Weekly Epidemiological Report

July 2019 Week 30


Building a Strong Workforce for Health Security: Nigeria’s Zonal RRT Strategy

Posted: 14-08-2019 09:02:42 AM

An important indicator in the Joint External Evaluation (JEE) of International Health Regulations (IHR) is the availability of human resource to effectively implement IHR. In addition, the JEE identifies the need for in-service training for a strong public health workforce. Towards meeting these needs, the Nigeria Centre for Disease Control (NCDC) has prioritised the identification and training of Rapid Response Teams (RRT) at the sub-national levels (states), specifically in emergency preparedness and response.

Through the World Bank REDISSE project, NCDC is identifying and training zonal RRTs across the country. This is to ensure that each state in Nigeria has sufficient workforce that are available and well-trained to respond to public health emergencies. This training has been carried out in the North-Central, North-East and South-West geo-political zones of Nigeria. The training in the final three zones will be conducted before the end of 2019.

As a form of continuous improvement process and also to identify possible gaps and best practices, NCDC conducted a mid-term review of the zonal training conducted so far. The participants in attendance included NCDC directors and staff, members of the training team as well as representatives from Ports Health Services, World Health Organisation, Pro- Health International and African Field Epidemiology Network.

The review meeting provided an opportunity to assess the effectiveness of the training conducted. Specifically, the curriculum for the key technical areas such as IHR implementation, outbreak investigation, case management, infection, prevention and control, RRT logistics, sample transportation and management, risk communication, psychological first aid were reviewed. Following discussions, slight modifications have been made to ensure that the training meets its objectives and Nigeria has an effective workforce for health emergency preparedness and response at sub-national level.

The NCDC remains committed to working with State Governments and other relevant stakeholders in order to ensure an efficient and effective pool of RRT is readily available to respond to and control infectious disease outbreaks. It is critical for states to support the activities of these RRTs as needed.

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 107 suspected cases of Lassa Fever reported from 20 LGAs in 13 States (Edo – 51, Ondo – 28, Ebonyi – 7, Bauchi – 2, Nasarawa – 1, Plateau – 11, Taraba – 1, Gombe – 1, Kaduna – 1, Kogi – 1, Enugu – 1, Oyo – 1, Borno - 1). Nine of the cases were confirmed and no death recorded.

• One new Health Care Worker (HCW) was infected in Ondo State in the reporting week. A total of 18 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 the strengthening of LF treatment centres with equipment

Support the implementation of rodent control measures in hotspot LGAs (phase 2)

Cerebrospinal Meningitis (CSM)

Key points

• There were 15 suspected cases of Cerebrospinal Meningitis reported from nine LGAs in four states (Bauchi – 1, Ebonyi – 1, Katsina – 12, Plateau - 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


• Training of Sokoto state health care workers on case and data management

• Plans to conduct After Action Review (AAR).

Yellow Fever


To date:

• The multiagency YF TWG is coordinating national response activities

• The Ebonyi state public health EOC is leading the state’s outbreak investigation with support from the National team (NCDC, NPHCDA) and WHO

• Risk communication activities have been scaled up in Ebonyi State

• Deployment of ad-hoc medical Staff to primary health care centre and general hospital, Iboko LGA, Ebonyi

• Ambulance services availlable for immediate referral to Federal Teaching Hospital Abakaliki (FETHA)


• Follow up with Ebonyi State RRT team to get daily Situation Report

• Train State surveillance teams on Yellow Fever surveillance, reporting and documentation

• Production and distribution of Yellow Fever IEC materials to states

• Operationalisation of the three new laboratories added to the Yellow Fever laboratory network


Key points

There were 192 suspected cases of Cholera reported from ten LGAs in four states (Adamawa – 75, Borno – 104, Kano - 2 & Katsina - 11). There were 18 laboratory confirmed and no death was 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

• Visit of the US-CDC cholera team to NCDC for support and collaboration


• 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 591 suspected cases of Measles reported from 173 LGAs in 29 States and FCT. None was laboratory confirmed and five deaths were 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

• NCDC 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 three suspected cases of Monkeypox reported from two LGAs in Bayelsa and Lagos States. Two cases were confirmed, and one death was recorded.


To date:

• The Monkeypox TWG is monitoring and coordinating response activities across the states

• Surveillance has been enhanced in all affected states

• Offsite support given to affected states


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

• Planned teleconference meeting with Bayelsa team to address issues on Monkeypox (MPX) surveillance in the state (next week)

• Regional monkeypox surveillance training in the South-East and South-South Zones in August 2019

Clinicians at the central hospital Sapele, Ughelli and Warri in Delta state to be trained on MPX case management

Acute Flaccid Paralysis (AFP)

Key points

• In the reporting week, 127 suspected cases of AFP were reported from 116 LGAs in 26 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

Key points

• There was a positive case of Influenza subtype A&B (2.2%)

• The percentage influenza positive was highest (66.7%) in week 27

Timeliness and Completeness of Reports

Timeliness and Completeness of Reports by States

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 States

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