Weekly Epidemiological Report

August 2020 Week 31

Editoral

Public Health Advisory: Measures to Prevent Cholera amidst COVID-19 Pandemic

Posted: 19-08-2020 09:16:12 PM

In Nigeria and several other West African countries, cholera is an endemic and seasonal disease, occurring annually mostly during the rainy season and more often in areas with poor sanitation, overcrowding, lack of clean food and water, and areas where open defecation is common practice. However, in addition to the ongoing COVID-19 outbreak in Nigeria, other diseases of public health importance are still being reported in various states of the country. Recently, confirmed cases of cholera were reported in Lagos, Borno, and Kebbi states. Given the current burden posed by the COVID-19 pandemic, this has limited the ability of states to effectively carry out risk communication activities on cholera as most resources are being harnessed towards COVID-19 control.

Cholera is caused by the bacterium Vibrio cholera which is found in the stool of an infected person and spreads to other people when they consume water contaminated by excreta from infected people. The disease is characterised by sudden acute watery diarrhoea in children and adults with or without vomiting. Other symptoms include nausea and weakness. Cholera is highly contagious and in severe cases, can lead to death within hours. However, if detected early, it can be treated, through prompt administration of oral rehydration solution (ORS) and supportive treatment. Most people who have been infected may not show symptoms or have mild symptoms of the disease.

In the last few years, the Nigeria Centre for Disease Control (NCDC) has worked closely with all the 36 states and the Federal Capital Territory through a variety of public health interventions for cholera control. This has contributed significantly to improved cholera epidemic intelligence and reduction in associated morbidity and mortality.

Given the current COVID-19 situation, and in order not to lose sight of the risk of cholera outbreak during this season, the NCDC advises that precautionary measures should be taken, and offers the following five priority actions to Nigerians:

1. Ensure water is well boiled before drinking and bottled water is properly sealed. Store boiled water in a clean and safe container

2. Wash your hands frequently with soap and clean water. Use alcohol-based hand sanitiser if soap and water are not available

3. Ensure all food is well cooked before consumption. Avoid raw foods such as fruits and vegetables, except you have washed them in safe water or peeled them yourself.

4. Avoid open defecation and indiscriminate refuse dumping and ensure proper disposal of waste and clearing of sewage

5. If you experience sudden watery diarrhoea, please visit a health care facility immediately and take all sick persons with the signs or symptoms above to a health care facility immediately.

NCDC urges states to begin to prioritise public health interventions towards cholera control. Priority should also be given to early reporting of suspected cases, provision of Water, Sanitation and Hygiene (WaSH) facilities, medical supplies, and the institutionalisation of proper case management practices.

The National Cholera Technical Working Group coordinated by NCDC will continue to work closely with all states, relevant stakeholders and partners, to provide the necessary support for cholera control in Nigeria.


Summary of Incidents

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 46 suspected cases, three were laboratory confirmed and one death was recorded from two LGAs in Ondo state.

Actions

To date:

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

• Enhanced surveillance (contact tracing and active case finding) ongoing in affected states

Planned:

• Continue mobilisation of resources


Cerebrospinal Meningitis (CSM)

Key points

There were three suspected cases of Cerebrospinal Meningitis (CSM) reported from two LGAs in two states (Ebonyi – 1 & Yobe - 1). There was no laboratory confirmed case and no death was recorded

Actions

To date:

• National CSM TWG meets weekly to review reports from states and plan appropriately

• Enhanced surveillance in all states

Planned:

• Continue harmonisation of the national line list and SORMAS data

• Continue to ensure that states reporting cases send their line lists and collect CSM samples


Yellow Fever

Key points

• There were 22 suspected cases of Yellow Fever (YF) reported from 20 LGAs in 11 states. None was laboratory confirmed and no death was recorded

Actions

To date:

• National multiagency YF Technical Working Group (TWG) is coordinating response activities

Planned:

• Continue harmonisation of surveillance and laboratory data ongoing


Cholera

Key points

• There were 12 suspected cases of cholera reported from three LGAs in three states (Borno – 2, Kebbi – 8 & Lagos – 2). None was laboratory confirmed and one death was recorded

Actions

To date

• National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states

Planned:

• Continue follow up and monitoring of non-reporting states

• Continue harmonisation of the national line list and SORMAS data


Measles

Key points

• There were 82 suspected cases of measles reported from 35 LGAs in 13 states. None was laboratory confirmed and no death was recorded

Actions

To date

• National Measles TWG is closely monitoring measles surveillance data and providing feedback to relevant agencies and development partners

• Weekly surveillance and laboratory data harmonisation ongoing

Planned:

• Intensify follow up with states to update and transmit line list

• Continue monthly measles surveillance data review


Monkeypox

Key points

• There was no suspected case of Monkeypox reported this week

Actions

To date

• National Monkeypox Technical Working Group (TWG) is monitoring activities in all states

Planned:

• Enhance surveillance for monkeypox in high burden states

• Continue harmonisation of the national line list and SORMAS data


Acute Flaccid Paralysis (AFP)

Key points

• There were 64 suspected cases of AFP reported from 58 LGAs in 25 states. None was laboratory confirmed and no death was recorded


National Influenza Sentinel Surveillance

Key points

• The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 0 (0.0%), 2 (9.5%) and 19 (90.5%) of the total influenza A positive sample, respectively. The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 0 (0.0%), 8 (100%) and 0 (0.0%) of the total influenza B positive samples, respectively.

• The percentage influenza positive was highest in week 10 with 40%.


Coronavirus Disease (COVID-19)

Actions

To date:

• National COVID-19 multi-partner Emergency Operations Centre (EOC) continues to coordinate response activities across states

• Daily escalation of appropriate state specific thematic strategies to state coordination teams to improve response

• A total of 43 RRTs have been deployed to states by NCDC

• Ongoing optimisation of a new GeneXpert laboratory in Federal Medical Centre Keffi, Nasarawa State

Planned:

• Commence the third batch of National Training of Trainers (TOT) for case managers from Federal Tertiary Hospitals and Institutions supporting the COVID-19 outbreak response in the South-east and South-south states

• Distribution of August / September Medical supplies to states and treatment centres, Federal Health Institution (FHI) and Primary Healthcare Centres (PHCs)

• Support the expansion of Event Based Surveillance (EBS) system in eight (8) more states

• Continue engagement with states on the need for increased sample collection, packaging and transport training

• Follow up on step-down and implementation of surveillance strategy at the states and LGAs


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
  • Coronavirus Disease (COVID-19)
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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