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Volume 25, Number 6—June 2019
CME ACTIVITY - Synopsis

Epidemiologic and Clinical Features of Lassa Fever Outbreak in Nigeria, January 1–May 6, 2018

Elsie A. Ilori1, Yuki Furuse1, Oladipupo B. Ipadeola1, Chioma C. Dan-Nwafor1, Anwar Abubakar, Oboma E. Womi-Eteng, Ephraim Ogbaini-Emovon, Sylvanus Okogbenin, Uche Unigwe, Emeka Ogah, Olufemi Ayodeji, Chukwuyem Abejegah, Ahmed A. Liasu, Emmanuel O. Musa, Solomon F. Woldetsadik, Clement L.P. Lasuba, Wondimagegnehu Alemu, Chikwe IhekweazuComments to Author , and Nigeria Lassa Fever National Response Team
Author affiliations: Nigeria Centre for Disease Control, Abuja, Nigeria (E.A. Ilori, O.B. Ipadeola, C.C. Dan-Nwafor, A. Abubakar, O.E. Womi-Eteng, C. Ihekweazu); Kyoto University, Kyoto, Japan (Y. Furuse); World Health Organization, Abuja (Y. Furuse, E.O. Musa, S.F. Woldetsadik, C.L.P. Lasuba, W. Alemu); US Centers for Disease Control and Prevention, Abuja (O.B. Ipadeola); African Field Epidemiology Network, Abuja (C.C. Dan-Nwafor); Irrua Specialist Teaching Hospital, Irrua, Nigeria (E. Ogbaini-Emovon, S. Okogbenin); Federal Teaching Hospital, Abakaliki, Nigeria (U. Unigwe, E. Ogah); Federal Medical Centre, Owo, Nigeria (O. Ayodeji, C. Abejegah, A.A. Liasu)

Main Article

Table 1

Number and incidence of Lassa fever cases, by state or territory, Nigeria, January 1–May 6, 2018

State or territory Population, ×1,000* No. confirmed cases (deaths) Case-fatality rate, % No. confirmed cases/100,000 population No. laboratory-negative suspected cases No. probable cases Positive rate, %
Abia 3,727 1 (1) 100.0 0.027 11 1 8.3
Adamawa 4,248 1 (1) 100.0 0.024 2 1 33.3
Anambra 5,528 4 (2) 50.0 0.072 3 0 57.1
Bauchi 6,537 10 (5) 50.0 0.153 50 0 16.7
Benue 5,742 1 (1) 100.0 0.017 6 1 14.3
Delta 5,663 7 (3) 42.9 0.124 3 0 70.0
Ebonyi 2,880 64 (15) 23.4 2.222 28 4 69.6
Edo 4,236 178 (26) 14.6 4.202 901 0 16.5
Ekiti 3,271 2 (1) 50.0 0.061 10 0 16.7
Federal Capital Territory 3,564 3 (2) 66.7 0.084 38 0 7.3
Gombe 3,257 2 (2) 100.0 0.061 13 0 13.3
Imo 5,409 4 (1) 25.0 0.074 11 0 26.7
Kaduna 8,252 1 (1) 100.0 0.012 4 0 20.0
Kogi 4,474 11 (4) 36.4 0.246 15 2 42.3
Lagos 12,551 1 (1) 100.0 0.008 28 0 3.4
Nasarawa 2,523 3 (2) 66.7 0.119 34 0 8.1
Ondo 4,672 99 (24) 24.2 2.119 214 1 31.6
Osun 4,706 2 (1) 50.0 0.043 2 0 50.0
Plateau 4,200 9 (7) 77.8 0.214 39 0 18.8
Rivers 7,304 1 (1) 100.0 0.014 7 0 12.5
Taraba
3,067
19 (5)
26.3
0.620
41
0
31.7
Total 193,393 423 (106) 25.1 0.219 1,460 10 22.5

*Data source: National Bureau of Statistics (22).

