Weekly Epidemiological Report

July 2019 Week 29


NCDC Intensifies Efforts in the Control of Monkeypox in Nigeria Through Animal Surveillance

Posted: 06-08-2019 09:04:14 AM

Since 2017 when the first monkeypox case was detected in Balyesa State after 39 years of the last outbreak in Nigeria, the disease has also been detected in other states. With the improved surveillance system, the Nigeria Centre for Disease Control (NCDC) has worked with states and partners to detect, respond and control the outbreaks.

Using the One Health approach, some of the strategies we use are enhanced case-based surveillance, deployment of multi-disciplinary response teams, development of One Health incident action plans, laboratory capacity strengthening, genetic sequencing and activation of emergency operation centres. NCDC has recently published a clinical and epidemiological report of the monkeypox outbreak in Nigeria, in the Lancet Infectious Diseases journal (see link).

In order to investigate and provide further evidence into the likely human, animal and environmental source of infection, as well as general predisposing factors and determinants of spread, NCDC is currently working with the Federal Ministry of Agriculture and Rural Development, National Veterinary Research Institute, US Centers for Disease Control and other partners. This is to carry out animal surveillance of mammals in selected states. Between July 1 and 12 2019, the Team was in Rivers state where trapping and laboratory methods were used to determine monkeypox virus prevalence in small mammals.

Currently, NCDC is working with partners to analyse the results from the field activities, which will define response activities and interventions. We are committed to strengthening the One Health approach to disease control which includes working closely with colleagues at the animal and environmental health components.

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

Information for sentinel influenza was retrieved from the laboratory

Lassa Fever

Key points

• There were 72 suspected cases of Lassa Fever reported from 16 LGAs in seven states (Edo – 45, Ondo – 11, Ebonyi – 6, Bauchi – 5, Nasarawa – 2, Plateau – 1 & Ogun - 2)

• One new Health Care Worker (HCW) was infected in Edo State in the reporting week. A total of 17 HCWs have been infected since the onset of the outbreak with two deaths


To date:

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

• Implementation of targeted risk communication and enhanced surveillance activities in affected States


• Conduct zonal (North and South) AAR meetings

• 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)

Key points

• There were 21 suspected cases of Cerebrospinal Meningitis reported from nine LGAs in five States (Ebonyi – 2, Kaduna – 1, Katsina – 15, Kwara – 2 & Nasarawa - 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


• Development of final outbreak report

• Development and submission of a proposal to the Ethical Committee on the use of blood samples to diagnose CSM

Yellow Fever


To date:

The multiagency YF TWG is coordinating national response activities

• Rapid Response Team deployed to Ebonyi State to support investigation and response

• Third draft of YF National Guideline on Preparedness and Response completed

• Finalisation of the YF National Guideline on Preparedness and Response commenced


• Follow up with National Primary Health Care Development Agency (NPHCDA) for the 2019 Preventive Mass Vaccination Campaign (PMVC) to take place in the last quarter of 2019 in Katsina, Ekiti, Borno, Rivers States in Anambra states

• Train state surveillance teams on YF surveillance, reporting and documentation


Key points

There were 225 suspected cases of cholera reported from 10 LGAs in five states (Abia – 1, Adamawa – 94, Bayelsa – 1, Borno - 124 & Katsina - 5). There were 13 laboratory confirmed and two deaths were recorded.


To date:

• 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 is leading the response to cases in the state

• Rapid Diagnostic Test kits (RDTs) distributed to all LGA DSNOs and health facilities in high risk areas


• Follow up with states to ensure continued surveillance and early reporting

• Deploy a team to conduct an in-depth investigation in Adamawa State


Key points

• There were 533 suspected cases of measles reported from 160 LGAs in 32 States. None was laboratory confirmed and no death was recorded


To date:

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

• A Rapid Response team (RRT) has been deployed to respond to measles outbreak in Kaduna state.

• The TWG is working closely with NPHCDA for immediate measles reactive vaccination in Igabi LGA of Kaduna state


• Continued review of measles surveillance data across the country

• Continued planning for AAR and measles guideline review meeting


Key points

• There were four suspected cases of monkeypox reported from three LGAs in Lagos and Delta States. Two cases were confirmed and no death was recorded.


To date:

• Surveillance has been enhanced in all affected states

• Offsite support given to affected states


• Regional monkeypox surveillance training to be conducted in South-East and South-South zones in August 2019

• Supportive supervision to non-reporting states in North-Central, South-East, South-West and South-South zones

Acute Flaccid Paralysis (AFP)

Key points

• In the reporting week, 126 suspected cases of AFP were reported from 111 LGAs in 31 States and FCT



• Complete documentation by the states on polio certification and presentation to National Committee on Certification for review from 5th – 9th August 2019

National Influenza Sentinel Surveillance

Timeliness and Completeness of Reports

Timeliness and Completeness of Reports by State

Highlight of the week

  • Summary of Incidents
  • Lassa Fever
  • Cerebrospinal Meningitis (CSM)
  • Yellow Fever
  • Cholera
  • Measles
  • Monkeypox
  • Acute Flaccid Paralysis (AFP)
  • National Influenza Sentinel Surveillance
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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