Weekly Epidemiological Report

April 2019 Week 16


NCDC Begins Congenital Rubella Surveillance in Nigeria

Posted: 07-05-2019 10:25:24 AM

Congenital Rubella Syndrome (CRS) is a vaccine preventable condition which usually affects children resulting in long term disability, poor quality of life and low life expectancy. The cost of correcting the disability caused by CRS is usually unaffordable especially in the low resource setting like Nigeria. Unfortunately, there are no reliable data on the national burden of CRS in Nigeria.

As part of its mandate to protect the health of Nigerians, NCDC has made significant progress towards introducing an effective surveillance system to determine the true burden of CRS. With this step, it is expected that there will be improved knowledge of the disease, as well as baseline data to estimate the true burden of CRS. This will provide support for the planned introduction of Rubella Vaccine into the National Program on Immunization.

To this end, NCDC has recently conducted an assessment of tertiary health facilities across geopolitical zones to identify potential rubella focal sites for inclusion into the National rubella sentinel sites. This was followed by a national CRS workshop with the aim of bringing selected facilities together to agree on common principles and identify site coordinators as well site surveillance focal points. Consequently, four tertiary health facilities were selected as sentinel sites and these included:

- Lagos University Teaching Hospital

- University of Enugu Teaching Hospital

- Jos University Teaching Hospital

- Aminu Kano Teaching Hospital

These sentinel sites will work closely with the NCDC and its National Reference Laboratory, as the foundation for a national CRS surveillance system in Nigeria. We are grateful to the US Centers for Disease Control (US CDC) for the technical support provided in this project.

Summary of Incidents

* Ongoing Incidents are defined as confirmed cases where a national EOC or equivalent has been activated (EOC is currently activated for Lassa fever, Cerebrospinal meningitis and Measles)

Other incidents are those confirmed cases for which EOC is not activated


1. Information for this disease was retrieved from the Technical Working Group and Situation Reports

2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only

3. Information for this disease was retrieved from IDSR 002 data

4. CFR for this disease is reported for total cases i.e. suspected + confirmed

5. Information for sentinel influenza was retrieved from the laboratory

Lassa Fever

Key points

• There were 71 suspected cases of Lassa fever reported from 19 LGAs in 10 States (Edo – 30, Ondo – 10, Bauchi - 4, Ebonyi – 16, Plateau – 4, Kogi – 1, Enugu – 1, Delta – 1, Kebbi – 1 & Taraba – 3). Six were laboratory confirmed and no death was recorded.

• In the reporting week 16, no new health care worker was affected


To date:

• National Lassa fever Emergency Operations Centre (EOC) continues to coordinate the response activities at all levels


• Declaration of outbreak emergency phase over based on composite indicators

• Deployment of multi-sectoral RRT to Kebbi State

• Dissemination of case management guidelines is ongoing

Cerebrospinal Meningitis (CSM)

Key points

• There were 59 suspected cases of Cerebrospinal Meningitis (CSM) reported from 42 LGAs in 19 States (Bauchi – 3, Bayelsa – 1, Cross River – 2, Delta – 1, Enugu – 1, Gombe – 7, Jigawa – 6, Kaduna – 1, Kano – 3, Katsina – 12, Kebbi - 3, Kogi – 3, Kwara – 2, Niger – 1, Osun – 1, Rivers – 4, Sokoto – 3, Yobe – 4 & Zamfara - 1). Of these, none was laboratory confirmed and two deaths were recorded

• Shinkafi LGA, Zamfara State crossed Alert Threshold in week15 with an attack rate of 4.4 per 100.000 population.


To date:

• The National CSM EOC meets weekly to review the national situation

• Training in other States on CSM case management, sample and data management.


• Intensify active CSM case search and enhanced surveillance to monitor progress being made.

Yellow Fever

Key points


To date:

• A multiagency Yellow fever TWG is coordinating the response activities

• Rapid Response Teams have been deployed to Abia, Delta, Ondo, Imo and Osun states

• Development of National Guideline on Preparedness and Response is ongoing


• A follow up with the yellow fever reactive vaccination campaign pre-implementation activities in the approved states and their respective LGAs.


Key points

There were 96 suspected cases of cholera reported from four LGAs in two States (Bayelsa – 95 & Ondo – 1). None was laboratory confirmed and no death recorded.


To date:

• NCDC cholera Technical Working Group (TWG) continues to coordinate Cholera activities in states collaborating with FMWR and support from partners

• TWG meets bi-weekly to review activities, reports from states and plan on new strategies

• A sensitization workshop was conducted on Hygiene for market women, religious leaders, motor park leaders, NGOs and Volunteers in Adamawa and Bauchi states


• A contract has been awarded for the construction of 107 sanitation facilities in Kebbi, Adamawa and Gombe states.

• A second round of OCV campaign to be conducted in Argungu LGA, Kebbi state and Michika LGA, Adamawa State in May

• Review cholera advisory and disseminate ahead of the season.


Key points

• There were 1977 suspected cases of measles reported from 32 States and FCT. None was laboratory confirmed and nine deaths were recorded


To date:

• The Measles Emergency Operation Center (EOC) continues to coordinate activities weekly

Continued engagement with states for early submission of data

• RRT deployed to support case management and EOC coordination in Borno State


• Deploy RRT to support emergency response in Katsina, Adamawa and Yobe states

• Follow up with NPHCDA on plan to resubmit ICG request for Katsina and Yobe States

• Field testing and piloting of Measles IEC materials.

Acute Flaccid Paralysis (AFP)

Key points

• As at 21st April 2019, no new case of WPV was recorded

• The last reported case of polio in Nigeria was in August 2016

• In the reporting week, 182 suspected cases of AFP were reported from 145 LGAs in 33 States and FCT


To date:

• Active case search for AFP is being intensified with the goal to eliminate polio in Nigeria


• Intensify active AFP case search and continue to monitor progress being made to eliminate polio in Nigeria.

National Influenza Sentinel Surveillance

Key points

• The predominant Influenza A subtype so far this year was A seasonal H3 19 (95%).

• The predominant Influenza B subtype so far this year was B not subtyped 2(100%).

Highlight of the week

  • Summary of Incidents
  • Lassa Fever
  • Cerebrospinal Meningitis (CSM)
  • Yellow Fever
  • Cholera
  • Measles
  • Acute Flaccid Paralysis (AFP)
  • National Influenza Sentinel Surveillance

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