scholarly journals Characteristics of Lassa Fever Outbreak in Ondo State, Nigeria, Year 2019

2021 ◽  
Vol 3 (1) ◽  
pp. 115-125
Author(s):  
Adaora Rosemary Ejikeme ◽  
Lois Olajide ◽  
Sola Sunday Thomas ◽  
Chimezie Anueyiagu ◽  
Gbetsere Aghogho ◽  
...  
Keyword(s):  
Case Fatality ◽  
Rapid Response Team ◽  
Lassa Fever ◽  
Control Measures ◽  
Contact Tracing ◽  
Suspected Case ◽  
Female Ratio ◽  
Emergency Operations Center ◽  
Response Team ◽  
Ondo State

Background: Lassa fever (LF) is an acute viral haemorrhagic illness of a 2–21-day incubation period that occurs in West Africa. It is endemic in Nigeria and peaks during the first 12 weeks of the year. On January 22, 2019, the Nigeria Centre for Disease Control (NCDC) declared an outbreak of LF following an upsurge of LF cases in the country. A total of 213 confirmed cases including 41 deaths were reported from sixteen states including Ondo State. A multi-sectoral national rapid-response-team (RRT) was deployed to Ondo State to characterise the outbreak, assess its determinants, and institute control measures. Methods: An Emergency Operations Center (EOC) was activated to coordinate activities. We defined a suspected case as anyone with one or more of the following symptoms: malaise, fever, headache, sore throat, cough, vomiting and either history of contact with rodents, or a probable or confirmed LF case in the past 21 days, or any person with inexplicable bleeding between January 1, 2019, to February 26, 2019, in Ondo State. A confirmed case was any suspected case with laboratory confirmation. We conducted active case search, collected data using the LF case investigation form and reviewed the existing line list. We conducted contact tracing in hospitals and affected Local Government Areas (LGA). Data was analysed using and Epi info 7.0. Results: We identified 287 LF suspected cases in 6 LGAs; 118 were confirmed with 21 deaths (case fatality rate: 17.8%). The mean age was 39.2 ±20 years with a male-to-female ratio of 1.3:1. Of the 1,269 contacts line-listed, 20 became symptomatic, while 14 (70.0%) were confirmed positive. The secondary attack rate was 1.1%. Conclusion: The confirmed cases were more of primary cases, hence the need to focus more on reducing rodent-to-human transmission of LF. We recommend continuous education on community and health facility infection prevention control, contact tracing and enforcement of environmental sanitation measures across the state to mitigate future outbreaks

scholarly journals Epidemiological trends of Lassa fever in Nigeria from 2015-2021: A review

2021 ◽  
Vol 8 ◽  
pp. 204993612110582
Author(s):  
John-Ugwuanya A. Grace ◽  
Ifunanya J. Egoh ◽  
Nnenna Udensi
Keyword(s):  
Case Fatality ◽  
Laboratory Diagnosis ◽  
Time Frame ◽  
Lassa Fever ◽  
Contact Tracing ◽  
Regulatory Body ◽  
African Countries ◽  
Female Ratio ◽  
Viral Haemorrhagic Fever ◽  
Proactive Measures

Introduction: Lassa fever is a viral haemorrhagic fever with non-specific symptoms that has shown an upward trend in Nigeria and other West African countries, which is depicted by high incidence and case fatality in recent years. There are different reports on the yearly case burden of Lassa fever from the Federal Ministry of Health in Nigeria, through the regulatory body – Nigeria Centre for Disease Control (NCDC). Being the epicentre of the disease, Lassa fever has been exported from Nigeria to both neighbouring and distant countries.Methods: The aim of this review was to carry out a retrospective analysis from January 2015 to 26 September 2021 of the weekly and yearly outbreak of Lassa fever in Nigeria based on selected publications. The focus was on timely diagnosis, treatment option, public health interventions and progress of clinical trials for vaccine candidates, and to identify proactive measures that can be sustained to curb periodic outbreaks. The review was done using percentages, cross-tabulation and graphical charts. Results: The predominant age group infected was 21 to 40 years with a male to female ratio of 1:0.8. A total of 3311 laboratory-confirmed Lassa fever cases out of 20,588 suspected cases were identified from 29 states. Edo, Ondo, Taraba, Ebonyi, Bauchi, Plateau and Nasarawa had yearly Lassa fever incidence over the time frame considered. Contact tracing was done on over 33,804 individuals with about 90% completing follow-up. Case fatality rate within the period ranged from 9.3% to 29.2%. There is a sharp decline in the epidemiological trend of Lassa fever in the yearly seasonal peaks from weeks 1 to 13 with about 75% reduction in incidence between 2020 and 2021. Conclusion: The effective management of Lassa fever needs the implementation of preventive methods, prompt laboratory diagnosis, timely treatment, provision of personal protective equipment, cross-border surveillance, contact tracing, community awareness and vector control in order to minimise spread.

