Weekly Epidemiological Report

August 2018 Week 34

Editoral

STRENGTHENING HEALTH SECURITY THROUGH FIELD EPIDEMIOLOGY

Posted: 11-09-2018 20:35:00 PM

The 3rd Annual Nigeria Centre for Disease Control (NCDC) and Nigeria Field Epidemiology and Laboratory Training Program (NFELTP) scientific conference held from the 4th - 6th of September, 2018.

The event which is held yearly, was a platform for field epidemiologists and public health physicians to share their scientific work with a larger public health audience. It also created an opportunity to deliberate on the application of epidemiological methods to address public health issues in Nigeria and beyond. The conference had representatives of programmes & agencies of the Federal Ministries of Health, Agriculture and Rural Development, Environment, development partners in disease control activities and the media as well as academia.

During the three day conference, several abstracts on emergency preparedness and response, risk communications, antimicrobial resistance, non-communicable diseases and other public health issues were presented and discussed.

The residents and graduates of NFELTP, and epidemiologists from NCDC, the Federal Ministries of Health and Agriculture as well as the collaborating universities, shared some of the excellent work that has been done with their experiences over the years, best practice and lesson learnt.

In concluding the conference, Dr. Chikwe Ihekweazu advised the audience especially residents and graduates of the NFELTP to rise to the challenge of strengthening health security in Nigeria through field epidemiology.


SUMMARY OF REPORTS

In the reporting week ending on August 26, 2018:

o There were 107 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 as Nigeria has reinvigorated its efforts at eradicating Polio.

o 452 suspected cases of Cholera were reported from 34 LGAs in five States (Bauchi – 3, Borno – 38, Kaduna – 20, Kano – 169 and Zamfara - 222). Of these, none was laboratory confirmed and 22 deaths were recorded.

o Ten suspected cases of Lassa fever were reported from six LGAs in six States (Bauchi – 1, Ebonyi – 1, Edo – 1, Ogun – 1, Ondo – 5 & Plateau - 1). Three were laboratory confirmed and two deaths were recorded.

o There were seven suspected cases of Cerebrospinal Meningitis (CSM) reported from five LGAs in four States (Cross Rivers – 2, Delta – 1, Enugu – 2 & Yobe – 2). Of these, none was laboratory confirmed and no death was recorded.

o There were 154 suspected cases of Measles reported from 24 States. None was laboratory confirmed and no death was recorded.

In the reporting week, all States sent in their report except Adamawa, Katsina and Taraba States. Timeliness of reporting remains 88% in both previous and current weeks (week 33 & 34) while completeness also remains 98% 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. AFP

1.1. As at August 26th 2018, no new case of WPV was recorded

1.2. In the reporting week, 107 cases of AFP were reported from 96 LGAs in 32 States

1.3. Between week 1 and 34 2018, 5573 suspected cases of AFP have been reported from 729 LGAs in 37 States

1.3.1. AFP Surveillance has been enhanced and outbreak response is on-going in Borno and other high-risk States

1.3.2. The 2nd NIPDs was conducted from 30th June to 3rd July, 2018 using bOPV in 36 States plus FCT

1.3.3. The 1st & 2nd Outbreak response (OBR) to cVDPV2 in Jigawa & Gombe States, Polio event in Sokoto (SLGAs) and mop-up response in 11 LGAs in Bauchi State conducted from 10th – 13th & 26th – 29th May, 2018 using mOPV2 respectively

1.3.4. Two SIPDs and one NIPDs were conducted from January to April, 2018 using bOPV in 18 high risk States and 36 States plus FCT respectively


2. CEREBROSPINAL MENINGITIS (CSM)

2.1 In the reporting week, seven suspected Cerebrospinal Meningitis (CSM) cases and two were reported from five LGAs (four States; Cross Rivers – 2, Delta – 1, Enugu – 2 & Yobe – 2) compared with eight suspected cases reported from three LGAs (three States) at the same period in 2017 (Figure 1)

