LASSA FEVER - WEST AFRICA (30): NIGERIA
Posted on 10TH AUG 2017
tagged Lassa Fever, West Africa; Nigeria
In this update:
 Surulere, Lagos
Date: Fri 4 Aug 2017
Source: Nigeria Centre for Disease Control Weekly Epidemiological Report 7(29) [edited]
1. Lassa fever
Please note that the data reflect the routine reports, i.e. all suspected cases including the laboratory positive and negative cases.
1.1. Five suspected cases of Lassa fever were reported from 5 LGAs [local government areas] (Plateau State) in week 29, 2017 compared with one case from Abuja Municipal Area Council (FCT) at the same period in 2016.
1.2. Laboratory results of the 5 suspected cases are 4 positives for Lassa fever, while one was negative for Lassa fever and other VHF.
1.3. Between weeks 1 and 29 (2017), 344 suspected Lassa fever cases with 86 laboratory confirmed cases and 56 deaths (CFR, 16.28 percent) from 67 LGAs (22 states) were reported compared with 746 suspected cases with 72 laboratory confirmed cases and 87 deaths (CFR, 11.66 percent) from 127 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) and are available on the NCDC website.
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 and Plateau state.
1.5.12. States are enjoined to intensify surveillance and promote infection, prevention and control (IPC) measures in health facilities.
[State-by-state case numbers are not provided in this report. - Mod.TY]
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
[Once again, ProMED-mail thanks Dr Olutayo Olajide Babalobi for sending in these Epidemiological Reports.
Case numbers continue to increase slowly. 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 Lassa 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]
 Surulere, Lagos
Date: Tue 8 Aug 2017
Source: Pulse [edited]
Two people have reportedly died from Lassa fever while receiving treatment at the Lagos University Teaching Hospital (LUTH).
Mr. Seun Ogungbure, who works at a diagnostic center in Surulere that gets patients from LUTH, confirmed to Pulse Nigeria in a private chat that the Accident and Emergency unit of the hospital, as well as a few others, have been shut down due to the incident. "It's very rare that they would close down the A and E if it wasn't something serious," he said.
He said after contacting medical staff working at the institution that it was revealed that 2 victims died during the weekend, while a medical officer is critically ill.
"It's not an airborne disease but one that can be passed by physical contact," he said.
Another doctor that works with the hospital confirmed the story, although he said he's only aware of one casualty. He also said: "There's a surveillance team at the hospital now to handle any other patients."
The management of the hospital finally confirmed the story on Tue 8 Aug 2017, as Chief Medical Director Prof. Chris Bode revealed that the 2 victims presented their symptoms too late to do anything to help them. He said: "Each of these 2 patients presented very late and died in spite of efforts to [save] them. The 1st was a 32-year old pregnant lady with a bleeding disorder who died after a stillbirth. Post-mortem examination had been conducted before her Lassa fever status was eventually suspected and confirmed. No less than 100 different hospital workers exposed to this index case are currently being monitored."
He also confirmed that the critically ill staff member of the hospital is a resident doctor from the Department of Anatomic and Molecular Pathology. He contracted the viral hemorrhagic fever after performing autopsies on the dead victims and is currently on admission at the isolation ward of the hospital.
Despite confirming that there are currently 2 other suspected cases of the virus, Prof. Bode also pleaded for members of the public not to panic as the state's Ministry of Health and the Federal Ministry of Health are doing their best to contain the situation. He said, "There are adequate materials for containing the disease while drugs have been made available to treat anyone confirmed with it. The Centre for Disease Control in Nigeria has also been contacted. Two other suspected cases from Lagos state are also currently admitted and quarantined while undergoing confirmatory laboratory tests.
"LUTH has always worked closely with officials of the state Ministry of Health in handling a number of diseases of public concern such as rabies, cholera, Lassa fever and the recent diarrhoea disease at Queen's College," [he added].
The viral hemorrhagic fever is spread by rats and leads to death in extreme cases.
[Byline: Samson Toromade]
ProMED-mail Rapporteur Mary Marshall
ProMED-mail from HealthMap Alerts
[Surulere, in Lagos is within the Lassa fever virus endemic area in Nigeria. It is not clear whether all of these cases were exposed in a hospital or health center or in other locations where rodents in the _Mastomys_ genus are present. Apparently, at least the physician was exposed in the hospital.
Hospital exposures are unfortunate and preventable if health care workers wear personal protective equipment and practice barrier nursing. Monitoring those who have had contact with the cases and provision of preventive medication are prudent. - Mod.TY
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