In providing care to patients, health care workers are particularly vulnerable to infection. This would often occur in context where there is poor infection prevention and control (IPC) practice. During the 2018 Lassa fever outbreak, there were infections and deaths among health workers. A paper was published here to describe this.
Following lessons learnt and to prevent the spread of nosocomial infections, the Nigeria Centre for Disease Control has launched a national IPC programme called “Turn Nigeria Orange Project” (TNO). This is a comprehensive five-year programme (2019 -2023) aimed at supporting health facilities across Nigeria, in setting up IPC programmes particularly hand hygiene. The goal is to use a multimodal strategy to develop and implement hand hygiene programmes.
To raise awareness on the project and as a show of political commitment to health security, the Chairman of the Senate Committee on Health, Distinguished Senator Lanre Tejuoso was selected to serve as the national IPC champion. In this role, the Distinguished Senator will support in raising awareness about, and encourage participation in hand hygiene activities.
Over the next five years, the core components of the TNO programme that will be implemented using multimodal strategies at the national and health facility levels are: IPC training programmes at national and health facility level; review and dissemination of the national IPC Guidelines; IPC education and training; monitoring, audit and feedback, among others.
The NCDC continues to work closely with partners including Germany’s national public health institute, the Robert Koch Institute (RKI). RKI has supported the strengthening of IPC capacity at NCDC and health facilities.
The NCDC remains committed to developing structures and designing interventions to protect the health of all Nigerians, especially health workers. Health workers are advised to practice universal care precautions and hand hygiene, at all times. Clean hands save lives!
Editor’s note: Do you know that the World Health Organisation celebrates annual World Hand hygiene Day on the 5th of May every year? The NCDC recently joined the global community to celebrate the Hand hygiene Day on the 5th of May 2019.
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
• There were 56 suspected cases of Lassa Fever in 10 states (Edo 30, Ondo 7, Ebonyi 8, Bauchi 2, Plateau 2, Taraba 1, Kogi 2, Enugu 1, Ogun 1, Kebbi 2). Four cases were confirmed from Edo, Ebonyi and Taraba States with no deaths.
• National Lassa fever multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate the response activities at all levels
• Multi sectoral one health national rapid response teams (NCDC and FMEnv) deployed to Kebbi State
• Outbreak emergency phase has been declared over based on composite indicators
• Support FMEnv to conduct LF National Environmental Response (Community rodent control, hygiene promotion) in collaboration with WHO
• Support indigent patients with treatment cost through Basic Health Care Provision Funds
Harmonisation of LF laboratory and surveillance data into one database platform is ongoing
Cerebrospinal Meningitis (CSM)
• There were 30 suspected cases of Cerebrospinal Meningitis reported from 18 LGAs in 10 States (Bauchi 2, Borno 2, Cross River 1, Ebonyi 3, Kaduna 1, Katsina 14, Kano 1, Kwara 2, Plateau 3, Sokoto 1). Of these, none was laboratory confirmed and no deaths were recorded
• The National CSM Emergency Operations Center meets weekly to review the situation
• Intensify surveillance in all States by providing onsite/offsite support
• Continued engagement with Sokoto State on lumbar puncture training for Clinicians
• Training of other prioritized States on CSM case management, sample and data management in conjunction with Laboratory and Surveillance pillars.
• A multiagency yellow fever TWG is coordinating the response activities
• Offsite support is being provided to Ondo and Delta States
• Yellow fever surveillance is enhanced in all the States and harmonization of surveillance and laboratory data is ongoing
• Training on yellow fever testing for the three new laboratories (UBTH, UNTH and NRL Gaduwa) is completed
• 2nd draft of the yellow fever national guideline on preparedness and response completed
• Yellow fever reactive vaccination campaign in Edo (5 LGAs), Ondo (7 LGAs) and Delta States (1 LGA) tentatively scheduled to commence from 30th May, 2019
• 2019 Preventive mass vaccination campaign to take place in Katsina, Edo, Ekiti and Rivers States
There were 12 suspected cases of cholera reported from five LGAs in two States (Bayelsa 8, Ebonyi 2 & Ondo 2). None was laboratory confirmed and no death recorded.
• NCDC cholera Technical Working Group (TWG) continues to coordinate cholera activities in States in collaboration with FMWR and support from partners
• 2019 national preparedness and response plan has been developed
• Stock of cholera response commodities has been reviewed
• Continuous monitoring of all States
• Assessment of State’s level preparedness and prepositioning of resources
• Anambra State is planning a sensitisation campaign on cholera
• Second round of OCV campaign to be conducted in Argungu, Kebbi State and Michika, Adamawa State is now pending due to global stock out of OCV.
• There were 2092 suspected cases reported from 35 States and FCT. None was laboratory confirmed and two deaths were recorded
• The multi-agency National Measles EOC is monitoring and coordinating response activities across the States
• Phase II reactive measles vaccination conducted in 13 LGAs (24 wards) of Borno state (Bama, Biu, Damboa, Gubio, Gwoza, Jere, Konduga, Mafa, Magumeri, Maiduguri, Mobbar, Monguno & Ngala)
• A Mop up was conducted from 19th – 20th May, 2019
• Media messages were developed and disseminated across social and conventional media
• Case management guideline was developed and disseminated
• Throat swab specimen collected in Borno, Yobe, Adamawa and Kaduna States for viral isolation and genotyping
• Teleconference next week with Borno, Yobe, Adamawa and Katsina States to follow up on outbreak response activities
• Follow up with Borno State on the progress of reactive vaccination activities
• Intensify surveillance and updating of Measles line list.
• Two new suspected cases were reported from Rivers (1) and Oyo (1). The case from Rivers was inconclusive while that from Oyo tested negative for monkey pox.
• Surveillance has been enhanced in all affected States
• Deployment of RRT to Oyo State to support case investigation and contact tracing
• Animal surveillance was successfully carried out in Bayelsa, Cross River and Edo States
• A zoom meeting took place with the Singapore team in respect to the exported case reported via IHR
• Deployment of RRT to Bayelsa, Cross River, Delta and Lagos States
• Supportive supervision to silent States (Akwa Ibom, Abia, Anambra, Imo)
• Follow up meeting is planned for next week with Singapore team in respect of the exported case.
Acute Flaccid Paralysis (AFP)
• In the reporting week, 154 suspected cases of AFP were reported from 135 LGAs in 33 States and FCT
• As at 12th May, 2019, no new case of WPV was recorded
• The last reported case of polio in Nigeria was in August 2016
• Complete Documentation report review mission by International Support Team (West Africa) is ongoing.
• Outbreak response (OBR) targeted at the South west States is ongoing.
National Influenza Sentinel Surveillance
• The predominant Influenza A subtype so far this year is A seasonal H3 19 (95%).
• The predominant Influenza B subtype so far this year is B not subtyped 2(100%).
• The percentage influenza positive was highest (100.0%) in week 8.