NCDC Weekly Epidemiological Report: Volume 8, No. 9 - 16 March 2018

The Lassa fever outbreak in Nigeria continued in the 10th Epi-week with a total of 1386 suspected cases reported across 19 affected states. Of this, 374 cases have been classified as: 365 confirmed cases, 9 probable cases with 90 deaths (81 in Lab confirmed and 9 in probable) recorded giving a case fatality rate (CFR) of 24%.

In the last three weeks, there has been a steady decline in the number of confirmed cases reported, from 54 in Epi-week 8 to 35 in Epi-week 9 and 12 in Epi-week 10. Historically, a steady decline in the number of cases reported is an indication of a gradual exit from the peak period of the disease.

The decline in the number of new cases can be linked to the enhanced response activities in the last few weeks. However, it is important to note that additional efforts need to be place on actively searching for cases and ensuring they are all tested for Lassa fever.

This has necessitated the deployment of active case teams to the three-hotspot states of Edo, Ondo and Ebonyi State to support active case search and contact tracing activities in these states. The expected outcomes of these activities is to

1. Identify and list all contacts of confirmed Lassa fever patients
2. Monitor all listed contacts for 21 days
3. Refer all symptomatic contacts for Lassa fever testing
4. Follow up all symptomatic cases who become positive and refer immediately to designated treatment centres.
5. Active search in communities for suspected cases and ensure lab investigations are carried out for them.

It is expected that these activities will provide more information for the Lassa fever Emergency Operation Centre (LF-EOC) to work with. The deployed teams are expected to carry out these activities for 21 days and provide daily updates from the field. Updates on the outbreak and control efforts are provided on different print and electronic media platforms and on the NCDC social media platforms and website: www.ncdc.gov.ng

SUMMARY OF REPORTS

In the reporting week ending on March 4, 2018:

• There were 153 new cases of Acute Flaccid Paralysis (AFP) reported. None was confirmed as Polio. The last reported case of Polio in Nigeria was in August 2016. Active case search for AFP is being intensified as Nigeria has reinvigorated its efforts at eradicating Polio.
• 12 suspected cases of Cholera were reported from three LGAs in three States (Bauchi – 6, Kaduna – 4 & Kano – 2). Of these, two were laboratory confirmed and two deaths were recorded.
• 32 suspected cases of Lassa fever were reported from 17 LGAs in 13 States (Bauchi – 1, Benue – 1, Borno – 1, Edo – 3, Ekiti – 1, Enugu – 1, FCT- 1, Gombe – 1, Kogi – 4, Nasarawa – 1, Ondo – 12, Plateau – 1 & Taraba - 4). Six were laboratory confirmed and four deaths were recorded.
• There were 236 suspected cases of Cerebrospinal Meningitis (CSM) reported from 75 LGAs in 15 States (Adamawa – 5, Bauchi – 3, Benue – 1, Borno – 3, FCT – 1, , Gombe - 5, Jigawa – 28, Kaduna – 1, Kano – 11, Katsina - 48, Kebbi – 19, Niger – 1, Sokoto – 21, Yobe - 11 & Zamfara - 78). Of these, four were laboratory confirmed and 19 deaths were recorded. Ongoing surveillance for CSM has been intensified in all the 26 States in the Nigeria meningitis belt and case-based surveillance commenced from 4th December 2017
• There were 534 suspected cases of Measles reported from 34 States. None was laboratory confirmed and two death were recorded.

In the reporting week, all States sent in their report. This is a remarkable improvement! Timeliness of reporting remains 85% in both previous & current weeks (week 8 & 9, 2018) while completeness also remains 100% at the same period. It is very important for all States to ensure timely and complete reporting at all times, especially during an outbreak