Weekly Epidemiological Report

June 2019 Week 25


Rainy Season and Infectious Diseases: 5 Tips to Prevent Cholera

Posted: 09-07-2019 12:24:12 PM

Various states in Nigeria have begun to experience high levels of rainfall. High rainfall can cause widespread flooding, and stagnant water can be a breeding ground for bacteria as well as mosquitoes. This also leads to increased transmission of communicable diseases such as cholera. The Nigeria Centre for Disease Control (NCDC) has issued a public health advisory, with five tips to prevent the spread of cholera.

1. Ensure that water is boiled and stored in a clean and safe container before drinking. Ensure that the seals of bottled water are in place

2. Wash your hands frequently with soap and clean running water. Use alcohol-based hand sanitiser if soap and clean water are not available

3. Ensure that food is well cooked before consumption. Avoid raw food such as fruits and vegetables, except you have washed them in safe water or peeled them yourself.

4. Avoid open defecation, indiscriminate refuse dumping and ensure proper disposal of waste and frequent clearing of sewage

5. If you experience sudden watery diarrhoea, please do not self-medicate, visit a health care facility immediately and take all sick persons with the signs or symptoms above to a health care facility immediately

Cholera is an easily treatable disease, if detected early. Most infected people can be treated successfully through prompt administration of oral rehydration solution (ORS), to replace lost fluids and electrolytes. The ORS solution is available as a powder that can be reconstituted in boiled or bottled water. Without rehydration, approximately half the people with cholera die. With treatment, the number of fatalities drops to less than 1 percent. Severely dehydrated people may also need intravenous fluids.

The NCDC cholera technical working group which includes representatives of partner agencies, continues to monitor cases and support states in improving preparedness and response. We advise an increased focus on the provision of potable water, adequate sanitation and institution of good hygiene practices (WaSH). States are also enjoined to ensure early reporting and confirmation of cases, for improved response.

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.


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 72 suspected cases of Lassa fever from 20 LGAs in 9 States (Edo - 40, Ondo - 20, Ebonyi - 1, Plateau - 6, Taraba – 1, FCT – 1, Kogi – 1, Kebbi – 1 & Cross River - 1). Ten cases were Laboratory confirmed and three deaths were recorded.


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

• Implementation of targeted risk communication activities in most affected States


• Conduct zonal specific After-Action Review meetings

• Harmonisation of LF Laboratory and surveillance data into one database

• Strengthening of capacity at LF treatment Centres

Cerebrospinal Meningitis (CSM)

Key points

• There were 21 suspected cases of Cerebrospinal Meningitis reported from 21 LGAs in six states (Borno – 4, Ebonyi – 2, Katsina – 12, Nasarawa – 1, Kebbi – 1 & Kwara - 1). None was Laboratory confirmed and no death was recorded


To date:

• The National CSM TWG meets weekly to review reports from states and plan appropriately


• Intensify surveillance in all states by providing technical support

• Continue harmonisation of SORMAS, national and laboratory linelist

• Review the case investigation form and include variables in SORMAS

Yellow Fever


To date:

• A multiagency YF TWG coordinates national response activities

• Offsite support is provided to all affected states

• YF surveillance has been enhanced in all states and harmonisation of surveillance and laboratory data is on-going

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


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

• Finalise and share the report of the YF After Action Review meeting

• Finalise the YF Technical Guidelines on preparedness and response


Key points

There were 75 suspected cases of cholera reported from eight LGAs in four states (Abia – 5, Adamawa – 55, Borno – 2 & Katsina - 13). None was Laboratory confirmed and no death was recorded.


To date:

• The cholera TWG continues to coordinate Cholera activities in states in collaboration with the Federal Ministry of Water Resources (FMWR) and support from partners

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


• Conduct state level trainings on sample management and RDT testing

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


Key points

• There were 1007 suspected cases reported from 32 States and FCT. None was Laboratory confirmed and four deaths were recorded


To date:

• The multi-agency National Measles TWG is monitoring and coordinating response activities across the States

• Conducted Risk assessment of the Measles outbreak


• 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 reported case for the week in Lagos State. It was confirmed and no new death was recorded.


To date:

• Surveillance has been enhanced in all affected states


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

Acute Flaccid Paralysis (AFP)

Key points

• In the reporting week, 153 suspected cases of AFP were reported from 129 LGAs in 30 States and FCT



• Complete dcumentation for certification presentation to NCC for review 5th – 9th Aug, 2019

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

• 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

• National ToT on AEFI for Northern states to be held in Kano from 24th – 28th July, 2019.

National Influenza Sentinel Surveillance

Key points

• Two of the suspected cases of influenza were discarded.

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

Connect Centre