Issue: Volume 12 No. 27. 27th July 2021 Nigeria Centre for Disease Control Protecting the health of Nigerians Weekly Epidemiological Report Week 27: 5th – 11th July, 2021 Highlight of the Week NCDC hosts her 5th Annual Scientific Conference titled- “Building Back Better_ COVID-19 and Other Disease Outbreaks” Since 2016, the Nigeria Centre for Disease Control (NCDC) in collaboration with the African Field Epidemiology Network (AFENET) has held her annual scientific conference on field epidemiology, the NCDC/NFELTP Conference. The 2020 edition could not hold due to the country-wide COVID-19 outbreak. Lessons and best practices learnt from previous conferences have continued to inform our preparedness, response and other public health actions in line with our mandate. To improve the scope of the conference while ensuring ownership and sustainability, the NCDC / NFELTP conference has now been renamed the “Nigerian Conference of Applied and Field Epidemiology (NiCAFE). This year, given the need to ensure strict compliance with the national COVID-19 protocol, the NCDC hosted a virtual NiCAFE in Abuja from 26th – 28th July 2021 with the pre-conference workshops on 26th July. With the theme “Building Back better - COVID-19 and other Disease Outbreaks”, the NiCAFE provided an opportunity to discuss the epidemiology of infectious diseases in Nigeria and the impact of these on regional and global health security. The objectives of the conference were: 1. Review the epidemiology and severity of COVID-19 and other infectious diseases in Nigeria 2. Evaluate the direct and indirect impacts of infectious diseases on the Nigerian health system, including protecting the health workforce 3. Review available public health, economic, and behavioural data to inform the implementation of robust public health and social measures at national and subnational levels 4. Synthesise the lessons learnt from Africa and Nigeria’s response to infectious disease outbreaks 5. Discuss emerging research and evidence on COVID-19 and other infectious diseases, and how this can affect future response activities 6. Improve core public health skills of conference attendees through workshops and lectures 7. Discuss the direct and indirect impact of COVID-19 and other infectious diseases on socio-economic activities The subthemes covered included but were not limited to epidemiology & surveillance; laboratory & diagnostics; health system strengthening; case management; governance and leadership; social sciences & community engagement; research and development etc. We are pleased with the vast knowledge and experience shared via parallel scientific oral sessions. Our renowned invited speakers from diverse backgrounds also shared their wealth of experience and impacted remarkably on the conference attendees. In his closing remarks, the Director-General of the NCDC, Dr. Chikwe Ihekweazu commended our partners - the World Health Organisation, World Bank REDISEE project, US Centres for Disease Control and Prevention, Resolve to Save Lives, Tony Blair Institute, Public Health England, E-Health Africa and the United States Children Fund for providing strong support and partnership for a successful conference. He also thanked the invited speakers for sharing their wealth of experience, leaving a remarkable impact on the conference attendees. He also appreciated the impressive participation of all conference attendees. The NCDC will continue to apply all lessons and best practices learnt from the conference to inform and shape our future public health actions. Weekly Issue: Volume 12 No. 27. 27th July 2021 Epidemiological Report Summary of Incidents Ongoing incidents 2 Ongoing incidents are defined as confirmed cases where a national EOC or equivalent has been activated (EOC is currently activated for COVID-19 and Cholera) Other incidents are those with confirmed cases for which EOC is not activated Data Source: SITAware Weekly Issue: Volume 12 No. 27. 27th July 2021 Epidemiological Report Summary Week 27: 5th – 11th July, 2021 Note: Coronavirus Disease is from outbreak onset till week 29 2021: 25th July, 2021) Cerebrospinal Lassa Fever1,2 Yellow Fever3,4 Meningitis (CSM) 3,4 69 5 22 Suspected case(s) Suspected case(s) Suspected case(s) 7 1 0 Confirmed case(s) Confirmed case(s) Confirmed case(s) 4 0 0 Death(s) Death(s) Death(s) Cholera3,4 Measles3,4 Monkeypox1,4 2559 523 3 Suspected case(s) Suspected case(s) Suspected case(s) 5 0 0 Confirmed case(s) Confirmed case(s) Confirmed case(s) 30 5 0 Death(s) Death(s) Death(s) Acute Flaccid National Sentinel Coronavirus Disease Paralysis (AFP) 3,4 influenza surveillance5 as at week 291, 106 0 2,439,850 Suspected case(s) Suspected case(s) Suspected case(s) 0 0 171,097 Confirmed case(s) Confirmed case(s) Confirmed case(s) 2,132 Death(s) Timeliness Completeness of reports3 of reports3 93.3% 98% Last 4 weeks Last 4 weeks 95.5% 98.2% Year to date Year to date Notes 1. Information for this disease was retrieved from the Technical Working Group and Situation Reports 2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only 3. Information for this disease was retrieved from IDSR 002 data 4. CFR for this disease is reported for total cases i.e. suspected + confirmed 5. Information for sentinel influenza was retrieved from the laboratory Weekly Issue: Volume 12 No. 27. 