2.2 Between weeks 1 and 34 (2018), 3263 suspected meningitis cases with 108 laboratory confirmed and 209 deaths (CFR, 6.41%) from 264 LGAs (32 States) were reported compared with 9776 suspected cases and 602 deaths (CFR, 6.2%) from 311 LGAs (33 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 - 34, 2018 as against 76.4% timeliness and 92.3% completeness recorded within the same period in 2017


CHOLERA

3.1 452 suspected cases of Cholera and 22 deaths (CFR, 4.87%) were reported from 34 LGAs (five States; Bauchi – 3, Borno – 38, Kaduna – 20, Kano – 169 and Zamfara - 222) in week 34, 2018 compared with 106 suspected cases and two deaths (CFR, 1.9%) reported from six LGAs (two States) during the same period in 2017 (Figure 2).

3.2 Between weeks 1 and 34 (2018), 14,762 suspected Cholera cases with 389 laboratory confirmed and 258 deaths (CFR, 1.78%) from 135 LGAs (23 States) were reported compared with 1198 suspected cases and 32 deaths (CFR, 2.67%) from 47 LGAs (16 States) during the same period in 2017.

3.3 A National Emergency Operations Centre (EOC) for Cholera has been activated at level 2 at NCDC.

3.4 Rapid Response Teams have been deployed to respond to recent cluster of cases in Kano, Bauchi, Plateau, Zamfara and Adamawa States.

3.5 NCDC and partners conducted the development of medium term strategies for Cholera control including mapping of the hot spots in Nigeria on the 19th of July, 2018.

3.6 National coordination team led by NCDC Incident Manager conducted an advocacy visit to Sokoto and Zamfara States to reinforce the ongoing response, strengthen the IMS structure and partner collaboration.

3.7 National Preparedness and Response to Acute Watery Diarrhoea/ Cholera Guidelines available via http://ncdc.gov.ng/themes/common/docs/protocols/45_1507196550.pdf


LASSA FEVER

4.1 In the reporting Week 34 (August 20 - 26, 2018) three new confirmed I cases were reported from Bauchi (1), Edo (1) and Ebonyi (1) with two new deaths from Bauchi (1) and Ebonyi (1) States.

4.2 From 1st January to 26th August 2018, a total of 2434 suspectedi cases have been reported from 22 states. Of these, 492 were confirmed positive, 10 are probable, 1931 negative (not a case)

4.3 Since the onset of the 2018 outbreak, there have been 130 deaths in confirmed cases and 10 in probable cases. Case Fatality Rate in confirmed cases is 26.4%

4.4 22 states have recorded at least one confirmed case across 74 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). Seventeen states have exited the active phase of the outbreak while five – Edo, Ondo, Ebonyi, Bauchi and Gombe States remain activeiv

4.5 NCDC and Partners deployed Rapid Response Team (RRT) to Enugu and Edo States

4.6 Supplies for Lassa fever management procured through UNICEF and distributed to all LF affected states

4.7 Lassa fever international Conference registration, abstract submission and sponsorship now open to the public on the conference website www.lic.ncdc.gov.ng

4.8 The Lassa fever national multi-partner, multi-agency Technical Working Group (TWG) continues to coordinate response activities at all levels. Response and laboratory supplies have been provided to priority States

4.9 National VHF guidelines (National Viral Haemorrhagic Fevers Preparedness guidelines, Infection Prevention and Control of VHF and Standard Operating Procedures for Lassa fever management) are available on the NCDC website- http://ncdc.gov.ng/diseases/guidelines



5 MEASLES

5.1 In the reporting week, 154 suspected cases of Measles were reported from 24 States compared with 344 suspected cases and four deaths (CFR, 1.2%) reported from 30 States during the same period in 2017

