NCDC Weekly Epidemiological Report: Volume 8, No.11 - 30 March 2018
IMPROVING LABORATORY RESPONSE TO FUTURE OUTBREAKS
The Lassa fever outbreak continued in Epi-week 12 with a total of 1,613 suspected cases reported across 12 states. Of this, 403 cases were classified as 394 confirmed case and 9 probable cases with 104 deaths (95 in Lab confirmed and 9 in probable) giving a case fatality rate of 24.1%.
In this reporting week, two states (Osun and Gombe) each reported a confirmed case, bringing them back to the active phase of the outbreak. This was made possible through the ongoing surveillance in the inactive states, despite having exited from the active phase of the outbreak. Evidently, surveillance activities have increased across all affected states with a major outcome being the number of suspected cases identified and tested, despite leaving the peak period of the Lassa fever outbreak season.
As the outbreak response is ongoing, the Laboratory pillar of the National Lassa fever emergency operations centre (LF-EOC) organized a 2day meeting to discuss issues arising in outbreak response with a view to improving laboratory processes with respect to sample management and diagnostics. Participants were Laboratory and case management experts drawn from the Nigeria Centre for Disease control (NCDC), World Health Organization (WHO), United States Centres for Disease Control and Prevention(US CDC), Public Health England (PHE), Bernard Nocht Institute for Tropical Medicine (BNITM) as well as the Laboratory scientists and key stakeholders from the Lassa fever testing Laboratories in Nigeria:-National Reference Laboratory (NRL) Gaduwa, Irrua Specialist Teaching Hospital (ISTH), Lagos University Teaching Hospital (LUTH) and Federal Teaching Hospital Abakaliki (FETHA). The outcome of this meeting includes:
Development of a national diagnostic testing algorithm
Development of principles for the implementation of operational research during emergency response
Identifying key areas of collaboration to strengthen laboratory capacity
In this outbreak, many lessons have been learnt in the course of diagnosing Lassa fever cases and the meeting, a first of its kind, was aimed at addressing challenges and preparing for the future in the area of Lassa fever diagnostics and research.
SUMMARY OF REPORTS
In the reporting week ending on March 18, 2018:
There were 164 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.
175 suspected cases of Cholera were reported from six LGAs in four States (Bauchi – 112, Borno – 40, Ebonyi – 21 & Kaduna – 2). Of these, 15 were laboratory confirmed and five deaths were recorded.
18 suspected cases of Lassa fever were reported from ten LGAs in seven States (Bauchi – 2, Ebonyi – 3, Ekiti – 2, Gombe – 3, Ondo – 3, Plateau – 1 & Taraba - 4). Two were laboratory confirmed and one death was recorded.
There were 166 suspected cases of Cerebrospinal Meningitis (CSM) reported from 59 LGAs in 16 States (Adamawa – 2, Borno – 6, Cross River – 2, Ebonyi – 2, Gombe - 4, Jigawa – 5, Kaduna – 2, Kano – 4, Katsina - 58, Kebbi – 13, Niger – 1, Oyo – 2, Sokoto – 11, Taraba – 1, Yobe - 5 & Zamfara - 48). Of these, seven were laboratory confirmed and 13 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 605 suspected cases of Measles reported from 36 States. None was laboratory confirmed and two death were recorded.
In the reporting week, all States sent in their report. Timeliness of reporting remains 86% in both previous & current weeks (week 10 & 11, 2018) while completeness increases from 99% to 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.