LASSA FEVER - WEST AFRICA (26): NIGERIA

Posted on 10TH JUL 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 report:
[1] Plateau state fatality
[2] National summary

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[1] Plateau state fatality
Date: Sat 8 Jul 2017 9:34 AM
Source: Vanguard [edited]
http://www.vanguardngr.com/2017/07/fresh-lassa-fever-break-kills-fggc-st...

A student of Federal Government Girls College, FGGC, Langtang in Plateau State has been confirmed dead as a result of fresh outbreak of Lassa fever, the State Commissioner for Health, Kuden Kamshak confirmed.

He added modality has been put in place to curtail its spread as the disease is not new to the State. Also, a statement issued yesterday [Fri 7 Jul 2017] after the burial of the deceased student and signed by Nkiruka Pedro-Iyalla, for the Exco of the School's Old Girls' Association said, "the student passed away at the Jos University Teaching Hospital (JUTH) on [Sat 1 Jul 2017] after showing symptoms of Typhoid Fever."

The Association which had been in close touch with the School authority added, "There were rumours of several other students also being ill with the same symptoms who were sent home. But this turns out to be incorrect as 3 other students were confirmed to be admitted at JUTH and are being treated for different ailments. "One of them was being treated for perforated intestine and has had surgery; the other fell and injured herself while the 3rd is being managed for renal problems."

Mr Magaji, a senior member of staff at the school, personally visited the family of the deceased and the girls being treated at JUTH over the weekend." Meanwhile, the school Authority has taken steps to help forestall any major health outbreak as the resumption of students from Mid-term break has been moved by one week. Instead of 2 July 2017, the students will be expected back on 9 July 2017.

All the water sources at the school have been treated and representatives of the Plateau State Water Board have taken samples for testing and fumigation of the entire school compound is ongoing and should be concluded today [Sat 8 Jul 2017].

The SS3 girls are currently in the school on Extension and so far, none of the girls is ill. The head nurse at the clinic has also confirmed that none of the SS3 students has reported any illness in the past 2 weeks.

[Bylibe: Marie-Therese Nanlong]

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Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Plateau state is endemic for Lassa fever virus. The above report provides no information about the circumstances under which the girl became infected.

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

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

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[2] National summary
Date: Fri 30 Jun 2017
Source: Nigeria Centre for Disease Control [NCDC] Weekly Epidemiological Report 7(24) [edited]
http://www.ncdc.gov.ng/reports/weekly

1. Lassa fever
Please note that the data reflects the routine reports i.e. all suspected cases including the laboratory positive and negative cases
1.1. A total of 6 suspected cases of Lassa fever with 3 Laboratory confirmed and one death were reported from 4 LGAs (Edo, Ondo and Plateau States) in week 24, 2017 compared with zero case at the same period in 2016.
1.2. Laboratory results of the 6 suspected cases were 3 positives (Edo - 2 and Ondo - 1) and 3 pending (Plateau - 3).
1.3. Between weeks 1 and 24 (2017), 308 suspected Lassa fever cases with 69 laboratory confirmed cases and 50 deaths (CFR, 16.23 percent) from 61 LGAs (22 States) were reported compared with 717 suspected cases with 71 laboratory confirmed cases and 87 deaths (CFR, 12.15 percent) from 125 LGAs (27 States) during the same period in 2016 (Figure 1).
1.4. Between weeks 1 and 52 2016, 921 suspected Lassa fever cases with 109 laboratory confirmed cases and 119 deaths (CFR, 12.92 percent) from 144 LGAs (28 States and FCT) were reported compared with 430 suspected cases with 25 laboratory confirmed cases and 40 deaths (CFR, 9.30 percent) from 37 LGAs (14 States and FCT) during the same period in 2015 (Figure 2).
1.5. Investigation and active case search ongoing in affected States with coordination of response activities by the NCDC with support from partners.
1.5.1. National Lassa Fever Working Group meeting and weekly National Surveillance and Outbreak Response meeting on-going at NCDC to keep abreast of the current Lassa fever situation in the country.
1.5.2. Response materials for VHFs prepositioned across the country by NCDC at the beginning of the dry season
1.5.3. New VHF guidelines have been developed by the NCDC (Interim National Viral Haemorrhagic Fevers Preparedness guidelines and Standard Operating Procedures for Lassa fever management).
1.5.4. Ongoing reclassification of reported Lassa fever cases
1.5.5. Ongoing review of the variables for case-based surveillance for VHF
1.5.6. VHF case-based forms completed by affected States are being entered into the new VHF management system. This system allows for the creation of a VHF database for the country.
1.5.7. NCDC team sent to Edo State to support Lassa fever data harmonization and Updating of VHF case-based management database.
1.5.8. Confirmed cases are being treated at identified treatment/isolation centres across the States with Ribavirin and necessary supportive management also instituted
1.5.9. Onsite support was earlier provided to Ogun, Nasarawa, Taraba, Ondo and Borno States by the NCDC and partners
1.5.10. Offsite support provided by NCDC/partners in all affected States
1.5.11. NCDC and partners are providing onsite support in Ondo State
1.5.12. States are enjoined to intensify surveillance and promote Infection, Prevention and Control (IPC) measures in health facilities.

