Weekly Epidemiological Report

Lassa fever

1. **Lassa fever update for week 40 as at 14th October, 2016; (**Please note that the data reflects the routine reports i.e. all suspected cases including the laboratory positive and negative cases)

1.1. Three suspected cases of Lassa fever were from 3 LGAs (3 States; Katsina -1, Nassarawa – 1 & Oyo -1) reported in week 40, 2016 compared with one case from Jos North LGA (Plateau State) at the same period in 2015 (Figure 1).

1.2. The three (3) suspected cases were negative for Lassa and other VHFs.

1.3. Between weeks 1 and 40 (2016), 841 suspected Lassa fever cases with 83 lab-confirmed and 98 deaths (CFR, 11.65%) from 137 LGAs (28 States) were reported compared with 228 suspected cases with 11 lab-confirmed and six (6) deaths (CFR, 2.63%) from 21 LGAs (11 States) at the same period in 2015 (Figure 1).

1.4. Between weeks 1 & 53 2015, 430 suspected Lassa fever cases with 25 lab-confirmed and 40 deaths (CFR, 9.30%) from 37 LGAs (14 States & FCT) were reported compared with 989 suspected cases with 110 lab-confirmed and 36 deaths (CFR, 3.64%) from 37 LGAs (13 States) at the same period in 2014 (Figure 2).

1.5. Investigation ongoing in affected states. States are enjoined to intensify surveillance.

1.5.1. Weekly Lassa fever working group meeting ongoing at the NCDC to assess the current Lassa fever situation in the country.

1.5.2. Ribavirin Injectable & Tablets with Personal Protective Equipment (PPE) and other consumables distributed to affected States.

1.5.3. The Emergency Operational Centre (EOC) in the Nigeria Centre for Disease Control and Prevention (NCDC)/FMOH was activated and technical supports were provided to affected states during the January – April 2016 outbreak.

Measles

2. Update on suspected Measles for week 40 as at 14th October, 2016

2.1. In the reporting week 40 (2016), one hundred & thirty-nine (139) suspected cases of Measles were recorded from 22 States compared with 221 suspected measles cases from 23 States at the same period in 2015.

2.2. So far, 22,970 suspected Measles cases and 100 deaths (CFR,0.44%) have been reported in 2016 from 36 states & FCT (Figure 3 & 4) compared with 20,250 suspected cases and 97 deaths (CFR, 0.48%) from 36 states & FCT at the same period in 2015.

2.3. In 2015 (week 1 -53), 24,421 suspected measles cases with 127 deaths (CFR, 0.52%) were reported from 36 States and FCT compared with 15,989 suspected cases with 85 deaths (CFR, 0.53%) at the same period in 2014

2.4. Confirmed Measles cases (lab, epi-link and clinical): Between week 1-40, (2016) 10,723 confirmed Measles cases were recorded compared to 10,370 confirmed at the same time in 2015. (Figure 5). Most affected were within the age group 9 - 59 months ( Figure 6 & 7 respectively). Vaccination status of the measles cases was 68.2% zero dose (Figure 8).

2.5. Response measure includes immunization for all vaccine-preventable diseases in some selected/ affected wards/LGAs during SIAs with case management.

2.6. Measles vaccination campaigns in the Northern and Southern States were conducted from 21st – 25th November, 2015 and 28th January – 1st February, 2016 respectively.

Poliomyelitis

3. Updates on poliomyelitis for week 40 as at October 7th , 2016

3.1. No Wild Polio Virus (WPV) was isolated in both weeks 40 of 2016 & 2015..

3.2. Between weeks 1 & 40, 2016, four (4) confirmed Wild Polio Virus (WPV) type 1 were isolated from Jere (1), Gwoza (1) & Monguno (2) LGAs (Borno State) compared to zero case at the same period in 2015 (Figure 9).

3.3. Between weeks 1 & 53, 2015 no WPV was isolated compared to six (6) WPVs isolated from 2

States at the same period in 2014.

3.3 One (1) circulating Vaccine Derived Polio Virus type 2 (cVDPV2) was isolated in Monguno LGA (Borno State) from week 1 - 40, 2016 compared to one (1) cVDPV2 isolated in Kwali, FCT at the same period in 2015 (Figure 10).

3.4 Between weeks 1 & 53, 2015 one (1) cVDPV2 was isolated in Kwali, FCT while thirty (30) cVDPV2 were isolated from 5 States at the same period in 2014.

