LASSA FEVER - WEST AFRICA (19): NIGERIA

Posted on 15TH MAR 2018
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
[2] Ekiti state

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[1] National
Date: Sun 11 Mar 2018
Source: Nigeria Centre for Disease Control Situation Report [edited]
http://www.ncdc.gov.ng/diseases/sitreps/?cat=5&name=An%20update%20of%20L...

Highlights [download the PDF for week 11]
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- In the reporting Week 10 (5-11 Mar 2018) 12 new confirmed cases were recorded from 7 States Edo (3), Ondo (2), Bauchi (2), Ebonyi (1), Plateau (1), Taraba (1) Ekiti (1) and Kaduna (1) with 4 new deaths, 3 in confirmed cases from Plateau (1), Edo (1), and Kaduna (1) and one probable death in Ondo.
- From 1 - 11 Mar 2018, a total of 1386 suspected cases. Of these, 365 are confirmed positive, 9 are probable, 988 are negative (not a case) and 24 are awaiting laboratory results (pending).
- Since the onset of the 2018 outbreak, there have been 114 deaths: 81 in positive-confirmed cases, 9 in probable cases and 24 in negative cases. Case Fatality Rate in confirmed and probable cases is 24 percent - Table 1.
- 19 states have recorded at least one confirmed case across 55 Local Government Areas (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo, Plateau, Lagos, Taraba, Delta, Osun, Rivers, FCT, Gombe, Ekiti and Kaduna). Kaduna state reported one new confirmed case for the 1st time in this outbreak. A total of 7 states have exited the active phase of the outbreak; 12 States remain active - Table 1/ Figure 1.
- In the reporting week 10, no healthcare worker was affected. Since the onset of the outbreak, 16 health care workers have been affected in 6 states: Ebonyi (9), Nasarawa (1), Kogi (1), Benue (1), Ondo (1) and Edo (3) with 4 deaths in Ebonyi (3) and Kogi (1).
- As many as 84 percent of all confirmed cases are from Edo (43 percent), Ondo (25 percent), and Ebonyi (16 percent) states.
- A total of 36 cases are currently under treatment in treatment centres across 7 states
- National RRT team (NCDC staff and NFELTP residents) batch C has been deployed to replace batch B in Ebonyi, Ondo, Edo and new team deployed to Bauchi State.
- A total of 3323 contacts have been identified from 19 active states. Of these 1150 are currently being followed up, 2182 have completed 21 days follow up and 21 of the 54 symptomatic contacts have tested positive from 3 states (Edo-11, Ondo-7 and Ebonyi-3).
- WHO and NCDC has scaled up response at National and State levels.
- NCDC deployed teams to four Benin Republic border states (Kebbi, Kwara, Niger and Oyo) for enhanced surveillance activities.
- National Lassa fever multi-partner multi-agency Emergency Operations Centre (EOC) continues to coordinate the response activities at all levels.

Figure 1 [map]. Distribution of Confirmed Lassa Fever cases in Nigeria as at 11 Mar 2018

Figure 2 [map]. Distribution of Suspected and Confirmed Lassa Fever cases in Nigeria by LGA [local government area]

Figure 3 [graph]. Confirmed (365) and Probable (9) Cases of Lassa fever by epidemiological week in Nigeria week 50, 2017 to week 10, 2018

Figure 4 [graph]. Confirmed Lassa fever cases in Nigeria with state specific Case Fatality Rates (CFR) as at 11 Mar 2018

Figure 5 [graph]. Epicurve of confirmed cases Lassa fever in Edo State week 52, 2017 to week 9, 2018

Figure 6 [graph]. Distribution of Lassa fever confirmed cases in Edo State by LGA as at 11 Mar 2018

Figure 7 [graph]. Epicurve of Lassa fever confirmed cases in Ondo State week 52, 2017 to week 10, 2018

Figure 8[graph]. Epicurve of Lassa fever confirmed cases in Ebonyi State week 52, 2017 to week 10, 2018

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Communicated by:
ProMED-mail from HealthMap Alerts

[New cases have occurred over the past few days in several states. Providing adequate surveillance and timely treatment over such a large geographic area is challenging. Fortunately, there is international help participating in treatment and surveillance. The maps and graphs in the above report are interesting and provide a good picture of how the outbreak has progressed over time. They can be accessed at the above URL.

