OUTBREAK INTELLIGENCE-UPDATE-NIGERIA-LASSA FEVER

26 MARCH 2019

DE FAAKTO OUTBREAK INTELLIGENCE

UPDATE-NIGERIA-LASSA FEVER

Nigeria Center for Disease Control is reporting,

01 January – 17 March 2019

  • The number of confirmed cases of LASSA FEVER reported across Nigeria remains high
  • 495 cases of Lassa fever
  • 23 new confirmed cases of Lassa Fever
  • 1801 probable cases of Lassa Fever
  • 114 deaths
  • Case fatality ratio = 23%
  • 16 confirmed cases of Lassa Fever among healthcare workers

WHO RISK ASSESSMENT

  • Although Lassa fever is known to be endemic in Nigeria with the peak season anticipated from December through June, the current increase in new confirmed cases and deaths should be monitored closely and addressed appropriately. Neighbouring countries should be monitored accordingly
  • With sixteen confirmed cases so far among healthcare workers, there is evidence of nosocomial transmission of the disease amidst reports of inadequate infection prevention and control (IPC) supplied in some health facilities and complacency on the part of health workers towards maintaining IPC measures

Background

  • There is a sustained endemic outbreak of Lassa Fever in Nigeria
  • Lassa fever is an acute viral haemorrhagic illness that occurs in West Africa
  • The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces
  • Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures
  • Patients hospitalized with severe cases of Lassa fever is 15%.
  • Early supportive care with rehydration and symptomatic treatment improves survival  (WHO)

Symptoms Lassa Fever

  • Incubation period 6–21 days
  • Fever, general weakness, and malaise
  • Headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow
  • Severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop
  • Protein may be noted in the urine
  • Shock, seizures, tremor, disorientation, and coma may be seen in the later stages
  • Death usually occurs within 14 days of onset in fatal cases
  • The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in more than 80% of cases during the third trimester (WHO)

Diagnosis

  • Clinical diagnosis is often difficult
  • Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever (WHO)

Treatment

  • The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness
  • There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever
  • There is currently no vaccine that protects against Lassa fever  (WHO)

Prevention

  • Good “community hygiene” to discourage rodents from entering homes
  • Storing grain and other foodstuffs in rodent-proof containers
  • Disposing of garbage far from the home, maintaining clean households and keeping cats
  • Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons  (WHO)

Health Care Infection Control

  • Standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis
  • Basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials)
  • Safe injection practices and safe burial practices
  • Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding
  • In close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures)
  • Laboratory workers are also at risk-Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions  (WHO)

WHO  https://www.who.int/csr/don/14-february-2019-lassa-fever-nigeria/en/

Nigeria Center for Disease Control  https://ncdc.gov.ng/themes/common/files/sitreps/d3cfc533ee17f071904aa4aec5f764cc.pdf

WHO  https://www.who.int/en/news-room/fact-sheets/detail/lassa-fever

______________________________________________________________________________

15 FEBRUARY 2019

DE FAAKTO OUTBREAK INTELLIGENCE

UPDATE-NIGERIA-LASSA FEVER

World Health Organization is reporting,

01 January – 10 February 2019

  • The number of confirmed cases of LASSA FEVER reported across Nigeria remains high
  • 327 cases of Lassa fever
  • 324 confirmed cases of Lassa Fever
  • 3 probable cases of Lassa Fever
  • 72 deaths
  • Case fatality ratio = 22%
  • 12 confirmed cases of Lassa Fever among healthcare workers

WHO RISK ASSESSMENT

  • Although Lassa fever is known to be endemic in Nigeria with the peak season anticipated from December through June, the current increase in new confirmed cases and deaths should be monitored closely and addressed appropriately. Neighbouring countries should be monitored accordingly
  • With twelve confirmed cases so far among healthcare workers, there is evidence of nosocomial transmission of the disease amidst reports of inadequate infection prevention and control (IPC) supplied in some health facilities and complacency on the part of health workers towards maintaining IPC measures

Background

  • There is a sustained endemic outbreak of Lassa Fever in Nigeria
  • Lassa fever is an acute viral haemorrhagic illness that occurs in West Africa
  • The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces
  • Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures
  • Patients hospitalized with severe cases of Lassa fever is 15%.
  • Early supportive care with rehydration and symptomatic treatment improves survival  (WHO)

Symptoms Lassa Fever

  • Incubation period 6–21 days
  • Fever, general weakness, and malaise
  • Headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow
  • Severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop
  • Protein may be noted in the urine
  • Shock, seizures, tremor, disorientation, and coma may be seen in the later stages
  • Death usually occurs within 14 days of onset in fatal cases
  • The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in more than 80% of cases during the third trimester (WHO)

Diagnosis

  • Clinical diagnosis is often difficult
  • Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever (WHO)

Treatment

  • The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness
  • There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever
  • There is currently no vaccine that protects against Lassa fever  (WHO)

Prevention

  • Good “community hygiene” to discourage rodents from entering homes
  • Storing grain and other foodstuffs in rodent-proof containers
  • Disposing of garbage far from the home, maintaining clean households and keeping cats
  • Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons  (WHO)

