Nigeria epidemiology reports 2013

[Ronan Kelly]

Link to 2012 thread; http://www.flutrackers.com/forum/sho...d.php?t=181234

Weekly updates on epidemics in Nigeria: As at 1st February 2013



1. Updates on Poliomyelitis as at 25th January, 2013
1.1. As at 25th January 2013, 121 cases of Wild Polio Virus (WPV) were recorded in 13 States (namely,
Bauchi, Borno, FCT, Jigawa, Kaduna, Kano, Katsina, Nasarawa, Niger, Sokoto, Taraba, Yobe and
Zamfara States) compared to 62 cases in 8 States for the same period in 2011 (Figure 1).
1.2. In the reporting week 4 (2013), no new WPV case was reported.
1.3. As at 25th January, 2013, Nigeria has 7 cases of cVDPV2: 3 in Kano State, 3 in Sokoto State and one in
Kebbi State as well as one aVDPV2 in Edo States compared to 35 cases of cVDPV2 in 10 States for the same period in 2011 (Figure 2).
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1.4. So far, 121 confirmed cases of WPV and 7 confirmed cases of cVDPV2 have been recorded in 13 States
as at week 4, 2013 (Table 2).
1.5. Nigeria now contributes up to 96% of polio burden in AFRO.
1.6. From February - December, 2012, seven (7) SIAs for OPV were conducted in both the entire (National)
and selected parts (Sub-National) of the country (Figure 3). Between 12th and 15th January, 2013, revaccination
activity was conducted at ward level in high risk LGAs.
1.7. A nationwide Immunization Plus Days (NIPDs) for 2nd – 5th February, 2013 with bOPV is on-going and
another NIPDs with tOPV to be synchronized with Niger Republic was planned for 2nd – 5th March, 2013
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2. Lassa fever update as at 1st February, 2013
2.1. As at 1st February 2013, a total of 228 suspected cases of Lassa fever, 64 laboratory-confirmed with
15 deaths were reported from 23 LGAs (9 States) in 2013 (Figure 4). In the reporting week 4 (2013), 7 suspected cases of Lassa fever, 4 Laboratory confirmed with 0 death were reported from Benue and Ebonyi States.
2.2. A total of 1723 suspected Lassa fever cases, 201 Laboratory confirmed and 112 deaths (CFR 6.50%)
were reported from 42 LGAs in 23 States in 2012 (Figure 5).
2.3. The National Lassa Fever outbreak rapid response team responded and contained confirmed outbreaks of Lassa fever in Benue, Edo, Nasarawa, Ondo and Plateau States.
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3. Updates on Cerebrospinal meningitis (CSM) as at 1st February, 2013
3.1. From weeks 01-04, 2013, 72 suspected CSM cases with 0 deaths and Case Fatality Rate of 0.0% were reported, and 32 LGAs (15 States) have reported at least one CSM case.
3.2. In the reporting week 4, 32 suspected CSM cases including 0 death were reported from 16
LGAs (8 States) (Figure 6). No LGA crossed the alert/epidemic threshold.
3.3. From week 1 - 52 2012, a total of 1206 suspected CSM cases, 13 laboratory confirmed and
74 deaths (CFR 6.14%) were reported (Figure 5). The CSM suspected cases in Nigeria slightly
rose between 2011 and 2012 as against the sharp drop between 2010 and 2011 (Figure 7).
3.4. CSM reporting from States to National Level: on the average, 62.8% of the 26 endemic
states sent CSM reports timely while 83.3% were complete. This is more than 44% timeliness
and 58% completeness recorded during the same period in 2012.
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4. Update on Suspected Cholera as at 1st February, 2013
4.1. So far in 2013 weeks 01 – 04, no suspected cholera case/death was reported compared to 13
suspected cases with one death recorded in the same period in 2012.
4.2. A total of 597 suspected Cholera cases with no laboratory confirmation and 18 deaths (CFR
3.02%) were reported between weeks 1 - 52 2012 (Figure 8). On the whole, 29 LGAs (11
States) reported at least 1 case of suspected cholera in 2012. The reported suspected cases of
cholera has drastically dropped between 2011 and 2012 (Figure 9).
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5. Update on Suspected Measles as at 1st February, 2013
5.1. In the reporting week 4 (2013), 537 suspected cases of measles with 1 death (CFR, 0.19%) were reported
from 23 States. So far in 2013 (weeks 1 - 4) a total of 2005 suspected measles cases with 21 deaths
(CFR, 1.05%) have been recorded.
5.2. In 2012, a total of 11061 suspected measles cases, 837 Laboratory confirmed and 126 deaths (CFR
1.14%) were recorded.

