During the week in view, a simulation for a global pandemic response involving more than 40 countries took place from the 4th – 6th of December 2018. This was coordinated by the World Health Organization’s (WHO) Global Emergency Operations Centre (EOC) and the ‘EOC Network’, a global network of health emergency operations centres.
While the activity was the first global pandemic response training exercise, it was the second simulation exercise for the Nigeria Centre for Disease Control’s Incident Coordination Centre.
The scenario revolved around an ‘outbreak of influenza’ with pandemic potential on the fictional island nation of Mizzou, located off the coast of North America. There was no actual virus: it was a training exercise. The training exercise took place within the offices of national and international EOCs, without the deployment of people or goods and the exercise or disruption of public activities.
In Nigeria, participants included officers from the NCDC Incident Coordination Centre (ICC), the ‘one health’ Ministries (Federal Ministry of Health, Federal Ministry of Environment, and the Federal Ministry of Agriculture and Rural Development), WHO country office and the US Centers for Disease Control and Prevention (US CDC) Country Office. A representative from Public Health England was part of the exercise as the evaluator for Nigeria. It was an opportunity to be networked with other national EOCs that participated in the interactive scenario.
This exercise offered an opportunity for participating countries including Nigeria, to test their plans and capabilities in a realistic environment- in the event of a pandemic. Evaluators watched how the participating EOCs perform in real time, measuring performance against what was expected from existing procedures.
This experience identified gaps and opportunities that will ultimately help in the assessment and improvement of countries’ readiness to respond jointly and effectively to a global public health emergency.
The invitation to Nigeria to participate in this global exercise through the NCDC is a recognition of the critical role of NCDC in global health security.
For more information on Influenza and Nigeria’s preparedness, visit: https://ncdc.gov.ng/diseases/factsheet/28
SUMMARY OF REPORTS
In the reporting week ending on November 25, 2018:
o There were 146 new cases of Acute Flaccid Paralysis (AFP) reported. None was confirmed as polio. The last reported case of polio in Nigeria was in August 2016. Active case search for AFP is being intensified with the goal to eliminate polio in Nigeria.
o There were 61 suspected cases of Cholera reported from 13 LGAs in eight States (Adamawa – 6, Bauchi – 1, Borno – 16, Cross River – 2, Kano – 17, Katsina – 3, Osun – 1 and Yobe - 15). Of these, no was laboratory confirmed and no death was recorded.
o There were 13 suspected cases of Lassa fever reported from four LGAs in three States (Edo – 5, Kaduna - 1 & Ondo - 7). Six were laboratory confirmed and no death was recorded.
o There were 16 suspected cases of Cerebrospinal Meningitis (CSM) reported from 11 LGAs in six States (Bayelsa – 1, Kaduna – 4, Katsina – 5, Niger – 1, Sokoto - 1 & Yobe – 4). Of these, none was laboratory confirmed and no death was recorded.
o There were 216 suspected cases of measles reported from 33 States. None was laboratory confirmed and no death was recorded.
In the reporting week, all States sent in their report. Timeliness of reporting remains 87% in both previous and current weeks (46 & 47) while completeness also remains 99% at same period. It is very important for all States to ensure timely and complete reporting at all times, especially during an outbreak.
REPORT ANALYSIS AND INTERPRETATION
1.1. As at November 25th 2018, no new case of WPV was recorded
1.2. In the reporting week, 146 cases of AFP were reported from 126 LGAs in 35 States
1.3. Between week 1 and 47 2018, 7992 suspected cases of AFP have been reported from 752 LGAs in 37 States
2. CEREBROSPINAL MENINGITIS (CSM)
2.1 In the reporting week, 16 suspected Cerebrospinal Meningitis (CSM) cases were reported from 11 LGAs (six States; Bayelsa – 1, Kaduna – 4, Katsina – 5, Niger – 1, Sokoto - 1 & Yobe – 4) compared with 23 suspected case reported from nine LGAs (five States) at the same period in 2017 (Figure 1)
2.2 Between weeks 1 and 47 (2018), 4432 suspected meningitis cases with 318 laboratory confirmed and 359 deaths (CFR, 8.1%) from 297 LGAs (34 States) were reported compared with 9902 suspected cases and 602 deaths (CFR, 6.1%) from 326 LGAs (34 States) during the same period in 2017.
2.3 Timeliness/completeness of CSM case-reporting from States to the National Level (2018 versus 2017): on average, 88.2% of the 26 endemic States sent CSM reports in a timely manner while 98.2% were complete in week 1 - 47, 2018 as against 76.4% timeliness and 92.3% completeness recorded within the same period in 2017
3.1 61 suspected cases of Cholera were reported from 13 LGAs (eight States; Adamawa – 6, Bauchi – 1, Borno – 16, Cross River – 2, Kano – 17, Katsina – 3, Osun – 1 and Yobe - 15) in week 47, 2018 compared with seven suspected cases reported from three LGAs (three States) during the same period in 2017 (Figure 2).
3.2 Between weeks 1 and 47 (2018), 50,401 suspected Cholera cases with 934 laboratory confirmed and 1127 deaths (CFR, 2.3%) from 244 LGAs (30 States) were reported compared with 3695 suspected cases and 84 deaths (CFR, 2.3%) from 73 LGAs (19 States) during the same period in 2017.
