Weekly Epidemiological Report

August 2019 Week 33


Lassa fever Clinical Fellowship in Nigeria: Strengthening Workforce for Health Security

Posted: 02-09-2019 12:42:29 PM

In January 2019, the Nigeria Centre for Disease Control (NCDC) hosted the first international conference on Lassa fever (LF) with the theme “50 years of Lassa in Nigeria, rising to the challenge”. Widely attended by global LF experts and researchers, the conference provided a unique opportunity to discuss critical ways to respond to Lassa fever outbreaks and share innovative measures such as vaccines under trial.

One of the key recommendations from the conference was the need to improve the country’s capacity for case management of Lassa fever. Our defined strategies included to support the strengthening of treatment centres and increase the number of well-trained physicians and nurses that can effectively manage Lassa fever and other infectious diseases

As part of activities to ensure Nigeria has adequate human resource for the management of Lassa fever cases, NCDC and partners are developing a clinical fellowship program for Lassa fever case management. An initial workshop was held in August and had the following outcomes:

1. Development of a training curriculum for a four-week fellowship program

2. Development of a four-week schedule of activities for the program

3. Identification and assigning of roles and responsibilities to various stakeholders of the program

4. Determination of criteria for selection of participants for the fellowship

In attendance were Lassa fever experts from NCDC, Irua Specialist Teaching Hospital, Federal Medical Centre (Owo, Ondo state), Federal Teaching Hospital (Abakaliki, Ebonyi state), World Health Organisation, US Centre for Disease Control, Médecins Sans Frontières and ALIMA foundation.

The Lassa fever clinical fellowship is targeted at health workers in government institutions primarily, especially working in hospitals with treatment centres for the management of infectious diseases. In addition to increasing the number of national experts for LF case management, it is anticipated that the fellowship programme when fully implemented will contribute to improved treatment outcomes of cases.

Through this clinical fellowship and more, we are rising to the challenge of 50 years of Lassa fever in Nigeria.

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 (LF) reported from eight LGAs in six states (Edo – 49, Ondo – 8, Ebonyi – 10, Bauchi – 3, Plateau – 1, Benue - 1). There were two confirmed cases and no death was recorded


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


• States to complete After Action Review (AAR) template

• National AAR retreat

• Implementation of rodent control measures in hotspot LGAs (Phase 2)

• Strengthening of LF treatment centres with equipment

Cerebrospinal Meningitis (CSM)

Key points

• There were 16 suspected cases of Cerebrospinal Meningitis reported from nine LGAs in five states (Ebonyi – 3, Katsina – 10, Nasarawa – 1, Ondo – 1, Zamfara - 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


• Conduct After Action Review (AAR)

• Harmonisation of surveillance and laboratory data

• Conduct case and data Management training in Sokoto state from September 26th – 28th, 2019

Yellow Fever

Key points

There were 63 suspected cases of Yellow Fever reported from 40 LGAs in 18 states. There was no confirmed case and no death was recorded


To date:

• The multiagency YF TWG is coordinating national response activities

• Ebonyi and Katsina states Incident Coordination Centres are leading the outbreak investigation with support from the National team (NCDC and NPHCDA) and WHO


• The 2019 preventive mass vaccination campaign will take place in the last quarter of 2019 in Katsina, Ekiti, Borno, Rivers and Anambra States

• Finalise draft of the national Yellow Fever guidelines


Key points

There were 57 suspected cases of Cholera reported from four LGAs in two states (Adamawa – 55 & Katsina - 2). There were 19 laboratory confirmed cases and no death was recorded


To date:

• The national 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 continues to coordinate response with support from NCDC and partners

• Conduct After Action Review (AAR) from 26th - 27th of September 2019

• Follow up with states with active outbreaks and monitor non-reporting states


Key points

• There were 266 suspected cases of measles reported from 106 LGAs in 27 States and FCT. None was laboratory confirmed and two deaths were recorded


To date:

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

• The TWG is closely monitoring response to reported measles outbreak and reviewing measles surveillance data in Abia and also outbreak response activities in Igabi, LGA of Kaduna

• The Measles TWG is working closely with NPHCDA towards measles Supplemental Immunization Activity in Nigeria


• Conduct measles guideline review meeting from 3rd – 5th September, 2019

• Follow up on reported measles outbreak in Abia and Kaduna states


Key points

• There was one suspected case of Monkeypox reported the week in Mushin LGA, Lagos State, which tested negative for MPX but positive for Varicella Zoster virus (VZV)


To date:

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

• Surveillance has been enhanced in all affected states

• Offsite support provided to affected states


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

• Conduct regional Monkeypox surveillance training in South-East and South-South Zone in September 2019

• Conduct training for clinicians in Delta state on Monkeypox case management in September 2019

Acute Flaccid Paralysis (AFP)

Key points

• In the reporting week, 83 suspected cases of AFP were reported from 74 LGAs in 28 states and FCT

National Influenza Sentinel Surveillance

Key points

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

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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