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

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[2] Ekiti state
Date: Wed 14 Mar 2018
Source: All Africa [edited]
http://allafrica.com/stories/201803140105.html

The Ekiti State Government has uncovered fresh cases of Lassa fever, which has claimed 3 lives. The victims were a patient who tested positive to the disease, and 2 others who had contact with the deceased.

Commissioner for Health, Rotimi Ojo, who made this disclosure in Ado-Ekiti yesterday [Tue 13 Mar 2018], said 5 of the 8 other suspected cases in the state tested negative, one was uncertain and the last was pending as at press time. He, however, stressed that there was no cause for alarm, noting that the state government was taking proactive steps in surveillance activities that would involve all residents due to some recorded cases and deaths in neighbouring states.

He assured that the State Disease Control team had been activated, while the process of sensitising the people with jingles, adverts and other communication media were ongoing. Ojo said similar actions taken during the 2016 outbreak were successful, adding that the epidemic was perfectly controlled while the patient, who was properly managed, survived.

He disclosed that the isolation centre's at Ido Federal Teaching Hospital, Ido-Ekiti; Oba Adejuyigbe General Hospital and the Ekiti State University Teaching Hospital, Ado-Ekiti were still operational. He urged health practitioners, teachers, traditional rulers, religious leaders, as well as community and opinion leaders to join hands with the state government to prevent a further spread of the disease in the state.

Meanwhile, the Cross River State government is set to commission a pharmaceutical company- CalaPharm that would manufacture drugs for the treatment of Lassa fever, meningitis and other diseases next month [April 2018].

The team, which was led by the Commissioner for Information and Orientation, Mrs. Rosemary Achibong, also visited Rice City and Industrial Zone, which would house private companies under APZ.

Consultant in charge of the project, Farhan Khan, made this known yesterday [Tue 13 Mar 2018] in Calabar during inspection of projects undertaken by the present administration. He said the factory, which would be of World Health Organisation (WHO) standard would complement the Governor Ben Ayade Care and also focus on mother and childcare. Khan said: "Production is coming up soon, so we will be producing drugs of WHO standards and by next month, it should be commissioned because the machines are already here."

[Byline: Ayodele Afolabi and Tina Todo]

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Communicated by:
ProMED-mail from HealthMap Alerts

[Active participation of individual households is essential for prevention of Lassa fever virus infections. Preventing Lassa virus transmission requires getting local people to understand that virus spread to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (in the genus _Mastomys_) or its excreta; and this can be difficult. Preventing this contact requires understanding that leads to action. This requires an extensive and continuous public education effort. Transmission of the virus also occurs in health facilities when personal protective equipment is not employed, and barrier-nursing practices are not adequate to protect staff from blood and secretions of infected patients. Although no vaccine is available, Ribavirin has been used to successfully treat patients and is most effective if patients are treated early in the course of infection.

Images of the mastomys mouse, the rodent reservoir of Lassa fever virus, can be seen at https://www.inaturalist.org/taxa/45326-Mastomys-natalensis. - Mod. TY]

See Also
Lassa fever - West Africa (18): Nigeria (BA) 20180313.5683816
Lassa fever - West Africa (16): Nigeria 20180306.5670231
Lassa fever - West Africa (14): Nigeria 20180228.5655382
Lassa fever - West Africa (13): Nigeria 20180222.5645501
Lassa fever - West Africa (12): Nigeria 20180221.5641157
Lassa fever - West Africa (11): Nigeria, WHO 20180215.5629350
Lassa fever - West Africa (10): Nigeria 20180212.5622070
Lassa fever - West Africa (07): Nigeria 20180206.5608967
Lassa fever - West Africa (06): Nigeria (DE, ON) 20180201.5600192
Lassa fever - West Africa (05): Nigeria 20180131.5597457
Lassa fever - West Africa (04): Nigeria 20180125.5585380
Lassa fever - West Africa (03): Benin (AK) ex Nigeria, WHO 20180124.5581805
Lassa fever - West Africa (02): Nigeria, Benin (AK) ex Nigeria 20180124.5576379
Lassa fever - West Africa: Nigeria 20180115.5561615
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