Health Care Infection Control

  • Standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis
  • Basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials)
  • Safe injection practices and safe burial practices
  • Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding
  • In close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures)
  • Laboratory workers are also at risk-Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions  (WHO)

WHO  https://www.who.int/csr/don/14-february-2019-lassa-fever-nigeria/en/

Nigeria Center for Disease Control  https://ncdc.gov.ng/diseases/sitreps/?cat=5&name=An%20update%20of%20Lassa%20fever%20outbreak%20in%20Nigeria

WHO  https://www.who.int/en/news-room/fact-sheets/detail/lassa-fever

________________________________________________________________________________________

DE FAAKTO OUTBREAK INTELLIGENCE

12 FEBRUARY 2019-UPDATE

OUTBREAK INTELLIGENCE-LASSA FEVER NIGERIA

Nigeria Center for Disease Control

28 January-03 February 2019

  • Lassa fever virus transmission is increasing fairly rapidly
  • 57 deaths in confirmed cases
  • Fatality rate in confirmed cases is 20.7%
  • 68 new confirmed cases were reported
  • 731 suspected cases have been reported
  • 4 new healthcare workers were infected
  • 9 health care workers have been affected since the onset

Background

  • There is a sustained endemic outbreak of Lassa Fever in Nigeria
  • Lassa fever is an acute viral haemorrhagic illness that occurs in West Africa
  • The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces
  • Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures
  • Patients hospitalized with severe cases of Lassa fever is 15%.
  • Early supportive care with rehydration and symptomatic treatment improves survival  (WHO)

Symptoms Lassa Fever

  • Incubation period 6–21 days
  • Fever, general weakness, and malaise
  • Headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow
  • Severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop
  • Protein may be noted in the urine
  • Shock, seizures, tremor, disorientation, and coma may be seen in the later stages
  • Death usually occurs within 14 days of onset in fatal cases
  • The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in more than 80% of cases during the third trimester (WHO)

Diagnosis

  • Clinical diagnosis is often difficult
  • Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever (WHO)

Treatment

  • The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness
  • There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever
  • There is currently no vaccine that protects against Lassa fever  (WHO)

Prevention

  • Good “community hygiene” to discourage rodents from entering homes
  • Storing grain and other foodstuffs in rodent-proof containers
  • Disposing of garbage far from the home, maintaining clean households and keeping cats
  • Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons  (WHO)

Health Care Infection Control

  • Standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis
  • Basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials)
  • Safe injection practices and safe burial practices
  • Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding
  • In close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures)
  • Laboratory workers are also at risk-Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions  (WHO)

Nigeria Center for Disease Control  https://ncdc.gov.ng/diseases/sitreps/?cat=5&name=An%20update%20of%20Lassa%20fever%20outbreak%20in%20Nigeria

WHO  https://www.who.int/en/news-room/fact-sheets/detail/lassa-fever

________________________________________________________________________________________

DE FAAKTO OUTBREAK INTELLIGENCE

07 FEBRUARY 2019

OUTBREAK INTELLIGENCE-LASSA FEVER NIGERIA

Nigeria Center for Disease Control

  • 2019 outbreak-42 deaths in confirmed cases Lassa Fever
  • Case fatality rate in confirmed cases is 19.7%
  • January 21 – January 27-2019
  • 77 new confirmed cases reported
  • 1 new healthcare worker infected
  • 4 health care workers have been infected since the onset
  • January 01 – January 27- 2019
  • 538 suspected cases

Background

  • There is a sustained endemic outbreak of Lassa Fever in Nigeria
  • Lassa fever is an acute viral haemorrhagic illness that occurs in West Africa
  • The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces
  • Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures
  • Patients hospitalized with severe cases of Lassa fever is 15%.
  • Early supportive care with rehydration and symptomatic treatment improves survival  (WHO)

Symptoms Lassa Fever

  • Incubation period 6–21 days
  • Fever, general weakness, and malaise
  • Headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow
  • Severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop
  • Protein may be noted in the urine
  • Shock, seizures, tremor, disorientation, and coma may be seen in the later stages
  • Death usually occurs within 14 days of onset in fatal cases
  • The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in more than 80% of cases during the third trimester (WHO)

Diagnosis

  • Clinical diagnosis is often difficult
  • Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever (WHO)

Treatment

  • The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness
  • There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever
  • There is currently no vaccine that protects against Lassa fever  (WHO)

Prevention

  • Good “community hygiene” to discourage rodents from entering homes
  • Storing grain and other foodstuffs in rodent-proof containers
  • Disposing of garbage far from the home, maintaining clean households and keeping cats
  • Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons  (WHO)

Health Care Infection Control

  • Standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis
  • Basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials)
  • Safe injection practices and safe burial practices
  • Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding
  • In close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures)
  • Laboratory workers are also at risk-Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions  (WHO)

Nigeria Center for Disease Control  https://ncdc.gov.ng/diseases/sitreps/?cat=5&name=An%20update%20of%20Lassa%20fever%20outbreak%20in%20Nigeria

WHO  https://www.who.int/en/news-room/fact-sheets/detail/lassa-fever