Figure 1: Map of Nigeria showing areas affected by Lassa fever, week 1 - 24, 2016 and 2017
Figure 2: Map of Nigeria showing areas affected by Lassa fever, week 1 - 53, 2015 and week 1 - 52, 2016

Table of cases by state, cumulative data weeks 1-24 [1 Jan-19 30 Jun 2017]:
State: Cases / Lab Confirmed / Deaths
Adamawa: 6 / 0 / 2
Anambra: 1 / 1 / 0
Bauchi: 9 / 3 / 3
Cross River: 7 / 0 /1
Ebonyi: 4 / 1 / 1
Edo: 122 / 28 / 9
Enugu: 1 / 1 / 1
FCT: 2 / 0 / 0
Gombe: 15 / 0 / 1
Jigawa: 1 / 0 / 0
Kadun: 1 / 0 / 0
Kano: 23 / 2 / 10
Katsina: 3 / 0 / 0
Kebbi: 1 / 0 / 1
Kogi: 3 / 1 / 1
Nasarawa: 28 / 6 / 2
Ogun: 12 / 1 / 0
Ondo: 14 / 7 / 2
Plateau:10 / 5 / 6
Rivers: 6 / 1 / 0
Taraba: 38 / 12 / 9
Yobe: 1 / 0 / 1
Total: 308 / 69 /50

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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

[The numbers of cases and deaths from Lass fever continue to slowly increase. As noted in earlier comments, 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 protective equipment is not employed and barrier nursing practices are not adequate to protect staff from blood and secretions of infected patients.

Images of _Mastomys_ mice, the rodent reservoir of Lass fever virus, can be seen at https://www.ispotnature.org/communities/southern-africa/view/observation....

Once again, Dr Olutayo Olajide Babalobi is thanked for sending in the above Epidemiological Report. - Mod.TY

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

See Also
Lassa fever - West Africa (25): Nigeria 20170629.5140763
Lassa fever - West Africa (24): Nigeria 20170626.5130588
Lassa fever - West Africa (23): Nigeria (ON) 20170622.5124247
Lassa fever - West Africa (22): Nigeria (AN) 20170620.5118831
Lassa fever - West Africa (21): Nigeria 20170617.5112720
Lassa fever - West Africa (20): Nigeria 20170607.5088880
Lassa fever - West Africa (19): Nigeria 20170604.5082193
Lassa fever - West Africa (18): Nigeria 20170530.5070103
Lassa fever - West Africa (17): Nigeria 20170513.5033800
Lassa fever - West Africa (16): Nigeria (BA) 20170412.4967018
Lassa fever - West Africa (15): Nigeria (KO) 20170404.4947996
Lassa fever - West Africa (14): Nigeria 20170402.4943005
Lassa fever - West Africa (13): update 20170328.4931422
Lassa fever - West Africa (12): Nigeria 20170327.4929174
Lassa fever - West Africa (11): Nigeria 20170319.4911462
Lassa fever - West Africa (10): Benin, Togo, Burkina Faso 20170312.4896305
Lassa fever - West Africa (09): Nigeria (BO) 20170302.4875164
Lassa fever - West Africa (08): Benin 20170301.4872702
Lassa fever - West Africa (07): Nigeria (BA) 20170225.4864837
Lassa fever - West Africa (06): Nigeria 20170225.4862689
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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