance for monkeypox in high burden States

• Continue harmonisation of the national line list and SORMAS data


Acute Flaccid Paralysis (AFP)

Key points

• There were 99 suspected cases of AFP reported from 87 LGAs in 26 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

• Commenced the deployment of additional 39 community volunteers in each State to strengthen ongoing response to COVID-19 with support from partners

• Ongoing testing of corps members and officials in NYSC orientation camps nation wide

• Conducted hand hygiene baseline assessment across various health facilities under Orange Network

• Ongoing data harmonisation and management

• Organised webinar for corps members on familiarisation with camp safety protocols

Planned:

• Finalise plans with PTF on testing 450 persons per Local Government Area (LGA) in a survey

• 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
  • Monkeypox
  • 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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