LASSA FEVER - WEST AFRICA (06): NIGERIA

Posted on 26TH FEB 2017
tagged Lassa Fever, West Africa; Nigeria

A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] National overview
[2] Cross River state

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[1] National overview
Date: Fri 10 Feb 2017
Source: Weekly Epidemiological Report, Nigeria Centre for Disease Control, Nigeria Federal Ministry of Health 7 (05) [edited]
http://www.ncdc.gov.ng/reports/weekly

The Lassa fever outbreak is currently active in 9 States across Nigeria; Ogun, Bauchi, Plateau, Ebonyi, Ondo, Edo, Taraba, Nasarawa and Rivers. In reporting week 6 2017, 13 new suspected cases were reported from 7 LGAs in 7 States. Laboratory investigations carried out for Lassa Fever and other VHFs confirmed 4 Lassa Fever positive cases. One death was recorded (Case Fatality Rate for the week among suspect cases: 8 percent). The onset of this outbreak in Nigeria
dates back to December 2016 (week 49). Cumulatively, a total of 196 suspected cases have been reported. So far, 53 cases have been laboratory confirmed and 5 cases classified as probable. Of these, 31 deaths have been recorded, 26 of them occurring in confirmed cases and 5 in probable cases. The Case fatality rate for all cases is 20.4 percent and for all confirmed/probable cases is 53.4 percent.

Nigeria records an annual increase in Lassa fever cases in the in the dry season. The Nigeria Centre for Disease control (NCDC) has the responsibility of coordinating the response to the outbreaks in Nigeria and has increased its efforts to respond to the current outbreak. In 2016, NCDC pre-positioned of commodities for case management of Lassa fever across the 36 states of the federation including the Federal Capital Territory (FCT). New VHF interim guidelines were developed and circulated and also put on the NCDC website. This year [2017], we are collecting
detailed epidemiological information on all probable or confirmed cases.

1.0 Thirteen (13) suspected cases of Lassa
fever with four (4) lab. confirmed and 1
death (CFR, 8 percent) were reported from 7
LGA (7 States) in week 5, 2017.

1.2. Laboratory results of the 13 suspected
were 4 positive and 4 negative for Lassa
fever and other VHFs [viral hemorrhagic fevers] while 5 pending.

1.3. Between weeks 1 and 5 (2017), 107
suspected Lassa fever cases with 18 lab confirmed
and 10 deaths (CFR, 9.4 percent)
from 20 LGAs (10 States) were reported.

1.4. Between weeks 1 & 52 2016, 921
suspected Lassa fever cases with 109
lab-confirmed and 119 deaths (CFR,
12.9 percent) from 144 LGAs (28 States & FCT)
were reported compared with 430
suspected cases with 25 lab-confirmed
and 40 deaths (CFR, 9.3 percent) from 37 LGAs (14 States & FCT) at the same
period in 2015.

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

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Communicated by:
Olutayo Olajide Babalobi
Lecturer and Consultant Epizootiologist,
(One Health, Participatory Epizootiology and Veterinary ICT Research Group),
Department of Veterinary Public Health and Preventive Medicine,
Faculty of Veterinary Medicine,
University of Ibadan, Ibadan,
Nigeria.

[Lassa fever remains a problem in Nigeria because the virus is endemic there. Virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (in the genus _Mastomys_) or their excreta. Transmission also occurs in health facilities when personal protection equipment is not employed and barrier nursing practices are not adequate to protect staff from blood and secretions of infected patients.

As noted in previous posts, prevention and control of Lassa fever in nature depends on control of the rodent reservoir, which occurs across Nigeria and beyond. Reduction of populations of this rodent will require active participation at the village level. That will necessitate mounting a public education program with support of rodent control technicians. Preventing entry of rodents into the home and keeping food materials tightly covered are helpful measures to prevent infection. Elimination of these rodents completely is probably not possible.

Olutayo Olajide Babalobi is thanked for sending in this report.

Images of _Mastomys_ mice can be seen at http://www.ispot.org.za/node/255877.

Maps of Nigeria can be accessed at http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf and http://healthmap.org/promed/p/62. - Mod.TY

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[2] Cross River state
Date: Thu 23 Feb 2017
Source: Premium Times [edited]
http://www.premiumtimesng.com/health/health-news/224356-woman-dies-lassa...

A 22-year old woman was on [Wed 22 Feb 2017] confirmed dead from Lassa fever in Calabar, capital of Cross River State. The deceased, who had taken ill in Benue State, reportedly requested an unnamed hospital where she was being treated to refer her to Eburutu Barracks clinic in Calabar to meet her husband who works with the military.

From Eburutu clinic, she was taken to the Navy Hospital, Calabar, where she was managed for some days before being referred to the University of Calabar Teaching Hospital where she died less than 12 hours after admission. A laboratory examination at the hospital confirmed that she died of viral haemorrhagic fever.

When contacted in a telephone conversation, the Chief Medical Director of the hospital, Thomas Agan, confirmed the incident but added that there was no cause for alarm as the matter was under control.

Mr Agan, who refuted the claims that the deceased was on admission for days in the teaching hospital before her death on [Wed 22 Feb 2017], disclosed that she was managed at Navy hospital before being brought to the teaching hospital in a critical condition. "There's no cause for alarm. The woman died less than 12 hours when she was brought to the teaching hospital. She was in Navy hospital all this while and was only brought here in a critical situation.

"We are just worried about our doctors and nurses who attended her. We have quarantined them and will write officially to the health minister and the director, Centre for Disease Control tomorrow".

[Byline: Inyali Peter]

--
Communicated by:
ProMED-mail from HealthMap Alerts

[Concern about the medical staff that attended the patient is justified. There are many documented cases where medical staff acquire their Lassa fever virus infections from patients in hospitals and medical centers. When Lassa fever is suspected, attending staff must wear personal protective equipment (PPE) and have received training about its proper use. - Mod.TY

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/62.]

See Also
Lassa fever - West Africa (05): Nigeria (NA) 20170215.4842179
Lassa fever - West Africa (04): Liberia 20170209.4827934
Lassa fever - West Africa (03): Nigeria (RI) 20170122.4782917
Lassa fever - West Africa (02): Nigeria (NA) 20170118.4773375
Lassa fever - West Africa (01): Nigeria (OG) 20170101.4735363
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