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Published Date: 2019-03-24 12:36:54
Subject: PRO/AH/EDR> Lassa fever - West Africa (19): Nigeria
Archive Number: 20190324.6383813
LASSA FEVER - WEST AFRICA (19): NIGERIA
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Date: Sun 17 Mar 2019
Source: Nigeria Center for Disease Control (NCDC) [edited]
https://ncdc.gov.ng/themes/common/files/sitreps/d3cfc533ee17f071904aa4aec5f764cc.pdf


Highlights
- In the reporting Week 11 (11 - 17 Mar 2019) 23 new confirmed cases were reported from 9 states - Edo (8), Ondo 4), Ebonyi (3), Bauchi (3), Taraba (1), Imo (1), Enugu (1), Benue (1) and Kebbi (1) with 4 new deaths in Edo (2), Benue (1) and Bauchi (1) States
- From 1 Jan - 17 Mar 2019, a total of 1801 suspected cases have been reported from states. Of these, 495 were confirmed positive, 15 probable and 1277 negative (not a case)-Table 1
- Since the onset of the 2019 outbreak, there have been 114 deaths in confirmed cases. Case fatality ratio in confirmed cases is 23.0%
- 21 States (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Plateau, Taraba, FCT, Adamawa, Gombe, Kaduna, Kwara, Benue, Rivers, Kogi, Enugu, Imo, Delta, Oyo, Kebbi and Cross River) have recorded at least one confirmed case across 73 Local Government Areas- Figure 1
- In the reporting week 11, one new health care worker was affected in Ebonyi state. A total of 16 health care workers have been infected since the onset of the outbreak in 7 States - Edo (7), Ondo (3), Ebonyi (2), Enugu (1), Rivers (1), Bauchi (1) and Benue (1) with 2 deaths in Enugu and Edo States
- 63 patients are currently being managed at various treatment centres across the country: Irrua Specialist Teaching Hospital(ISTH) treatment Centre (26), Federal Medical Centre Owo (16), Federal Teaching Hospital Abakaliki (10), Nasarawa(1), Bauchi(1), Plateau (3), Taraba (4) and others (2)
- A total of 5790 contacts have been identified from 19 States. Of these 2353 (40.6%) are currently being followed up, 3384 (58.4%) have completed 21 days follow up, while 4 (0.1%) were lost to follow up. 84 (1.5%) symptomatic contacts have been identified, of which 49(1.0%) have tested positive
- Assessment of the 2 treatment centres in Plateau state by NCDC case management team
- National Lassa fever multi-partner, multi-sectoral 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 17 Mar 2019
Figure 2 [map]. LGA attack rate of confirmed Lassa fever cases in Nigeria as at 17 Mar 2019
Figure 3 [graph]. Epicurve of Lassa fever Confirmed (495) Cases in Nigeria - week 01-11, 2019
Figure 4 [graph]. Weekly trends of Lassa fever Confirmed Cases in Nigeria, 2016/week 01-2019/week 11
Figure 5 [graph]. Confirmed Lassa fever cases in Nigeria with state specific Case Fatality Rates (CFR) as at 17 Mar 2019

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Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

[The 52 new confirmed and 1801 suspected cases (up from 52 confirmed and 1374 suspected cases in the previous report) indicate that Lassa fever virus transmission is continuing, as Nigeria is now well within the period of the year when more cases usually occur, as illustrated in the graph in Figure 3. There has been a peak in case numbers between weeks 1 - 11 over the past 3 years and probably will be the case again this year (2019). There are 114 confirmed deaths, up from 93 in the previous reporting period. Unfortunately, one new healthcare worker was infected during this reporting period, and the total infected healthcare workers is 16. This outbreak remains widespread so far in 2019, with confirmed cases occurring in 21 states, and the number of affected LGAs has increased from 66 2 previous reporting periods ago to 73 at week 11.

Transmission of Lassa virus occurs when individuals are in contact with rodent reservoir hosts' excreta or are within healthcare facilities. It would be interesting to know whether the prevalence of Lassa fever virus has been increasing in populations of rodent hosts in areas where human cases are occurring.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_: https://www.inaturalist.org/taxa/45326-Mastomys-natalensis
_Mastomys erythroleucus_ and _Hylomyscus pamfi_: http://punchng.com/nigerias-large-rat-population-threatens-lassa-fever-war/.

The maps and graphs in the report above are interesting and provide a good picture of how the outbreak has progressed over time. - Mod.TY

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

See Also

Lassa fever - West Africa (18): Nigeria 20190318.6374495
Lassa fever - West Africa (17): Nigeria 20190309.6359113
Lassa fever - West Africa (16): Nigeria 20190304.6348673
Lassa fever - West Africa (15): Nigeria (ON) 20190301.6342760
Lassa fever - West Africa (15): Nigeria (ON) 20190301.6342760
Lassa fever - West Africa (14): Nigeria (PL) 20190222.6331712
Lassa fever - West Africa (13): Nigeria 20190222.6330382
Lassa fever - West Africa (12): Nigeria (EB) 20190219.6325960
Lassa fever - West Africa (11): Nigeria 20190218.6322390
Lassa fever - West Africa (10): Nigeria 20190211.6307740
Lassa fever - West Africa (09): Nigeria (ON) 20190204.6294229
Lassa fever - West Africa (07): Nigeria 20190201.6290606
Lassa fever - West Africa (06): Nigeria 20190131.6288130
Lassa fever - West Africa (05): Nigeria 20190124.6274305
Lassa fever - West Africa (04): Nigeria (PL, KW ex Benin) 20190117.6264610
Lassa fever - West Africa (03): Nigeria 20190111.6253867
Lassa fever - West Africa (01): Nigeria 20190107.6246303
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