In line with the Nigeria Centre for Disease Control (NCDC) five-year strategic plan and as part of the requirements of the International Health Regulations (IHR), workforce development at all levels remains a top priority. For the year 2019, our target is to have a One-Health oriented Rapid Response Team (RRT) in every state in Nigeria.
To achieve this, NCDC began a Zonal RRT training on Health Emergency Preparedness and Response, through the World Bank Regional Disease Surveillance System Enhancement project (REDISSSE). Through this training, we are supporting states in establishing their RRTs. The goal is to reinforce the capacity and skills of inter-disciplinary RRT and their individual members for early detection and effective response to public health events, irrespective of origin or source as a team. The teams being trained are expected to cascade the training to other health workers in their respective states, ensuring that all states in Nigeria have adequate personnel that can be mobilised quickly for outbreak response.
With full participation of all states’ RRT from the North-West zone, the fourth zonal RRT training held from September 16-20 2019 in Kaduna state, Nigeria. Till date, 232 state level officers have been trained across 26 states in Nigeria. Our goal is to complete the RRT training in the remaining two zones (South-East and South-South) before the end of 2019.
In states where these training have been completed, the skills acquired are now being consistently applied in the management of public health emergencies.
The Nigeria Centre for Disease Control remains committed to supporting states in building a strong public health workforce capable of providing quick and effective response to public health threats. The zonal RRT training has begun to yield key results, contributing to national health security.
Summary of Incidents
Ongoing Incidents are defined as confirmed cases where a national EOC or equivalent has been activated (EOC is currently activated for Yellow Fever)
Other incidents are those confirmed cases for which EOC is not activated.
Notes
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 63 suspected cases of Lassa Fever (LF) reported from 15 LGAs in 11 states and FCT (Edo – 30, Ondo – 14, Ebonyi – 3, Bauchi – 7, Nasarawa – 1, Plateau – 2, FCT – 1, Kwara – 1, Gombe – 1, Kaduna – 1, Benue – 1 & Kogi – 1). There were seven confirmed cases and two deaths were recorded
Actions
To date:
• National LF multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate the response activities at all levels
• Visits to Bauchi, Taraba and Plateau states to assess the Lassa Fever treatment centers
• Implementation of targeted risk communication and enhanced surveillance activities in affected states
• Lassa fever now being diagnosed in the five LF testing laboratories across the country
Planned:
• Conduct a meeting to finalise the LF psycho-social guideline in October 2019
• Review LF case management and surveillance tools and SOPs in October 2019
Cerebrospinal Meningitis (CSM)
Key points
There were 23 suspected cases of Cerebrospinal Meningitis (CSM) reported from 12 LGAs in seven states (Akwa Ibom - 2, Borno – 2, Cross river – 2, Gombe – 1, Katsina – 11, Ondo – 2 & Yobe – 3). None was laboratory confirmed and no death was recorded
Actions
To date:
• The National CSM TWG meets weekly to review reports from states and plan appropriately
Planned:
• Conduct After Action Review (AAR)
• Harmonise surveillance and laboratory data
• Establish a mechanism for getting weekly feedback from states
Yellow Fever
Key points
There were 117 suspected cases of Yellow Fever (YF) reported from 73 LGAs in 26 states and FCT. None was laboratory confirmed and three deaths were recorded
Actions
To date:
• A national multiagency YF Incident Management System (IMS) is coordinating response activities
• Reactive mass vaccination campaigns have been concluded in Ebonyi and Bauchi states while it is ongoing in Dan Musa LGA of Katsina state
• National Rapid Response Team (RRT) was deployed to Bauchi state to support outbreak response
• The Ebonyi, Katsina, Bauchi, Gombe and Borno states’ Incident Coordination Centres are leading the outbreak investigation with support from the national team (NCDC) and WHO
Planned:
• Continue on-site and off-site support to affected states
• Follow up with ICG request for the vaccination of the affected states
• Scale up risk communication activities, advisories and press release
Cholera
Key points
There were 21 suspected cases of Cholera reported from four LGAs in two states (Adamawa – 20 & Borno – 1). None was laboratory confirmed and no death was recorded
Actions
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 activities with support from partners
Planned:
• Follow up with states with active outbreak and monitoring of non-reporting states
• Review Standard Operating Procedures (SOPs) for sample management and testing
Measles
Key points
There were 327 suspected cases of measles reported from 140 LGAs in 29 states. None was laboratory confirmed and one death was recorded
Actions
To date:
• The measles TWG is closely monitoring surveillance data and response activities across the country
• The TWG is working closely with NPHCDA towards measles Supplemental Immunization Activity in Nigeria
Planned:
• Continue the review of measles surveillance data across the country
• Finalise and validate measles/rubella surveillance guideline
Monkeypox
Key points
• There were four suspected cases of monkeypox reported this week in Akwa Ibom (3) and Lagos (1) states. There were two confirmed cases and no death was recorded
• This is the first time Akwa Ibom state is reporting a case this year
Actions
To date:
• The national monkeypox TWG is monitoring and coordinating response activities across the states
• Surveillance has been enhanced in all affected states
• Offsite support is being given to affected states
Planned:
• Train clinicians in Ughelli and Warri, Delta state on monkeypox case management in October 2019
• Conduct regional monkeypox case management and surveillance training in South-East, South-West and North-Central Zones in October, 2019
Acute Flaccid Paralysis (AFP)
Key points
• There were 109 suspected cases of AFP were reported from 93 LGAs in 31 states and FCT. None was laboratory confirmed and no death was recorded
National Influenza Sentinel Surveillance
Key points
• The subtypes A seasonal H3 and A/not subtyped account for 43 (87.8%) and 6 (12.2%) of the total influenza A positive sample respectively
• The B Not subtyped account for 3 (100%) of the total influenza B positive sample
Timeliness and Completeness of Reports
Timeliness and Completeness of Reports by State