27th July 2021 Epidemiological Report Lassa Fever Week 27 Suspected Confirmed Number of States Deaths cases cases and LGAs affected State: 2 69 7 4 LGA: 4 Year to date (week 1 – 52) Suspected Confirmed Deaths CFR cases cases 2020 2021 2020 2021 2020 2021 2020 2021 5253 2379 1043 325 218 66 20.9% 20.3% *Outbreak data added to routine data Figure 1: Number of suspected and confirmed Figure 2: Location of confirmed cases of cases of Lassa Fever, Nigeria, Weeks 1 – 52, Lassa Fever by State, Nigeria, week 27, 2021 2021 Key points ● There were 69 suspected cases, seven were laboratory confirmed and four deaths were recorded from four LGAs in two states Actions To date: ● Conducted 2021 Lassa fever (LF) high burden states preparedness/response engagement meeting ● Dissemination of reviewed case management and safe burial practices guidelines ● Ensured all five LF molecular laboratories in the NCDC network are working at full capacity for timely testing of samples with reduced turnaround time Planned: ● Finalise LF five-year strategic plan Weekly Issue: Volume 12 No. 27. 27th July 2021 Epidemiological Report Cerebrospinal Meningitis (CSM) Week 27 Suspected Confirmed Number of States and Deaths cases cases LGAs affected State: 3 5 1 0 LGA: 5 Year to date (week 1 – 52) Suspected Confirmed Deaths CFR cases cases 2020 2021 2020 2021 2020 2021 2020 2021 466 158 11 11 9 3 1.9% 1.9% Figure 3: Number of suspected and confirmed Figure 4: Location of suspected cases of CSM by cases of CSM, Nigeria, weeks 1 – 52, 2021 State, Nigeria, week 27, 2021 Key points ● There were five suspected cases of cerebrospinal meningitis (CSM) reported from five LGAs in three states (Ebonyi – 1, Katsina – 3 & Oyo – 1). One case was laboratory confirmed and no death was recorded. Actions To date: ● National CSM TWG meets weekly to review reports from states and plan appropriately ● Enhanced surveillance in all states Planned: ● Continue harmonisation of the national line list and SORMAS data ● Continue to ensure that states reporting cases send their line lists and collect CSM samples Weekly Issue: Volume 12 No. 27. 27th July 2021 Epidemiological Report Yellow Fever Week 27 Suspected Confirmed Number of States and Deaths cases cases LGAs affected State: 11 22 0 0 LGA: 16 Year to date (week 1 – 52) Suspected Confirmed Deaths CFR cases cases 2020 2021 2020 2021 2020 2021 2020 2021 1202 993 12 13 0 2 0% 0.2% Figure 5: Number of suspected and Figure 6: Location of suspected cases of confirmed cases of Yellow Fever, Nigeria, Yellow Fever by States, Nigeria, week 27, weeks 1 – 52, 2021 2021 Key points ● There were 22 suspected cases of Yellow Fever (YF) reported from 16 LGAs in 11 states. None were laboratory confirmed and one death was recorded Actions To date: ● National YF multi-partner Technical Working Group (TWG) continues to coordinate activities across states. ● Ongoing plans to strengthen orientation of at-risk states on YF surveillance ● Ensured availability of reagents and consumables in all testing laboratories Planned: ● Continue monitoring and analysis of YF (Yellow fever) data across all states and FCT to guide response ● Continue coordination of prompt transportation samples to the laboratories Weekly Issue: Volume 12 No. 27. 27th July 2021 Epidemiological Report Cholera Week 27 Suspected Confirmed Number of States Deaths cases cases and LGAs affected State: 9 2559 5 30 LGA: 59 Year to date (week 1 – 52) Suspected Confirmed Deaths CFR cases cases 2020 2021 2020 2021 2020 2021 2020 2021 976 12095 40 251 55 263 5.6% 2.2% Figure 7: Number of suspected and confirmed Figure 8: Location of suspected cases of cases of Cholera, Nigeria, weeks 1 – 52, 2021 Cholera by State, Nigeria, week 27, 2021 Key points ● There were 2559 suspected cases of cholera reported from 59 LGAs in nine states (Adamawa – 1, Bauchi – 1699, Bayelsa – 4, Ebonyi – 5, Kano – 563, Kebbi – 158, Kogi – 12, Plateau – 114 & Taraba – 3). Five cases were laboratory confirmed and 30 deaths were recorded Actions To date ● National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states ● National Rapid Response Teams (RRTs) with response commodities were deployed to support