6 Update on Guinea Worm Disease (GWD) as at 31st December, 2012
6.1 In 2012, a total of 138 GWD rumour reports were received and investigated
6.2 110 (80%) of these were investigated within 24 hours
6.3 None of these rumours were confirmed to be GWD case
6.4 Nigeria has celebrated 4 consecutive years of zero reporting of Guinea worm disease.
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8. Update on National Influenza Sentinel Surveillance, Nigeria Week 1 - 4, 2013
8.1 From weeks 1 - 4, a total of 94 cases were recruited of which 79 were Influenza like illness (ILI)
and 15 were Severe Acute Respiratory Infection (SARI).
8.2 Up to week 48, 2012, 154 samples (8.2%) tested positive, out of which 105 (68.2%) were
influenza A and 49 (31.8%) influenza B. The subtypes A (2009) H1N1, seasonal H3, seasonal
H1and A/H5 account for 30 (28.6%), 66 (62.8%), 0(0.0%) and 0 (0.0%) of the total influenza A
positive samples respectively. A/not sub typed accounts for 9 (8.6%) of the total positive
influenza A samples.
8.3 The percentage influenza positive in year 2012 was highest (60.7%) in week 39.
8.4 In the reporting week3, 94 samples received but not yet processed.
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[Ronan Kelly]

Weekly Epidemiology Report
Nigeria Centre for Disease Control (NCDC)
Federal Ministry of Health - Nigeria
Issue: Volume 3 No. 5 8th February, 2013



1. Updates on poliomyelitis for week 5 as at 1st February, 2013
1.1. In week 5 2013, no new Wild Polio Virus (WPV) was reported compared with 2 WPV for the period in 2012 (Figure 1).
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2. Lassa fever update for week 5 as at 8th February, 2013
2.1. In week 5 2013, 22 suspected cases of Lassa fever, 3 Laboratory confirmed with 2 deaths (CFR,
9.09%) were reported from 7 LGAs (4 States) compared with 111 cases with 8 deaths (CFR, 7.2%)
in the same period in 2012.
2.2. Between week 1–5 2013, 232 suspected Lassa fever cases with 61 lab confirmed and 12 deaths were
reported compared with 278 cases with 26 deaths (9.35%) in the same period in 2012 (Figure 3).
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3. Update on Suspected Cholera for week 5 as at 8th February, 2013
3.1. In week 5, 2013, no case of cholera reported
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4. Updates on cerebrospinal meningitis (CSM) for week 5 as at 8th February, 2013
4.1. In Week 5 2013, 6 suspected CSM cases including 0 death were reported from 6 LGAs (4
States) compared with 21 suspected CSM cases and 1 death (CFR, 4.76%) in the same period in
2012. No LGA crossed the alert/ epidemic threshold in week 5.
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5. Update on suspected measles for week 5 as at 8th February, 2013
5.1. In week 5 2013, 557 suspected cases of measles with 0 lab confirmed and 0 death were reported from 21
States compared with 220 measles cases and 2 deaths (CFR, 0.91%) in the same period in 2012.
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6 Update on Guinea Worm Disease (GWD) for week 52 as at 31st December, 2012
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6.4 Nigeria has celebrated 4 consecutive years of zero reporting of Guinea worm disease.
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8. Update on National Influenza Sentinel Surveillance, Nigeria week 1 - 4, 2013
8.1 From weeks 1 – 4 2013, a total of 94 cases were recruited of which 79 were Influenza like
illness (ILI) and 15 were Severe Acute Respiratory Infection (SARI).
8.2 Up to week 48, 2012, 154 samples (8.2%) tested positive, out of which 105 (68.2%) were
influenza A and 49 (31.8%) influenza B. The subtypes A (2009) H1N1, seasonal H3, seasonal
H1and A/H5 account for 30 (28.6%), 66 (62.8%), 0(0.0%) and 0 (0.0%) of the total influenza A
positive samples respectively. A/not sub typed accounts for 9 (8.6%) of the total positive
influenza A samples.
8.3 The percentage influenza positive in year 2012 was highest (60.7%) in week 39.
8.4 In the reporting week 4, 94 samples received but not yet processed.
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[Ronan Kelly]

