Weekly Epidemiological Report

March 2019 Week 12


Nigeria’s Alliance for Epidemic Preparedness and Response- Private Sector and Health Security

Posted: 09-04-2019 08:07:13 AM

Partnerships are critical for the functions delivered by national public health institutes. Since its establishment, the Nigeria Centre for Disease Control (NCDC) has utilised a network of partners, integrating their support with the primary funding that we receive from the Federal Government of Nigeria.

Nigeria’s response to the 2014 Ebola outbreak is a good example of how strong partnerships can support our work during outbreaks. During the outbreak, the country benefited immensely from the support of the private sector. They made several contributions ranging from hiring and paying extra staff to work in the Emergency Operations Centres, to providing medical supplies and logistics, as well as providing training opportunities for responders.

In August 2018, NCDC partnered with the Private Sector Health Alliance of Nigeria to develop an initiative called the ‘Alliance for Emergency Preparedness and Response (A4EPR)’. This is a formal structure for NCDC to engage with the private sector to effectively protect the health of Nigerians. The goal is to work with private businesses, philanthropists and foundations to strengthen the country’s outbreak preparedness and response capacity.

The A4EPR is a recognition of the strength that public and private institutions have, when they work together for health security. The collaborative relationship with private organisations such as the Tony Blair Institute (TBI) has helped our work, especially in NCDC’s formative years. Specifically, the Institute has supported NCDC in developing and implementing a strategy plan, strengthening communications and partnerships as well as building our leadership, management and development framework.

In a remarkable way to show the strong and collaborative partnership between NCDC and TBI, the NCDC hosted the Executive Chairman of the organisation and former Prime Minister of the United Kingdom, Tony Blair on the 5th of April 2019.

The NCDC remains committed to working closely with private sector organisations in the delivery of our mandate to protect the health of Nigerians.


In the reporting week ending March 24, 2019:

o There were 153 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 25 suspected cases of cholera reported from five LGAs in three States (Bayelsa – 14, Kano – 10 & Taraba – 1). No was laboratory confirmed and three deaths recorded.

o There were 126 suspected cases of Lassa fever reported from 19 LGAs in nine States (Edo – 26, Ebonyi – 20, Ondo – 17, Bauchi - 38, Enugu – 8, Gombe – 2, Adamawa – 2, Taraba – 3 & Plateau – 10). Fifteen were laboratory confirmed and five deaths were recorded.

o There were 98 suspected cases of Cerebrospinal Meningitis (CSM) reported from 44 LGAs in 13 States (Adamawa – 1, Bayelsa – 4, Borno – 2, Gombe – 3, Jigawa – 2, Kano – 6, Katsina – 49, Kebbi - 3, Niger – 1, Oyo – 1, Sokoto – 18, Yobe – 1 & Zamfara - 7). Of these, none was laboratory confirmed and seven deaths were recorded.

o There were 2567 suspected cases of measles reported from 36 States. None was laboratory confirmed and two deaths were recorded.

In the reporting week, all States sent in their reports except Delta. Timeliness of reporting remained 93.0% in both weeks eleven & twelve while completeness remains 99.0% at the same period. It is very important for all States to ensure timely and complete reporting at all times, especially during an outbreak.


1. AFP

1.1 As at March 24 2019, no new case of WPV was recorded

1.2 In the reporting week, 153 suspected cases of AFP were reported from 132 LGAs in 32 States and FCT

1.3 Between week 1 and 12 (2019), 1506 suspected cases of AFP were reported from 591 LGAs in 36 states and FCT


2.1 In the reporting week, 98 suspected Cerebrospinal Meningitis (CSM) cases and seven deaths (CFR, 7.1%) were reported from 44 LGAs in 13 States (Adamawa – 1, Bayelsa – 4, Borno – 2, Gombe – 3, Jigawa – 2, Kano – 6, Katsina – 49, Kebbi - 3, Niger – 1, Oyo – 1, Sokoto – 18, Yobe – 1 & Zamfara - 7) compared with 224 suspected cases with 14 laboratory confirmed and seven deaths (CFR, 3.1%) reported across 65 LGAs (14 States) at the same period in 2018 (Figure 1)

