LASSA FEVER - WEST AFRICA (28): NIGERIA

Posted on 28TH JUL 2017
tagged Lassa Fever, West Africa; Nigeria

A ProMED-mail post
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In this report:
[1] Plateau state
[2] National

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[1] Plateau state
Date: Tue 25 Jul 2017
Source: News Agency of Nigeria [edited]
http://www.nan.ng/headlines/lassa-fever-one-case-confirmed-plateau/

The Plateau State Commissioner ‎for Health, Dr Kuden Deyin on [Tue 25 Jul 2017] confirmed another case of Lassa fever in the state.

Deyin who made the confirmation to our correspondent in Jos, said the patient who was brought-in from Garkawa in Mikang Local Government Area was displaying symptoms of Lassa fever.

"After blood sample was taken from the patient, the result came out positive and the patient is currently responding to treatment at the Jos University Teaching Hospital (JUTH).

"The state has so far recorded 4 cases of Lassa fever and 3 out of the 4 patients are responding to treatment at the Jos University Teaching Hospital while one patient died,'' he said.

The commissioner advised the public to ensure that they maintain a very high standard of personal hygiene and ensure that their environments are kept clean.

"Food stuffs should be kept in rodent-proof containers and people should also desist from drying their food stuffs on the highway, as they never can tell when rats will defecate or urinate on them.

"Health workers should be on the alert while private medical practitioners are advised not to keep patients who manifest symptoms of Lassa fever for long. Rather such patients should be referred to tertiary health institutions for prompt medical attention as time was of the essence in treating Lassa fever,'' the commissioner said.

On [Sat 8 Jul 2017], students from Federal Government Girls College, were rushed from the school clinic to the Jos University Teaching Hospital and it was observed that they were displaying symptoms of Lassa fever.

Their blood samples were taken to Lagos University Teaching Hospital (LUTH) were it was discovered that 3 out of the 4 samples were positive.

Lassa fever, also known as Lassa hemorrhagic fever (LHF), is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not develop symptoms.

When symptoms occur they typically include fever, weakness, headaches, vomiting, and muscle pains.

The virus is commonly transmitted by rats and is said to be responsible for about 5000 deaths every year.

Recently the Nigerian Medical Association (NMA) alerted Nigerians on the need to raise their guard against another outbreak of Lassa fever and Ebola.

Dr Tunde Olawepo, the Chairman of the association in Kwara told our correspondent in an interview that Nigeria must not let down its guard against the deadly viruses, Ebola and Lassa fever.

According to him, surveillance of travellers entering the country has stopped just as people had relaxed with personal hygiene like regular washing of hands and use of sanitizers. "People have stopped using hand sanitizers and frequent hand washing as before. We need to step up with preventive measures and this means people must keep up with hygiene at all times," he said.

[Byline: Blessing Odega]

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Communicated by:
ProMED-mail from HealthMap Alerts

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[2] National
Date: Fri 14 Jul 2017
Source: Nigeria Centre for Disease Control [NCDC] Weekly Epidemiological Report 7(26) [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. 3 suspected cases of Lassa fever with 3 Laboratory confirmed and one death (CFR, 33. 33 percent) were reported from Owo LGA (Ondo State) in week 26, 2017 compared with zero case at the same period in 2016.
1.2. Laboratory results of the 3 suspected cases were 3 positives (Ondo - 3) for Lassa fever.
1.3. Between weeks 1 and 26 (2017), 320 suspected Lassa fever cases with 79 laboratory confirmed cases and 53 deaths (CFR, 16.56 percent) from 63 LGAs [local government areas] (22 States) were reported compared with 744 suspected cases with 72 laboratory confirmed cases and 87 deaths
(CFR, 11.69 percent) from 126 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 & 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, including Infection, Prevention and Control training.
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- 26, 2016 & 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 1-26 [1 Jan-2 Jul 2017]:
State: Cases / Laboratory confirmed / Deaths
Adamawa: 6 / 0 / 2
Akwa Ibom 1 / 1 / 0
Bauchi: 10 / 3 / 3
Cross River: 7 / 0 / 1
Ebonyi: 4 / 1 / 1
Edo: 123 / 29 / 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: 10 / 1 / 0
Ondo: 23 / 15 / 5
Plateau: 10 / 5 / 6
Rivers: 6 / 1 / 0
Taraba: 38 / 12 / 9
Yobe: 1 / 0 / 1
Total: 320 / 79 / 53

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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

[Cases have increased by 3, confirmed cases by 3 and deaths by one in the past week.

Once again, ProMED thanks Dr Olutayo Olajide Babalobi for sending in the Epidemiological Report above. - Mod.TY]

[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 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]
]

See Also
Lassa fever - West Africa (27): Nigeria 20170714.5173313
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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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