Humanitarian Bulletin
Nigeria
Issue 02 | 01 April 2013

Malnutrition remains a critical humanitarian
challenge
The situation of children and women in the 8 Sahel States of Nigeria remains critical in
terms of food insecurity. UNICEF and partners have estimated that 296,500 children
under-5 will be affected by severe acute malnutrition and an estimated 910,516 by
moderate acute malnutrition in 2013.
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HEALTH
 The 2012 flood led to destruction of health facilities limiting access to basic health services in the affected states. In addition, medical staff, supplies and commodities were generally inadequate, while sexual and reproductive health care including emergency obstetric and newborn care were lacking. Also, access to management of childhood illnesses and referral services for life threatening conditions were poorly organized or non-existent. Existing health centres reported high cases of diarrhoeal, malaria and typhoid.
 WHO is providing support to the Nigerian Centre for Disease Control (NCDC) of the Federal Ministry of Health NCDC/FMOH to implement Early Warning and Alert Network (EWARN) in 15 States that were most severely hit by the 2012 Flood disaster. EWARN aims to provide timely disease surveillance and other health events information for detecting and responding rapidly to signals which may indicate disease outbreaks or other public health emergencies.
 The week 10 EWARN report indicates that there were 1065 cases of malaria reported, of these 51 cases (4.8%) described as severe and another 64 cases (6%) affecting pregnant women. In addition, there were 162 cases of diarrhoea reported. Of these, 48 cases (29.6%) were due to diarrhoea with blood while the remaining 114 cases (70.4%) were due to acute watery diarrhoea. WHO in collaboration with the NCDC/Federal Ministry of Health organized a review meeting of all EWARN Coordinators and Facilitators from the target States at Nassarawa from 13-14th March 2013. Gaps were identified and solutions proffered. A work plan for the next 3-months was also developed.
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[Ronan Kelly]

Weekly Epidemiology Report
Issue: Volume 3 No. 17 3rd May, 2013



1. Updates on poliomyelitis for week 17 as at April 26th, 2013
1.1. In the reporting week (Week 17) 2013, one (1) Wild Polio Virus (WPV) was reported in
Borno State compared with 1 WPV reported from Jigawa State for the same period in 2012.
1.2. From weeks 1-17 2013, 14 new WPV were reported in 7 States compared with 38 WPV in
10 States for the same period in 2012 (Figure 1).
1.3. In the reporting week (Week 17) 2013, no confirmed circulating Vaccine Derived Polio
Virus type 2 (cVDPV2) was reported just as same period in 2012.
1.4. From week 1-17 of both 2012 and 2013, Nigeria had one (1) cVDPV2 each respectively
(Figure 2).
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1.5. So far, 14 confirmed polio cases were reported in 2013 and Nigeria now contributes up to
100% of polio burden in AFRO.
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2. Lassa fever update for week 17 as at 3rd May, 2013
2.1. In the reporting week (Week 17) 2013, 34 suspected Lassa fever cases with 0 death was
reported in 2 States compared with 5 cases with 3 deaths (CFR, 60.0%) in 2 States also the
same period in 2012.
2.2. Between week 1-17 2013, 670 suspected Lassa fever cases with 135 lab confirmed and 26
deaths (CFR, 3.88%) were reported in 22 LGAs across 11 States compared with 866 cases
with 140 lab confirmed 92 deaths (10.67%) in 33 LGAs (21 States) the same period in 2012
(Figure 5).
2.3. National Lassa fever Rapid Response team had investigated and responded to the outbreaks
in the affected States.
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3. Update on suspected Cholera for week 17 as at 3rd May, 2013
3.1. In reporting week (Week 17), 2013, no suspected cholera case/death was reported compared
with 10 cases with 0 death in the same period 2012.
3.2. From week 1-17, 2013, only 3 suspected cholera cases with one death (CFR, 33.33%) were
reported from 2 LGAs in 2 States compared with 230 suspected cholera cases including 4
death with CFR, 1.74% from 17 LGAs in 4 States within the same period in 2012 (Figure 6).
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4. Updates on cerebrospinal meningitis (CSM) for week 17 as at 3rd May, 2013
4.1. In the reporting week (Week 17) 2013, 19 suspected CSM cases with 0 death were reported
from 6 LGAs, 6 States compared with 25 suspected CSM cases and 1 death (CFR, 4.0%) from
17 LGAs, 6 States in the same period in 2012. No LGA has reached alert/epidemic threshold in
the reporting week.
4.2. Between week 1-17 2013, there were 721 CSM cases with 4 lab confirmed 35 deaths (CFR,
4.88%) from 102 LGAs in 24 States compared with 767 cases and 52 deaths (CFR, 6.78%) from
152 LGAs in 26 States within the same period 2012 (Figure 7). Aliero and Gwandu in Kebbi
State, Shagari and Tambuwal LGAs (Sokoto State) have reached alert /epidemic threshold
between weeks 7 and 17.
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5. Update on suspected Measles for week 17 as at 3rd May, 2013
5.1. In the reporting week (Week 17) 2013, two thousand, three hundred seventy-nine (2,379) suspected
cases of measles with 8 deaths (CFR, 0.34%) were reported from 29 States and FCT compared with
288 measles cases and 0 death from 28 States and FCT in the same period in 2012.
5.2. Between week 1 & 17 2013, thirty-three thousand, six hundred and fifty-five (33,655) suspected
measles cases (Figure 8) with 398 deaths (CFR, 0.66%) were reported from 36 States and FCT(Figure
9), about six times increase compared with 5,398 cases with 83 deaths (CFR, 1.54%) from 36 States
and FCT in the same period in 2012.
5.3. Confirmed (lab, epi-link and clinical): 20,258 (Figure 10) from 516 LGAs (Figure 11).
5.4. Age group of most affected children: 9 - 59 months (77%; Figure 12).
5.5. Vaccination status of measles cases: 88% zero dose.
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6. Update on Yellow fever for week 17 as at 3rd May, 2013
6.1. A planned Yellow fever mass campaign, to be supported by Global Alliance for Vaccines
and Immunization (GAVI) and coordinated by NPHCDA, would be coming up later this
year.
Cross Border Surveillance for Yellow fever
The WHO has informed the FMOH of a confirmed case of Yellow fever in Diffa, Republic of
Niger, a community sharing border with two States (Borno and Yobe) in Nigeria. Alert was sent to
the Disease Surveillance and Notification Officers (DSNOs) at the border LGAs ( i.e Abadam and
Mobbar in Borno State and Yusufari and Yunusari in Yobe State) and the two States' epidemiologist to step up active surveillance for Yellow fever and carry out sensitization activities especially in the
border communities to Diffa. Reports received, so far, from the four LGA DSNOs, indicated that
active Yellow fever surveillance and sensitization, including public awareness creation are ongoing
in the LGAs, especially at the border communities to Diffa.