scholarly journals Experiential learnings from the Nipah virus outbreaks in Kerala towards containment of infectious public health emergencies in India

2020 ◽  
Vol 148 ◽  
Author(s):  
Rima R. Sahay ◽  
Pragya D. Yadav ◽  
Nivedita Gupta ◽  
Anita M. Shete ◽  
Chandni Radhakrishnan ◽  
...  
Keyword(s):  
State Government ◽  
Single Case ◽  
Point Of Care ◽  
Nipah Virus ◽  
Case Fatality ◽  
Control Measures ◽  
Contact Tracing ◽  
Effective Control ◽  
Hospital Infection Control ◽  
Kerala State

Abstract Nipah virus (NiV) outbreak occurred in Kozhikode district, Kerala, India in 2018 with a case fatality rate of 91% (21/23). In 2019, a single case with full recovery occurred in Ernakulam district. We described the response and control measures by the Indian Council of Medical Research and Kerala State Government for the 2019 NiV outbreak. The establishment of Point of Care assays and monoclonal antibodies administration facility for early diagnosis, response and treatment, intensified contact tracing activities, bio-risk management and hospital infection control training of healthcare workers contributed to effective control and containment of NiV outbreak in Ernakulam.

scholarly journals Epidemiology and transmission dynamics of COVID-19 in two Indian states

2020 ◽  
Author(s):  
Ramanan Laxminarayan ◽  
Brian Wahl ◽  
Shankar Reddy Dudala ◽  
K Gopal ◽  
Chandra Mohan ◽  
...  
Keyword(s):  
Tamil Nadu ◽  
Andhra Pradesh ◽  
Case Fatality ◽  
Control Measures ◽  
Contact Tracing ◽  
Primary Data ◽  
Indian States ◽  
Middle Income ◽  
Time To Death ◽  
Middle Income Countries

Although most COVID-19 cases have occurred in low-resource countries, there is scarce information on the epidemiology of the disease in such settings. Comprehensive SARS-CoV-2 testing and contact-tracing data from the Indian states of Tamil Nadu and Andhra Pradesh reveal stark contrasts from epidemics affecting high-income countries, with 92.1% of cases and 59.7% of deaths occurring among individuals <65 years old. The per-contact risk of infection is 9.0% (95% confidence interval: 7.5-10.5%) in the household and 2.6% (1.6-3.9%) in the community. Superspreading plays a prominent role in transmission, with 5.4% of cases accounting for 80% of infected contacts. The case-fatality ratio is 1.3% (1.0-1.6%), and median time-to-death is 5 days from testing. Primary data are urgently needed from low- and middle-income countries to guide locally-appropriate control measures.

scholarly journals Contact Tracing is Associated with Lower COVID-19 Case Fatality Rates: Evidence from 40 countries

2020 ◽  
Author(s):  
ABDULLAH YALAMAN ◽  
GOKCE BASBUG ◽  
CEYHUN ELGIN ◽  
ALISON P. GALVANI
Keyword(s):  
Panel Data ◽  
Early Detection ◽  
Medical Care ◽  
Regression Models ◽  
Case Fatality ◽  
Control Measures ◽  
Contact Tracing ◽  
Regression Analyses ◽  
Cross Sectional ◽  
Lower Case

Abstract The coronavirus disease (COVID-19) outbreak has killed over 725,000 people since its emergence in late 2019. As of early August 2020, there has been substantial variability in the policies and intensity of diagnostic efforts between countries. In this paper, we quantitatively evaluate the effectiveness of the national contact tracing policy in decreasing case fatality rates of COVID-19 in 40 countries. Our regression analyses indicate that countries that utilize comprehensive contact tracing have significantly lower case fatality rates. The association of contact tracing policy and case fatality rates is robust and observed in regression models using cross-sectional and panel data, even controlling for the number of tests conducted and non-pharmaceutical control measures adopted by governments. Our results suggest that comprehensive contact tracing is instrumental not only to curtailing transmission but also to reducing case fatality rates by early detection and isolation of secondary cases and ultimately diminishing the burden on the healthcare system and speeding the rate at which infected individuals receive the medical care they need to maximize their chance of recovery.

scholarly journals COVID 19 and Nepal: Identification of Critical Public Health Measures

2020 ◽  
Vol 58 (225) ◽  
Author(s):  
Harish Chandra Neupane ◽  
Niki Shrestha ◽  
Shital Adhikari ◽  
Basanta Gauli
Keyword(s):  
Public Health ◽  
Social Life ◽  
Critical Mass ◽  
Rapid Response Team ◽  
Contact Tracing ◽  
Infection Prevention And Control ◽  
Response Team ◽  
National Public Health ◽  
Engagement Interventions ◽  
Critical Public Health