3.3 The cholera National Emergency Operations Centre (EOC) has been de-escalated to a Technical Working Group following decline in number of new cases reported from States for the last six weeks.
3.4 National Preparedness and Response to Acute Watery Diarrhoea/ Cholera Guidelines available via http://ncdc.gov.ng/themes/common/docs/protocols/45_1507196550.pdf
4 LASSA FEVER
4.1 In the reporting Week 47 (19 – 25 November, 2018) six new confirmed I cases were reported from Edo (3) and Ondo (3) States with no new death
4.2 From 1st January to 25th November 2018, a total of 3142 suspectedi cases have been reported from 22 states. Of these, 568 were confirmed positive, 17 are probable, 2557 negative (not a case)
4.3 Since the onset of the 2018 outbreak, there have been 144 deaths in confirmed cases and 17 in probable cases. Case Fatality Rate in confirmed cases is 25.4%
4.4 22 states have recorded at least one confirmed case across 90 Local Government Areas (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo, Plateau, Lagos, Taraba, Delta, Osun, Rivers, FCT, Gombe, Ekiti, Kaduna, Abia, Adamawa and Enugu). Nineteen states have exited the active phase of the outbreak while three – Edo, Ondo and Ebonyi States remain activeiv
4.5 Good clinical practice workshop in collaboration with World Health Organisation ongoing
4.6 Lassa fever international Conference scheduled for 16th to 17th January 2019, registration is ongoing on @ www.lic.ncdc.gov.ng
4.7 The Lassa fever national multi-partner, multi-agency Technical Working Group (TWG) continues to coordinate response activities at all levels.
5.1 In the reporting week, 216 suspected cases of measles were reported from 33 States compared with 282 suspected cases with one Lab confirmed reported from 30 States during the same period in 2017
5.2 Since the beginning of the year, 16159 suspected measles cases with 1110 Lab. Confirmed and 123 deaths (CFR, 0.8%) were reported from 36 States and FCT compared with 20884 suspected cases with 109 laboratory confirmed and 112 deaths (CFR, 0.54 %) from 36 States and FCT, during the same period in 2017
5.3 Response measures include immunization for all vaccine-preventable diseases in some selected/affected wards/LGAs during SIAs, as well as case management
6 Yellow fever
6.1 In the reporting week 47 (19th – 25th November), three new suspected cases were reported from Edo State with two presumptive positives
6.2 Two new confirmed cases from Nigeria were reported by the WHO reference laboratory, Institute Pasteur Dakar; from Katsina (1) and Kebbi (1).
6.3 From the onset of this outbreak on September 12, 2017, a total of 3,456 suspected yellow fever cases with 56 Laboratory confirmed and 55 deaths (CFR, 1.6%) have been reported from 570 LGAs (36 States & FCT)
6.4 A total of 58 cases have been confirmed by IP Dakar from 14 states (Kwara, Kogi, Kano, Zamfara, Kebbi, Nasarawa, Niger, Katsina, Edo, Ekiti, Rivers, Anambra, FCT, and Benue States)
6.5 A multi-agency national Emergency Operations Centre is coordinating the national response
6.6 Yellow fever reactive vaccination campaigns conducted in the following States [Kebbi (7 LGAs), Niger (5 LGAs), Sokoto (1 LGA) & Katsina (1 LGA)]
6.7 Yellow fever vaccination campaigns have been successfully completed in six States (Nassarawa, Cross River, Akwa-Ibom, Kogi, Kwara & Zamfara) and 57 political wards in 25 LGAs in Borno State
6.8 Two Rapid Response Teams have been deployed to support the ongoing response in Edo state
6.9 The 2018 phase 2b November PMVC implementing is ongong from 22nd November – 1st December, 2018 in Sokoto, Kebbi, Niger, FCT, Plateau and some LGAs in Borno States. Target population 9 months to 44 years, (85% of the total population)
7. Update on national Influenza sentinel surveillance, Nigeria week 1 – 48, 2018
7.1. From week 1- 48, 363-suspected cases were reported, of which 325 were Influenza like-illness (ILI), 38 Severe Acute Respiratory Infection (SARI).
7.2 A total of 363 samples were received and all samples were processed. Of the processed samples, 325(89.5%) were ILI cases, 38 (10.5%) were Severe Acute Respiratory Infection (SARI).
7.3 Of the 325 processed ILI samples, 34 (10.7%) was positive for Influenza A; 31(9.5%) positive for Influenza B and 260 (79.8%) were negative.
7.4 For the processed 37 SARI samples, seven (18.4%) were positive for Influenza A, three (7.9%) were positive for Influenza B, while the remaining 28 (73.7%) were negative.
7.5 Of the 363 processed samples, 75 (20.7%) were positive for Influenza, with 41 (54.7%) of these positive for Influenza A and 34 (45.3%) positive for Influenza B.
7.6 The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 2(4.9%), 24 (58.5%) and 15 (36.6%) of the total influenza A positive samples respectively.
7.7 The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 24(70.6%), 7(20.6%) and 3(8.8%) of the total influenza B positive samples respectively
7.8 The percentage of influenza positive was highest (100.0%) in week 43, 2018
7.9 In the reporting week 1 -48, all samples were processed
FOR MORE INFORMATION CONTACT
Nigeria Centre for Disease Control,
801 Ebitu Ukiwe Street, Jabi, Abuja, Nigeria.