Nigeria

NCDC Weekly Epidemiological Report: Volume 6, No. 46 - 25 November 2016

Weekly updates on epidemics in Nigeria: as at 25th November, 2016 Issue: Volume 6 No. 46

Lassa fever

1.**Lassa fever update for week 46 as at 25th November, 2016; (**Please note that the data reflects the routine reports i.e. all suspected cases including the laboratory positive and negative cases)

1.1. Six suspected cases of Lassa fever were reported from 4 LGA (3 States) in week 46, 2016 compared with 22 suspected cases from Jos North LGA (Plateau State) at the same period in 2015 (Figure 1).

1.2. All suspected cases were negative for Lassa fever and other VHFs.

1.3. Between weeks 1 and 46 (2016), 874 suspected Lassa fever cases with 89 lab-confirmed and 107 deaths (CFR, 12.24%) from 140 LGAs (29 States) were reported compared with 309 suspected cases with 13 lab-confirmed and seven (7) deaths (CFR, 2.27%) from 23 LGAs (12 States) at the same period in 2015 (Figure 1).

1.4. Between weeks 1 & 53 2015, 430 suspected Lassa fever cases with 25 lab-confirmed and 40 deaths (CFR, 9.30%) from 37 LGAs (14 States & FCT) were reported compared with 989 suspected cases with 110 lab-confirmed and 36 deaths (CFR, 3.64%) from 37 LGAs (13 States) at the same period in 2014 (Figure 2).

1.5. Investigation and active case search ongoing in affected states with coordination of all response activities by NCDC and support from partners.

1.5.1. National Surveillance and Outbreak Response Working Group meeting on-going at NCDC to assess the current Lassa fever situation in the Country

1.5.2. Response materials for VHFs prepositioned across the country by NCDC

1.5.3. New VHF guidelines being produced by NCDC

1.5.4. Reclassification of reported Lassa fever cases is ongoing

1.5.5. Reviewing the variable for case based surveillance for VHF

1.5.6. States are enjoined to intensify surveillance.

Measles

2.Update on suspected Measles for week 46 as at 25th November, 2016 2.1. In the reporting week 46 (2016), one hundred & fifty-five (155) suspected cases of Measles were recorded from 27 States compared with 337 suspected measles cases and 12 deaths (CFR, 3.56%) from 23 States & FCT at the same period in 2015.

2.2. So far, 24,180 suspected Measles cases and 100 deaths (CFR,0.41%) have been reported in 2016 from 36 states & FCT (Figure 3 & 4) compared with 22,567 suspected cases and 112 deaths (CFR, 0.50%) from 36 states & FCT at the same period in 2015.

2.3. In 2015 (week 1 -53), 24,421 suspected measles cases with 127 deaths (CFR, 0.52%) were reported from 36 States and FCT compared with 15,989 suspected cases with 85 deaths (CFR, 0.53%) at the same period in 2014 2.4. Confirmed Measles cases (lab, epi-link and clinical): Between week 1- 46, (2016) 11,781 confirmed Measles cases were recorded compared to 11,779 confirmed at the same time in 2015. (Figure 5). Most affected were within the age group 9 - 59 months ( Figure 6 & 7 respectively). Vaccination status of the measles cases was 52.2% zero dose (Figure 8).

2.5. Response measure includes immunization for all vaccine-preventable diseases in some selected/ affected wards/LGAs during SIAs with case management.

2.6. Measles vaccination campaigns in the Northern and Southern States were conducted from 21st – 25th November, 2015 and 28th January – 1st February, 2016 respectively.

Poliomyelitis

3.Updates on poliomyelitis for week 46 as at November 18th , 2016 3.1. No new WPV1 isolated since the last reported confirmed case.

3.2. No new cVDPV2, environmental derived and Polio compatible cases identified 3.2.1. In the reporting week 46 (2016), 363 cases of AFP were reported from 246 LGAs in 34 States and FCT 3.2.2. AFP Surveillance has been enhanced and outbreak response is on-going in Borno and other high risk states 3.3. The 5th round of the outbreak response (NIPDs) is being proposed for 3rd – 6th December, 2016.

3.4. Between weeks 1 & 46, 2016, four (4) confirmed Wild Polio Virus (WPV) type 1 were isolated from Jere (1), Gwoza (1) & Monguno (2) LGAs (Borno State) compared to zero case at the same period in 2015 (Figure 9).

3.5. Between weeks 1 & 53, 2015 no WPV was isolated compared to six (6) WPVs isolated from 2 States at the same period in 2014.

3.3 One (1) circulating Vaccine Derived Polio Virus type 2 (cVDPV2) was isolated in Monguno LGA (Borno State) from week 1 - 46, 2016 compared to one (1) cVDPV2 isolated in Kwali, FCT at the same period in 2015 (Figure 10).