7. Update on Guinea worm disease: as at 3rd May, 2013
7.1. So far as at 3rd May, 2013, no GWD rumours report was received and investigated for week
17, 2013.
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8. Update on flood for week 17 as at 3rd May, 2013
8.1. From the Early Warning Alert and Response Network (EWARN): as at week 17 in 215
reporting sites (11 States):
8.1.1. 1,763 cases of malaria, 434 cases of malaria in pregnancy & 173 cases of severe malaria
were reported (Table 1).
8.1.2. Other diseases were 907 cases of diarrhoea with blood, 385 cases of URTI, 769 cases of
acute watery diarrhoea, 62 measles cases and 57 AJS cases.
8.1.3. Others were 8 cases of suspected cholera, 6 cases each of AHF, 3 cases of suspected
bacterial meningitis, 1 case each of AFP, NNT and schistosomiasis.
8.1.4. Other health conditions: High blood pressure (142 cases), malnutrition (84 cases), diabetes
mellitus (43 cases), stress related problems (39 cases), boating accident (18 cases), asthma
(17 cases), trauma/injury (6 cases), and snake bites (4 cases) (Table 1).
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9. Update on national Influenza sentinel surveillance, Nigeria week 1 - 17, 2013
9.1. From week 1 - 17, a total of 710 cases were reported of which 601 were Influenza like
illness (ILI), 107 Severe Acute Respiratory Infection (SARI) and 2 non-ILI non-SARI cases.
9.2. A total of 705 samples were received out of which 504 were processed. Of the processed
samples, 435(86.3%) were ILI cases while 68(13.5%) were SARI.
9.3. Of the 435 ILI cases, 38 were positive for Influenza as follows:
9.3.1. 20(52.6%) of these positive for Influenza A and 18(47.4%) positive for Influenza B.
9.3.2. 20 positive samples for Influenza A are all (100%) positive for A/H1N1 subtype.
9.4. Of the 68 processed SARI samples,3(4.4%) were positive for A/H1N1while 1(1.5%) was
positive for Influenza B.
9.5. The percentage influenza positive was highest (24.3%) in week 8 (Figure 9).
9.6. In the reporting week 17, 30 samples have not been processed.
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