2.2 Between weeks 1 and 12 (2019), 703 suspected meningitis cases with 44 laboratory confirmed and 47 deaths (CFR, 6.69%) from 157 LGAs (26 States) were reported compared with 2222 suspected cases with 254 Laboratory confirmed and 203 deaths (CFR, 9.14%) from 211 LGAs in 25 states during the same period in 2018

2.3 Timeliness/completeness of CSM case-reporting from states to the national level (2019 versus 2018): on average, 92.6% of the 26 endemic States sent CSM reports in a timely manner while 99.8% were complete in week 1 - 12, 2019 as against 88.5% timeliness and 95.2% completeness recorded within the same period in 2018

2.4 NCDC deployed Rapid Response Team (RRT) to Katsina and Niger States

2.5 NCDC and WHO conducted training on CSF collection and enhanced surveillance for clinicians and surveillance officers in Katsina State

2.6 The CSM National Emergency Operations Centre (EOC) is on response mode and meets weekly to review the situation

2.7 CSM preparedness and response assessment checklist form sent to all States


3.1 25 suspected cases of cholera and three deaths (CFR, 12.0%) were reported from five LGAs in three States (Bayelsa – 14, Kano – 10 & Taraba – 1) compared with 351 suspected cases with six laboratory confirmed and five deaths (CFR, 1.4%) reported from nine LGAs in seven States during the same period in 2018 (Figure 2).

3.2 Between weeks 1 and 12 (2019), 362 suspected cholera cases with six laboratory confirmed and 24 deaths (CFR, 6.63%) from 18 LGAs (eight states) were reported compared with 2264 suspected cases and 44 deaths (CFR, 2.1%) from 62 LGAs in 15 States during the same period in 2018.

3.3 NCDC deployed a Rapid Respose Team (RRT) to Bayelsa State to assess the current situation

3.4 NCDC has disseminated cholera alert mails and line list template to all states in preparedness for dry season transmission

3.5 NCDC is supporting ongoing Oral Cholera vaccination campaign (28th March – 3rd April) through supervision in Michika LGA, Adamawa State.

3.6 National Preparedness and Response to Acute Watery Diarrhoea/Cholera Guidelines. Available from



4.1 In the reporting Week 12 (18th – 24th March, 2019), fifteen new confirmed I cases were reported from six States - Edo (4), Ondo (3),Plalteau (2), Bauchi (3), Taraba (2) and Ebonyi (1) States with five new deaths in Edo (2), Ondo (2) and Bauchi (1)States. Decline in number of new cases

4.2 From 1st January – 24th March 2019, a total of 1924 suspectedi cases have been reported from 21 States including FCT. Of these, 510 were confirmed positive, 15 probable and 1511 negatives (not a case).

4.3 Since the onset of the 2019 outbreak, there have been 117* deaths among confirmed cases. Case Fatality Rate in confirmed cases is 22.9%

4.4 Twenty-one states have recorded at least one confirmed case across 74 LGAs (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Plateau, Taraba, FCT, Adamawa, Gombe, Kaduna, Kwara, Benue, Rivers, Kogi, Enugu, Imo, Delta, Oyo, Kebbi & Cross River)

4.5 Multi sectoral one health national rapid response teams (NCDC, NFELTP, Federal Ministry of Agricultural and Federal Ministry of Environment) deployed to Taraba and Bauchi states

4.6 Assessment of the two treatment centres in Plateau state by NCDC case management team

4.7 NCDC provided an ambulance to the Infection Control Centre of Federal Medical Centre Owo

4.8 NCDC prepositioned PPEs, Ribavirin (injection and tablets), beds, Tents, body-bags, thermometers, hypochlorite hand sanitizers, IEC materials, guidelines and SOPS distributed across 36 states, FCT and treatment centres

4.9 A National Lassa fever multi-partner, multi-sectoral Emergency Operational Centre (EOC) continues to coordinate the response activities at all levels.


