In the last three years, the Nigeria Centre for Disease Control (NCDC) has responded to outbreaks of epidemic prone diseases, utilizing effective coordination through Emergency Operations Centres as one of our main strategies. In 2017, a national Public Health Emergency Operation Centre (PHEOC) was established as the NCDC Incident Coordination Centre (ICC). Using the principle of the incident management system, the ICC has been used to monitor signals and coordinate outbreak response.
In addition to the national ICC, NCDC has also supported 16 states in the establishment of state level PHEOCs. This project which began in 2018, is set to be complete by the end of the second quarter of 2020, in all states in Nigeria. The goal is to ensure that states have the capacity to manage the coordination of small outbreaks, with support from NCDC.
To build on the establishment of these centres, it is important that a workforce is developed with the requisite set of skills to manage EOCs. NCDC with the support of the US Centers for Disease Control, Pro Health International and the Walter Reed Programme held a five-day training on Public Health Emergency Management, from the 15th -19th of July 2019. The objectives of the training were to:
1. Train incident managers, state epidemiologists and other focal persons on managing PHEOCs.
2. Provide a course on the fundamentals of PHEOC activations and deactivations.
3. Improve the understanding of the development of situation reports and risk communication.
Participants at the training included selected state epidemiologists from sixteen states, representatives of the Ministry of Defense, Port Health Services, Pro-Health International and also technical staff of NCDC. In addition to strengthening capacities of state epidemiologists and other attendees, the training provided an opportunity to strengthen our work in linking public health and security services.
An important aspect of disease preparedness is in developing and testing systems- either through simulation exercises or during outbreaks. Therefore, with this training provided and structures developed, NCDC will continue supporting and working with states, to ensure effective coordination of outbreak preparedness and response for national health security.
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.
• There were 78 suspected cases of Lassa Fever reported from 17 LGAs in eight States (Edo - 40, Ondo - 16, Ebonyi - 7, Plateau - 9, Gombe – 1, Enugu – 1, Kebbi – 3 & Cross River - 1). Twelve cases were laboratory confirmed and three deaths were recorded.
• National LF multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate the response activities at all levels
• Conducted Psychosocial Support Guideline Development workshop
• Mortality review of deaths
• Support indigent patients with treatment cost through Basic Health Care Provision Funds
• Harmonisation of LF laboratory and surveillance data into one database.
Cerebrospinal Meningitis (CSM)
• There were 26 suspected cases of Cerebrospinal Meningitis reported from 14 LGAs in 11 states (Akwa Ibom – 3, Bauchi – 1, Benue – 1, Cross River – 1, Ebonyi – 3, Katsina – 7, Ondo – 1, Osun – 1, Plateau – 5, Rivers – 2, Yobe - 1). None was laboratory confirmed and no deaths were recorded.
• The National CSM TWG meets weekly to review reports from states and plan appropriately
• Harmonisation of SORMAS, national and laboratory line lists
• Training of Cross River State on case and data management
• Development of final outbreak report.
• The multiagency YF TWG is coordinating national response activities
• On-site support provided by NCDC Rapid Response Teams (RRTs) to Kogi, Katsina, Nasarawa, Abia, Imo and Osun States
• Third draft of YF National Guideline on Preparedness and Response completed
• Finalise the YF Action Plan for 2019 -2021
• Develop risk communications assessment plan
• Train state surveillance teams on YF surveillance, reporting and documentation
• Operationalisation of the three new laboratories added to the YF Laboratory Network
• Finalise draft of the national YF guidelines.
There were 82 suspected cases of Cholera reported from nine LGAs in three states (Adamawa – 60, Bauchi - 2 & Katsina - 20). Thirty-six cases were laboratory confirmed and one death was recorded.
• The Cholera TWG continues to coordinate activities in states in collaboration with the Federal Ministry of Water Resources (FMWR) and support from partners
• Adamawa state EOC leading response to cases in the state
• Rapid Diagnostic Test kits (RDTs) distributed to all LGA DSNOs and health facilities in high risk areas
• Technical Working Group members with a team from John Hopkins universities visited four states to conduct training on use of measles RDTs
• Follow up with states to ensure continued vigilance and early reporting
• Conduct state level training on sample management and RDT testing for other high priority states
• Conduct community sensitisation across all LGAs of Adamawa State.
• There were 633 suspected cases reported from 30 States. None was laboratory confirmed and six deaths were recorded
• The multi-agency National Measles TWG is monitoring and coordinating response activities across the States
• TWG is working closely with NPHCDA, National Measles Technical Coordination Committee towards the upcoming Measles SIA (Supplementary Immunisation Activity) and introduction of second dose of Measles vaccination
• Conducted a planning meeting for AAR and measles guideline review meeting
• Travel advisory on measles outbreak shared across different media platforms
• Continue review of measles surveillance data across the country
• Continue planning for AAR and measles guideline review meeting.
• There was one confirmed case of monkeypox reported from Enugu State.
• Surveillance has been enhanced in all affected states
• Offsite support given to affected states
• Investigation of confirmed cases in Mushin LGA, Lagos State is ongoing
• Regional Monkeypox Surveillance Training to be conducted in South-East and South-South Zones.
Acute Flaccid Paralysis (AFP)
• In the reporting week, 128 suspected cases of AFP were reported from 107 LGAs in 28 States and FCT
• Complete documentation for certification presentation to NCC for review from 5th – 9th August 2019
• NIPD phase 1 proposed for 13th – 16th July 2019 is to be conducted in South-South zone, South-East zone, FCT as well as Ekiti, Ondo, Osun, Benue, Kogi, and Nasarawa states.
National Influenza Sentinel Surveillance