3.4 Between weeks 1 & 53, 2015 one (1) cVDPV2 was isolated in Kwali, FCT while thirty (30) cVDPV2 were isolated from 5 States at the same period in 2014.

3.5 Six (6) confirmed WPV were isolated in 2014.

3.5.1 Field supportive supervision and monitoring.

3.5.2 Improved Enhanced Independent Monitoring (EIM) and Lots Quality Assessments (LQAs) in all Polio-high risk States.

3.5.3 High level of accountability framework 3.6 In response to the isolation of WPV1 in the Country, an outbreak response plan was developed for supplemental immunizations (House to house, Hit and run, and Health camps) with bOPV in high risk states (Figure 12)

3.7 The first outbreak response (OBR) was conducted in 5 States in the North east (Borno, Yobe, Adamawa, Gombe and Taraba) from the 27th – 30th August 2016, while the second and third OBR were conducted in 18 States (11 high risk states plus Taraba, Adamawa, Gombe, Plateau, Nasarawa, Benue and the FCT from the 17th – 20th September 2016 and 15th – 18th October 2016 respectively. The 4th outbreak response scheduled from the 12th – 15 November, 2016 have also been completed in 18 high risk states 3.8 From January – May, 2016 (4) Supplemental Immunization Activities (SIAs) for Oral Polio Vaccine (OPV) were conducted across the country using tOPV .

3.9 The SIAs were strengthened with the following events:

3.9.1 Immunization for all vaccine-preventable diseases in some selected wards/LGAs.

3.9.2 Use of health camp facilities.

Cholera

4.Update on suspected Cholera for week 46 as at 25th November, 2016 4.1 One suspected case of Cholera was reported from Gombe LGA (Gombe State) in the reporting week 46 (2016), compared with zero case at the same period in 2015 (Figure 13).

4.2 Between weeks 1 and 46 (2016), 716 suspected cholera cases, 14 Lab confirmed and 32 deaths (CFR, 4.47%) from 53 LGAs (13 States) were reported compared with 5186 cases with 29 lab-confirmed and 186 deaths (CFR, 3.59%) from 99 LGAs (19 States) at the same period in 2015 (Figure 13)

4.3 Between weeks 1 and 53 (2015), 5301 suspected cholera cases with 29 lab-confirmed and 186 deaths (CFR, 3.51%) from 101 LGAs (18 States and FCT) were reported compared with 35,996 cases with 306 lab confirmed and 755 deaths (CFR, 2.10%) from 182 LGAs (19 States and FCT) at the same period in 2014 (Figure 14).

4.4. States are enjoined to intensify surveillance.

Cerebrospinal meningitis (CSM)

5.Update on cerebrospinal meningitis (CSM) for week 46 as at 25th November, 2016 5.1. In the reporting week 46 (2016), 10 suspected cerebrospinal meningitis (CSM) cases were reported from 2 LGAs (2 States) compared with 15 cases from 4 LGAs (7 States) at the same period in 2015.

5.2. Between weeks 1 & 46 (2016), 793 suspected CSM cases with 39 Lab. confirmed and 31 deaths (CFR, 3.91%) were recorded from 148 LGAs (31 States) compared with 2691 suspected cases with 43 Lab. Confirmed and 130 deaths (CFR, 4.83%) from 163 LGAs (28 States) at the same period in 2015 (Figure 15).

5.3. Between weeks 1 & 53, 2015, 2711 suspected CSM cases with 43 lab-confirmed and 131 deaths (CFR, 4.83%) were recorded from 170 LGAs (28 States and FCT) compared with 1175 suspected cases and 81 deaths (CFR, 6.89%) from 125 LGAs (26 States and FCT) at the same period in 2014 (Figure 16)

5.4. Timeliness/completeness of CSM case-reporting from States to National Level (2016 versus 2015): on the average, 85.8% of the 26 endemic states sent CSM reports timely while 99.2% were complete in week 1 – 46, 2016 as against 80.4% timeliness and 96.8% completeness recorded within the same period in 2015.

5.5. Intensive Surveillance is on-going in high risk States.

Guinea worm disease

6.Update on Guinea worm disease: as at 30th September, 2016 6.1. As at 30th September, 2016, 185 GWD rumour reports were received from 71 LGAs in 16 States. All (100%) of the rumours were investigated within 24 hours and none of these rumours were confirmed to be GWD case.

6.2. In 2015, a total of 384 GWD rumour reports were received and investigated from 134 LGAs (24 States), of which 373 (97%) were investigated within 24 hours. None of these rumours were confirmed to be GWD case.

6.3. Nigeria has celebrated 7 consecutive years of zero reporting of Guinea worm disease in the country. The Country has been officially certified free of Dracunculiasis transmission by the International Commission for the Certification of Dracunculiasis Eradication (ICCDE). (For further information, contact NIGEP NC/Director: Mrs. I, Anagbogu: +2348034085607, ifechuba@yahoo.co.uk)