Main Article

References
  1. Frame  JD, Baldwin  JM Jr, Gocke  DJ, Troup  JM. Lassa fever, a new virus disease of man from West Africa. I. Clinical description and pathological findings. Am J Trop Med Hyg. 1970;19:6706. DOIPubMedGoogle Scholar
  2. Monath  TP, Newhouse  VF, Kemp  GE, Setzer  HW, Cacciapuoti  A. Lassa virus isolation from Mastomys natalensis rodents during an epidemic in Sierra Leone. Science. 1974;185:2635. DOIPubMedGoogle Scholar
  3. Richmond  JK, Baglole  DJ. Lassa fever: epidemiology, clinical features, and social consequences. BMJ. 2003;327:12715. DOIPubMedGoogle Scholar
  4. Keenlyside  RA, McCormick  JB, Webb  PA, Smith  E, Elliott  L, Johnson  KM. Case-control study of Mastomys natalensis and humans in Lassa virus-infected households in Sierra Leone. Am J Trop Med Hyg. 1983;32:82937. DOIPubMedGoogle Scholar
  5. Fisher-Hoch  SP, Tomori  O, Nasidi  A, Perez-Oronoz  GI, Fakile  Y, Hutwagner  L, et al. Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice. BMJ. 1995;311:8579. DOIPubMedGoogle Scholar
  6. Ajayi  NA, Nwigwe  CG, Azuogu  BN, Onyire  BN, Nwonwu  EU, Ogbonnaya  LU, et al. Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January-March 2012). Int J Infect Dis. 2013;17:e10116. DOIPubMedGoogle Scholar
  7. World Health Organization. Lassa fever fact sheet [cited 2018 May 13]. http://origin.who.int/mediacentre/factsheets/fs179
  8. Centers for Disease Control and Prevention. Lassa fever [cited 2018 May 13]. http://www.cdc.gov/vhf/lassa
  9. Nigeria Centre for Disease Control. Standard operating procedures for Lassa fever case management [cited 2018 May 13]. http://www.ncdc.gov.ng/themes/common/docs/protocols/30_1502277315.pdf
  10. Nigeria Centre for Disease Control. Honourable Minister of Health announces end of emergency phase of Nigeria’s Lassa fever outbreak [cited 2018 May 13]. http://ncdc.gov.ng/news/142/honourable-minister-of-health-announces-end-of-emergency-phase-of-nigeria%5C%27s-lassa-fever-outbreak
  11. McCormick  JB, King  IJ, Webb  PA, Scribner  CL, Craven  RB, Johnson  KM, et al. Lassa fever. Effective therapy with ribavirin. N Engl J Med. 1986;314:206. DOIPubMedGoogle Scholar
  12. Stephenson  EH, Larson  EW, Dominik  JW. Effect of environmental factors on aerosol-induced Lassa virus infection. J Med Virol. 1984;14:295303. DOIPubMedGoogle Scholar
  13. Fichet-Calvet  E, Lecompte  E, Koivogui  L, Soropogui  B, Doré  A, Kourouma  F, et al. Fluctuation of abundance and Lassa virus prevalence in Mastomys natalensis in Guinea, West Africa. Vector Borne Zoonotic Dis. 2007;7:11928. DOIPubMedGoogle Scholar
  14. Nigeria Centre for Disease Control. Weekly Epidemiological Report. Weekly updates on epidemics in Nigeria: as at 16th September, 2016 [cited 2018 May 13]. http://www.ncdc.gov.ng/reports/7/2016-september-week-37
  15. Nigeria Centre for Disease Control. Weekly Epidemiological Report. Weekly updates on epidemics in Nigeria: as at 6th January, 2016 [cited 2018 May 13]. http://www.ncdc.gov.ng/reports/23/2017-january-week-1
  16. Nigeria Centre for Disease Control. Weekly Epidemiological Report. Stopping spread of Lassa fever: instituting infection prevention control measures in health facilities [cited 2018 May 13]. http://www.ncdc.gov.ng/reports/104/2018-january-week-3
  17. Nigeria Centre for Disease Control. An update of Lassa fever outbreak in Nigeria for week 19 [cited 2018 May 13]. http://www.ncdc.gov.ng/themes/common/files/sitreps/473e68581953ff7e0d0b08445c1f6726.pdf
