Weekly Epidemiological Report

November 2016 Week 44

Editoral

Weekly updates on epidemics in Nigeria: as at 4th November, 2016

Posted: 02-12-2016 03:19:50 PM

Issue: Volume 6 No. 43


Lassa fever

1. **Lassa fever update for week 43 as at 4th November, 2016; (**Please note that the data reflects the routine reports i.e. all suspected cases including the laboratory positive and negative cases)

1.1. One suspected case of Lassa fever was reported from Owo LGA (Ondo State) in week 43, 2016 compared with 1 case from Bokkos LGA (Plateau State) at the same period in 2015 (Figure 1).

1.2. The Lab. result for the one (1) suspected case is still pending.

1.3. Between weeks 1 and 43 (2016), 859 suspected Lassa fever cases with 87 lab-confirmed and 102 deaths (CFR, 11.87%) from 139 LGAs (29 States) were reported compared with 245 suspected cases with 13 lab-confirmed and seven (7) deaths (CFR, 2.86%) from 22 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 43 as at 4th November, 2016

2.1. In the reporting week 43 (2016), one hundred & seventy-two (172) suspected cases of Measles were recorded from 26 States compared with 451 suspected measles cases from 26 States & FCT at the same period in 2015.

2.2. So far, 23,589 suspected Measles cases and 100 deaths (CFR,0.42%) have been reported in 2016 from 36 states & FCT (Figure 3 & 4) compared with 21,519 suspected cases and 99 deaths (CFR, 0.40%) 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- 43, (2016) 10,674 confirmed Measles cases were recorded compared to 11,062 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 68.4% 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 43 as at October 28th , 2016

3.1. No Wild Polio Virus (WPV) was isolated in both weeks 43 of 2016 & 2015..

3.2. Between weeks 1 & 43, 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 - 43, 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.

3.6 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)

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

3.8 The first outbreak response (OBR) supplemental immunizations (House to house, Hit and run, and Health camps) with bOPV was conducted in 5 States in the North east (Borno, Yobe, Adamawa, Gombe and Taraba) from the 27th – 30th August 2016, while the second and third OBR were conducted in 18 States (11 high risk states plus Taraba, Adamawa, Gombe, Plateau, Nasarawa, Benue and the FCT from the 17th – 20th September 2016 and 15th – 18th October 2016 respectively

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

3.10 The SIAs were strengthened with the following events:

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

3.10.2 Use of health camp facilities.

3.10.3 Field supportive supervision and monitoring.

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

3.10.5 High level of accountability framework


Cholera

4 Update on suspected Cholera for week 43 as at 4th November, 2016

4.1 In reporting week 43 (2016), no suspected cases of cholera was recorded compared with 36 cases from 2 LGAs (2 States) at the same period in 2015 (Figure 13).

4.2 Between weeks 1 and 43 (2016), 712 suspected cholera cases, 14 Lab confirmed and 32 deaths (CFR, 4.49%) from 48 LGAs (12 States) were reported compared with 5056 cases with 29 lab-confirmed and 184 deaths (CFR, 3.64%) from 96 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 43 as at 4th November, 2016

5.1. In the reporting week 43 (2016), 11 suspected cerebrospinal meningitis (CSM) cases were reported from 3 LGAs (3 States) compared with 3 cases from 2 LGAs (2 States) at the same period in 2015.

5.2. Between weeks 1 & 43 (2016), 758 suspected CSM cases with 39 Lab. confirmed and 31 deaths (CFR, 4.09%) were recorded from 144 LGAs (31 States) compared with 2670 suspected cases with 43 Lab. Confirmed and 130 deaths (CFR, 4.87%) from 160 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, 85.70% of the 26 endemic states sent CSM reports timely while 99.0% were complete in week 1 – 43, 2016 as against 81.6% timeliness and 99.3% 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])

Highlight of the week

  • Lassa fever
  • Measles
  • poliomyelitis
  • Cholera
  • cerebrospinal meningitis (CSM)
  • Guinea worm disease

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