5.2 So far, 13529 suspected Measles cases with 901 Lab. Confirmed and 100 deaths (CFR, 0.74%) were reported from 36 States and FCT compared with 17177 suspected cases with 108 laboratory confirmed and 105 deaths (CFR, 0.61 %) from 37 States 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

5.4 NCDC and partners visited Edo and Cross River states to assess the laboratories in preparation for the establishment of a Zonal Measles/YF lab in the South South States

5.5 NCDC RRT conducted detailed investigation of measles outbreak in Oyo State


6 Yellow fever

6.1 In this reporting week 20th – 26th August, 2018, 19 suspected cases were added to the national line list

6.2 No new in-country presumptive positive was report in the reporting week, last presumptive positive case in the Nigerian lab was 2nd July, 2018 and last IP Dakar confirmed case from Nigeria was on 6th June, 2018

6.3 From the onset of this outbreak on September 12, 2017, a total of 2,787 suspected yellow fever cases with 47 Laboratory confirmed and 47 deaths (CFR, 1.7%) have been reported from 504 LGAs (36 States & FCT)

6.4 Predominant age groups affected among the suspected cases are 20 years and below accounting for 62.8%; [male to female ratio is 1.4 to 1 (male 57.8%, female 42.2%)]

6.5 Yellow fever reactive vaccination campaigns conducted in the following States [Kebbi (7 LGAs), Niger (5 LGAs), Sokoto (1 LGA) & Katsina (1 LGA)]

6.6 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

6.7 Follow up on ICG request for Yellow fever reactive vaccination campaigns in Ekiti (Irepodun/Ifelodun LGA), Edo (Etsako East LGA) and Rivers (Ikwerre LGA)

6.8 Surveillance activities have been intensified across all States

6.9 NCDC and partners have completed the assessment of some laboratories in Nigeria for possible inclusion into the testing laboratory network

6.10 NCDC & partners conducted detailed case investigation in Edo and Ekiti states following recent reports and currently in Rivers State


7. Update on national Influenza sentinel surveillance, Nigeria week 1 - 31, 2018

7.1. From week 1- 30, 175-suspected cases were reported, of which 155 were Influenza like-illness (ILI), 20 Severe Acute Respiratory Infection (SARI).

7.2 A total of 175 samples were received and all samples were processed. Of the processed samples, 155(88.6%) were ILI cases, 20 (11.4%) were Severe Acute Respiratory Infection (SARI).

7.4. Of the 155 processed ILI samples, 16 (10.3%) was positive for Influenza A; 26(16.8%) positive for Influenza B and 113 (72.9%) were negative.

7.5 For the processed 20 SARI samples, five (25.0%) were positive for Influenza A while the remaining 15 (75.0%) were negative.

7.6 42 (24.0%) of the processed 175 samples were positive for Influenza, with 16 (38.1%) of these positive for Influenza A and 26 (61.9%) positive for Influenza B.

7.5. The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for (0.0%), 11 (68.8%) and 5 (31.2%) of the total influenza A positive samples respectively.

7.6 The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 10(38.5%), 16(61.5%) and 0(0.0%) of the total influenza B positive samples respectively

7.7 The percentage influenza positive was highest (75.0%) in week 6, 2018

7.8 In the reporting week 1 -31, all samples were processed

FOR MORE INFORMATION CONTACT

Surveillance Unit:

Nigeria Centre for Disease Control,

801 Ebitu Ukiwe Street, Jabi, Abuja, Nigeria.

[email protected]

www.ncdc.gov.ng/reports

0800-970000-10

Highlight of the week

  • SUMMARY OF REPORTS
  • REPORT ANALYSIS AND INTERPRETATION
  • 2. CEREBROSPINAL MENINGITIS (CSM)
  • CHOLERA
  • LASSA FEVER
  • 5 MEASLES
  • 6 Yellow fever
  • 7. Update on national Influenza sentinel surveillance, Nigeria week 1 - 31, 2018

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