Weekly Epidemiological Report

June 2019 Week 24

Editoral

Recent Ebola Virus Disease Scare in Nigeria: Are we prepared?

Posted: 04-07-2019 04:44:03 PM

The Democratic Republic of Congo (DRC) continues to experience an outbreak of Ebola viral disease (EVD). Despite the moderate risk of spread to countries like Nigeria, the Nigeria Centre for Disease Control (NCDC) continues to work with sister agencies and partners to ensure Nigeria is prepared to prevent, quickly detect and respond to an Ebola outbreak.

On the 17th of June 2019, a passenger traveling through the Lagos airport fell ill and was immediately suspected for Ebola. While this turned out to be false, it provided an opportunity for NCDC, Port Health Services and other partners to test the country’s level of preparedness.

The passenger who came in with a fever was immediately detected and isolated, and managed under strict infection prevention and control measures. In addition, NCDC, PHS, World Health Organisation (WHO) and partners carried out a risk assessment immediately to define response activities as needed. The Permanent Secretary of Health quickly issued a press release and led a high-level delegation of staff from the Federal Ministry of Health and NCDC, to Lagos state.

The ‘Ebola scare’ in June 2019, provided an opportunity for a simulation that highlighted gaps and strengths in the country’s level of preparedness. NCDC’s capacity has improved, with ability to detect the virus in the National Reference Laboratory, trained human resource for outbreak response and highly pathogenic infection management, an Incident Coordination Centre for response coordination, risk communications and other aspects. NCDC remains committed to working with our parent Ministry and partners, to ensure Nigeria is prepared in the event of an outbreak.


Summary of Incidents

Ongoing Incidents are defined as confirmed cases where a national EOC or equivalent has been activated)

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

Notes

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 65 suspected cases of Lassa fever from 20 LGAs in 11 States (Edo - 39, Ondo - 15, Ebonyi - 2, Plateau - 2, FCT – 1, Gombe – 1, Kaduna – 1, Kogi – 1, Enugu – 1, Delta – 1 & Kebbi – 1). Four cases were laboratory confirmed and one death was recorded

Actions

To date:

• National LF multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate the response activities at all levels

• Dissemination of reviewed case management and IPC guidelines

• Implementation of IPC ring strategy in hot spot LGAs

Planned:

• Conduct zone-specific AAR meetings

• Support indigent patients with treatment cost through basic health care provision funds (BHCPF)

• Strengthening of LF treatment Centres with equipment


Cerebrospinal Meningitis (CSM)

Key points

• There were 10 suspected cases of Cerebrospinal Meningitis reported from seven LGAs in seven States (Ebonyi – 3, Gombe – 1, Katsina – 4, Nasarawa – 1, Plateau – 1). None was laboratory confirmed and no death was recorded

Actions

To date:

• The National TWG meets weekly to review the situation

Planned:

• Intensify surveillance in all states by providing technical support

• Continue follow-up with the States to enhance reporting and preparedness

• Review Case Investigation Form and add variables into SORMAS

• Conduct a general review on the data management process.


Yellow Fever

Key points

• There were 72 suspected cases of Yellow Fever reported from 54 LGAs in 22 States. None was laboratory confirmed and no death was recorded

Actions

To date:

• A multiagency YF TWG coordinates the response activities

• Offsite support is provided to all affected States

• YF surveillance is enhanced in all the States and harmonization of surveillance and laboratory data is on-going

• 2019 Preventive mass vaccination campaign to take place in last quarter of 2019 in Katsina, Edo, Ekiti and Rivers States

• The second draft of the YF National Guidelines on Preparedness and Response has been completed

Planned:

• Finalise the YF National Guidelines on Preparedness and Response

• Continue updating the national Yellow Fever line-list with harmonization of both surveillance and laboratory data, and update of cases onto SORMAS platform

• Follow up with the next steps on the Yellow Fever Guidelines and action plans.


Cholera

Key points

There were 86 suspected cases of cholera reported from 10 LGAs in four States (Abia – 4, Adamawa – 28, Kano – 18, Katsina - 36). None was laboratory confirmed and one death was recorded

Actions

To date:

• NCDC Cholera Technical Working Group (TWG) continues to coordinate Cholera activities in states in collaboration with Federal Ministry of Water Resources (FMWR) and support from partners

• Rapid Response Team deployed to support outbreak response in Adamawa state

• Routine monitoring of States through IDSR followed by calling states with suspected cases of Acute Watery Diarrhoea (AWD) weekly

• WaSH sector meeting by FMWR and partners

Planned:

• Advocate to state government and partners for funds to support airing of jingles and other risk communication activities.


Measles

Key points

• There were 587 suspected cases reported from 32 States and FCT. None was laboratory confirmed and no death was recorded

Actions

To date:

• National multi-agency measles EOC is monitoring and coordinating response activities across the states

• Conducted risk assessment of the measles outbreak for possible de-escalation of response

• Measles EOC de-escalated

Planned:

• Follow up with CPHL Lagos on throat swab specimen transportation for viral isolation and genotyping

• Continue review of Measles surveillance data across the country.


Monkey pox

Key points

• There was one new reported case for the week from Ughelli North Local Government Area of Delta State. Laboratory confirmation is being awaited. No new death for the week

Actions

To date:

• Surveillance has been enhanced in all affected States

Planned:

• Supportive supervision visits to Bayelsa, Delta and Lagos States

• An outbreak investigation team to be sent to Lagos State.


Acute Flaccid Paralysis (AFP)

Key points

• In the reporting week, 128 suspected cases of AFP were reported from 106 LGAs in 32 States and FCT

• An Unclassified VDPV2 was isolated in Wurno LGA, Sokoto State from human

Actions

Planned:

• NIPD phase 1 proposed for 13th – 16th July, 2019 will be conducted in south-south zone, south-east zone, FCT as well as Ekiti, Ondo, Osun, Benue, Kogi, and Nasarawa states

• Supportive supervision Abia, Imo, Delta and Ebonyi from 7th – 10th July, 2019.


National Influenza Sentinel Surveillance

Key points

• There was a positive case of Influenza subtype A & B (3.8%)

• The predominant Influenza A subtype so far this year was A seasonal H3 23(88.5%).

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

• The percentage influenza positive was highest (60%) in week 9.

Highlight of the week

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

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