5.1 In the reporting week, 2567 suspected cases of measles with laboratory confirmed cases and two deaths (CFR, 0.08%) were reported from 36 states compared with 782 suspected cases with four laboratory confirmed and 16 deaths (CFR,2.05%) reported from 34 states during the same period in 2018

5.2 Since the beginning of the year, 14171 suspected measles cases with 535 laboratory confirmed and 29 deaths (CFR, 0.20%) were reported from 36 states and FCT compared with 5548 suspected cases and 50 deaths (CFR, 0.90 %) from 36 States and FCT, during the same period in 2018

5.3 Response measures include immunization for all vaccine-preventable diseases in some selected/affected wards and LGAs during Supplementary Immunization Activities (SIAs), as well as case management

5.4 NCDC deployed Rapid Respose Team (RRT) to Yobe State to access the current situation

5.5 A National Measles multi-partner, multi-sectoral Emergency Operational Centre (EOC) activated on the 10th March, 2019 to coordinate response activities

6 Yellow fever

6.1 In the reporting week 9 (24th February – 3rd March, 2019), eight suspected yellow fever cases were recorded in Nigeria

6.2 No new confirmed case from Institute Pasteur (IP) Dakar and the last IP Dakar confirmed cases was on the 20th of February 2019

6.3 From 1st January – 3rd March 2019, 364 suspected cases have been recorded from 177 LGAs across the country with blood samples collected from all cases. Of these, five were confirmed positive with no death recorded so far.

6.4 From the onset of this outbreak on September 12, 2017 to date, 4,100 suspected cases were reported from 604 (78.0%) LGAs in all the 36 States and FCT

6.5 A total of 139 cases have been confirmed by IP Dakar from 17 states (Kwara (8), Kogi (10), Kano (1), Zamfara (19), Kebbi (7), Nasarawa (3), Niger (1), Katsina (2), Edo (69), Ekiti (2), Rivers (1), Anambra (1), FCT (10), Benue (1), Delta (1), Ondo (2) and Abia (1) States) in 46 Local Government areas (LGAs).

6.6 Since the onset of the outbreak, 80 deaths were recorded among all cases with 29 deaths among IP Dakar confirmed cases. Case Fatality Rates (CFR) in all cases (suspected, probable & confirmed) and among IP Dakar confirmed cases is 2.0% and 21. 0% respectively

6.7 Yellow fever reactive vaccination campaigns were conducted in the following States: Edo (13 LGAs), Kebbi (7 LGAs), Niger (5 LGAs), Sokoto (1 LGA) &

6.8 Yellow fever vaccination campaigns have been successfully completed in 12 States (Nasarawa, Cross River, Akwa-Ibom, Kogi, Kwara, Zamfara, Sokoto, Kebbi, Niger, FCT, Plateau & Borno) and 57 political wards in 25 LGAs in Borno State. Another campaign to commence in Vandekeiya LGA in Benue State

6.9 A multi-agency national Emergency Operations Centre is coordinating the national response

6.9.1 Yellow fever After Action Review (AAR) being planned and is slated for April 2019

7. Update on national Influenza sentinel surveillance, Nigeria week 1 – 13, 2019

7.1 From week 1- 13 2019, a total of 106 samples were recruited, of which 99 were Influenza like-illness (ILI) and seven was Severe Acute Respiratory Infection (SARI) .

7.2 A total of 106 samples were received and all samples were processed. Of the processed samples, 99(93.4%) were ILI cases and 7 (6.6%) was Severe Acute Respiratory Infection (SARI).

7.3 Of the 99 processed ILI samples, 12(12.1%) were positive for Influenza A; 2(2.0%) was positive for Influenza B and 85 (85.9%) were negative.

7.4 For the processed seven SARI samples, 3(42.9%) were positive for Influenza A, 0(0.0%) for Influenza B and 4(57.1%) were negative.

7.5 Of the 99 processed samples, 17 (16.0%) were positive for Influenza, with 15 (88.2%) of these positive for Influenza A and 2 (11.8%) positive for Influenza B.

7.6 The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 15 (100.0%), 0 (0.0%) and 0 (0.0%) of the total influenza A positive samples respectively.

7.7 The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 0(0.0%), 2(100.0%) and 0(0.0%) of the total influenza B positive samples respectively

7.8 The percentage of influenza positive was highest (100.0%) in week 8, 2019

7.9 In the reporting week 1- 13, all samples were duely processed


Surveillance Unit:

Nigeria Centre for Disease Control,

801 Ebitu Ukiwe Street, Jabi, Abuja, Nigeria.

[email protected]



Highlight of the week

  • 3. CHOLERA
  • 6 Yellow fever
  • 7. Update on national Influenza sentinel surveillance, Nigeria week 1 – 13, 2019

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