  18. Otto  JL, Holodniy  M, DeFraites  RF. Public health practice is not research. Am J Public Health. 2014;104:596602. DOIPubMedGoogle Scholar
  19. Nikisins  S, Rieger  T, Patel  P, Müller  R, Günther  S, Niedrig  M. International external quality assessment study for molecular detection of Lassa virus. PLoS Negl Trop Dis. 2015;9:e0003793. DOIPubMedGoogle Scholar
  20. Andersen  KG, Shapiro  BJ, Matranga  CB, Sealfon  R, Lin  AE, Moses  LM, et al.; Viral Hemorrhagic Fever Consortium. Clinical sequencing uncovers origins and evolution of Lassa virus. Cell. 2015;162:73850. DOIPubMedGoogle Scholar
  21. Isere  EE, Fatiregun  AA, Ajayi  IO. An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control. Niger Med J. 2015;56:1618. DOIPubMedGoogle Scholar
  22. National Bureau of Statistics. National population estimates [cited 2018 May 19] https://nigerianstat.gov.ng/download/474
  23. Yalley-Ogunro  JE, Frame  JD, Hanson  AP. Endemic Lassa fever in Liberia. VI. Village serological surveys for evidence of Lassa virus activity in Lofa County, Liberia. Trans R Soc Trop Med Hyg. 1984;78:76470. DOIPubMedGoogle Scholar
  24. Bausch  DG, Demby  AH, Coulibaly  M, Kanu  J, Goba  A, Bah  A, et al.; Epidemiology of Human Disease and Clinical Observations. Lassa fever in Guinea: I. Epidemiology of human disease and clinical observations. Vector Borne Zoonotic Dis. 2001;1:26981. DOIPubMedGoogle Scholar
  25. Fraser  DW, Campbell  CC, Monath  TP, Goff  PA, Gregg  MB. Lassa fever in the Eastern province of Sierra Leone, 1970–1972. I. Epidemiologic studies. Am J Trop Med Hyg. 1974;23:11319. DOIPubMedGoogle Scholar
  26. Yinka-Ogunleye  A, Ipadeola  O, Saleh  M, Ilori  E, Dan-Nwafor  C, Nwachukwu  W, et al. 2016/2017 Lassa fever outbreak in Nigeria: age and sex have no effect on treatment outcome. Pan Afr Med J. 2018;8:3.
  27. McCormick  JB, King  IJ, Webb  PA, Johnson  KM, O’Sullivan  R, Smith  ES, et al. A case-control study of the clinical diagnosis and course of Lassa fever. J Infect Dis. 1987;155:44555. DOIPubMedGoogle Scholar
  28. Okokhere  P, Colubri  A, Azubike  C, Iruolagbe  C, Osazuwa  O, Tabrizi  S, et al. Clinical and laboratory predictors of Lassa fever outcome in a dedicated treatment facility in Nigeria: a retrospective, observational cohort study. Lancet Infect Dis. 2018;18:68495. DOIPubMedGoogle Scholar
  29. McCormick  JB. Clinical, epidemiologic, and therapeutic aspects of Lassa fever. Med Microbiol Immunol (Berl). 1986;175:1535. DOIPubMedGoogle Scholar
  30. Lo Iacono  G, Cunningham  AA, Fichet-Calvet  E, Garry  RF, Grant  DS, Khan  SH, et al. Using modelling to disentangle the relative contributions of zoonotic and anthroponotic transmission: the case of lassa fever. PLoS Negl Trop Dis. 2015;9:e3398. DOIPubMedGoogle Scholar
  31. Siddle  KJ, Eromon  P, Barnes  KG, Mehta  S, Oguzie  JU, Odia  I, et al. Genomic analysis of Lassa virus during an increase in cases in Nigeria in 2018. N Engl J Med. 2018;379:174553. DOIPubMedGoogle Scholar

Main Article

1These first authors contributed equally to this article.

2Other members of the Nigeria Lassa Fever National Response Team are listed at the end of this article.

Page created: May 19, 2019
Page updated: May 19, 2019
Page reviewed: May 19, 2019
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