3.5 Six (6) confirmed WPV were isolated in 2014.

3.3 In response to the isolation of WPV1 in the Country, the Federal Government had immediately made a public notification and developed an outbreak response plan on the 10th August, 2016 with activities commencing from 15th August – 22nd November 2016. (Figure 12)

3.4 Investigation was conducted in the 3 affected LGAs (Gwoza, Jere and Monguno LGAs)

3.5 First and second outbreak response supplemental immunizations (House to house, Hit and run, and Health camps) with bOPV were conducted in 5 States (Borno, Yobe, Adamawa, Gombe and Taraba) from the 27th – 30th August 2016 and 18 States (11 high risk states plus Taraba, Adamawa, Gombe, Plateau, Nasarawa, Benue and the FCT from the 17th – 20th September 2016 respectively

3.6 From January – May, 2016 (4) Supplemental Immunization Activities (SIAs) for Oral Polio Vaccine (OPV) had been conducted across the country using tOPV .

3.7 The SIAs (SNIPDs) were strengthened with the following events:

3.7.1 Immunization for all vaccine-preventable diseases in some selected wards/LGAs.

3.7.2 Use of health camp facilities.

3.7.3 Field supportive supervision and monitoring.

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

3.7.5 High level of accountability framework

3.8 NSTOP in collaboration with FMOH conducted 2 training sessions: "Reaching every child with OPV especially in underserved population" for specialized health workers and "assessment of routine immunization activities in the LGAs" for NSTOP consultants.

Cholera

4. Update on suspected Cholera for week 40 as at 14th October, 2016

4.1 In reporting week 40 (2016), 13 suspected cases of cholera with 1 Lab. Confirmed and 4 deaths (CFR, 30.77%) were recorded from 2 LGAs (2 States) compared with 65 cases with 4 Lab. Confirmed and 2 deaths (CFR, 3.07) from 3 LGAs (3 States) at the same period in 2015 (Figure 13).

4.2 Between weeks 1 and 40 (2016), 554 suspected cholera cases, 15 Lab confirmed and 25 deaths (CFR, 4.51%) from 48 LGAs (12 States) were reported compared with 4542 cases with 23 lab-confirmed and 176 deaths (CFR, 3.87%) from 91 LGAs (19 States) at the same period in 2015 (Figure 13)

4.3 Between weeks 1 and 53 (2015), 5301 suspected cholera cases with 29 lab-confirmed and 186 deaths (CFR, 3.51%) from 101 LGAs (18 States and FCT) were reported compared with 35,996 cases with 306 lab confirmed and 755 deaths (CFR, 2.10%) from 182 LGAs (19 States and FCT) at the same period in 2014 (Figure 14).

4.4 States are enjoined to intensify surveillance.

Cerebrospinal Meningitis (CSM)

5. Update on cerebrospinal meningitis (CSM) for week 40 as at 14th October, 2016

5.1. In the reporting week 40 (2016), 11 suspected cerebrospinal meningitis (CSM) cases were reported from 7 LGAs (5 States) compared with 1 case from Akko LGA (Gombe State) at the same period in 2015.

5.2. Between weeks 1 & 40 (2016), 719 suspected CSM cases with 39 Lab. confirmed and 30 deaths (CFR, 4.17%) were recorded from 140 LGAs (29 States) compared with 2656 suspected cases with 43 Lab. Confirmed and 130 deaths (CFR, 4.89%) from 158 LGAs (28 States) at the same period in 2015 (Figure 15).

5.3. Between weeks 1 & 53, 2015, 2711 suspected CSM cases with 43 lab-confirmed and 131 deaths (CFR, 4.83%) were recorded from 170 LGAs (28 States and FCT) compared with 1175 suspected cases and 81 deaths (CFR, 6.89%) from 125 LGAs (26 States and FCT) at the same period in 2014 (Figure 16)

5.4. Timeliness/completeness of CSM case-reporting from States to National Level (2016 versus 2015): on the average, 86.0% of the 26 endemic states sent CSM reports timely while 99.6% were complete in week 1 – 40, 2016 as against 81.3% timeliness and 98.2% completeness recorded within the same period in 2015.

5.5. Intensive Surveillance is on-going in high risk States.

Guinea worm disease

6. Update on Guinea worm disease: as at 30th September, 2016

6.1. As at 30th September, 2016, 185 GWD rumour reports were received from 71 LGAs in 16 States. All (100%) of the rumours were investigated within 24 hours and none of these rumours were confirmed to be GWD case.

6.2. In 2015, a total of 384 GWD rumour reports were received and investigated from 134 LGAs (24 States), of which 373 (97%) were investigated within 24 hours. None of these rumours were confirmed to be GWD case.

6.3. Nigeria has celebrated 7 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])

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