The COVID-19 pandemic is unfolding at an unprecedented pace. The unprecedented threat providesan opportunity to emerge with robust health systems. Nepal has implemented several containmentmeasures such as Rapid Response Team formulation; testing; isolation; quarantine; contact tracing;surveillance, establishment of COVID-19 Crisis Management Centre and designation of dedicatedhospitals to gear up for the pandemic. The national public health emergency managementmechanisms need further strengthening with the proactive engagement of relevant ministries; weneed a strong, real-time national surveillance system and capacity building of a critical mass of healthcare workers; there is a need to further assess infection prevention and control capacity; expandthe network of virus diagnostic laboratories in the private sector with adequate surge capacity;implement participatory community engagement interventions and plan for a phased lockdownexit strategy enabling sustainable suppression of transmission at low-level and enabling in resumingsome parts of economic and social life.

scholarly journals Outbreak of Cholera in Tilathi VDC Saptari Nepal

2014 ◽  
Vol 10 (4) ◽  
pp. 36-39 ◽  
Author(s):  
DK Yadav ◽  
D Tamrakar ◽  
R Baral ◽  
P Jha ◽  
S Gautam ◽  
...  
Keyword(s):  
Vibrio Cholerae ◽  
Water Samples ◽  
Diarrheal Disease ◽  
Age Groups ◽  
Case Fatality ◽  
Pond Water ◽  
Control Measures ◽  
Suspected Case ◽  
Source Of Infection ◽  
Stool Samples

Background On 2011, Cluster of cholera cases was reported in the Tilathi VDC of Saptari, Nepal. Objective The outbreak was investigated to identify the etiological agent and possible source of infection and guiding the prevention and control measures. Methods Demographic and clinical details were collected from the suspected case-patients, and the outbreak was described by time, place, and person. Focus group discussion and Key informant interview were conducted to assess the practice of sanitation, source of drinking water and probable cause of diarrheal disease. Five stool samples and 10 water samples of tube well and ponds were collected and microbiological study was done in BPKIHS Dharan. Results A total of 111 persons suffered with diarrhea and 02 died of it (attack rate 3.05%, case fatality rate 1.8%). All age groups were affected with disease (median age 26 yrs) and males were affected more than females. Descriptive epidemiology suggested the clustering of cases were around the pond where they clean utensils, take bath and wash clothes. The Vibrio cholerae 01 El Tor, Ogawa serotype was isolated in 03 out of 05 suspected stool samples and in all three of the pond water samples. They reported that most of the houses do not have the toilet and people do not wash their hands regularly with soap and water after defecation. Conclusion Vibrio cholerae was the causative agent behind the outbreak and probable source of infection was the problematic pond water which they used for different purpose. Immediate chlorination of the pond was recommended to halt further spread of the epidemics. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10992 Kathmandu Univ Med J 2012;10(4):36-39

scholarly journals Lassa Fever in post-Ebola Sierra Leone. Sociodemographics and case fatality rates of in-hospital patients admitted at the Kenema Government Hospital Lassa Fever Ward between 2016-2018

2019 ◽  
Author(s):  
Jia Bainga Kangbai ◽  
Fatima Kinto Kamara ◽  
Rosaline Chukwu Lahai ◽  
Fatmata Gebeh
Keyword(s):  
West Africa ◽  
Sierra Leone ◽  
Case Fatality ◽  
Lassa Fever ◽  
Control Measures ◽  
Government Hospital ◽  
Treatment History ◽  
Human Contact ◽  
Hospital Patients ◽  
Viral Illness

Abstract Background Lassa fever (LF) is a zoonotic acute viral illness mainly found in West Africa. The disease is endemic in some parts of West Africa including Sierra Leone, Liberia, Guinea and Nigeria; while other neighboring countries at high risk of its outbreak since the animal vectors are distributed throughout the region.Methods This is a retrospective mixed cohort study that analysed the treatment history containing the sociodemographic and clinical characteristics of 52 laboratory-confirmed LF cases that were admitted to the Kenema Government Hospital Lassa Fever Ward (KGHLFW) during 2016 to 2018; i.e. during the post Ebola outbreak in Sierra Leone. The LF patients whose treatment history we analysed came from either within or outside Kenema district were the KGHLFW is located.Results Majority (59.6%, n = 31/52) of the LF cases recorded during the period under review were adults; females (65.4%, n = 34/52). 2016 recorded more (40.4%, n = 21/52) LF cases; 2017 (28.8%, n = 15/52) and 2018(30.8%, n = 16/52).Conclusions We highlighted the significance of LF preventive and control measures that can target its seasonal epidemics. These measures could include strategies that can reduce human contact with the rodent vector as well as raise sensitization and awareness about LF among local residents especially those residing along the LF belt in eastern Sierra Leone.

scholarly journals A prolonged cholera outbreak caused by drinking contaminated stream water, Kyangwali Refugee Settlement, Hoima District, Western Uganda: 2018

2020 ◽  
Author(s):  
Fred Monje ◽  
Alex Riolexus Ario ◽  
Angella Musewa ◽  
Kenneth Bainomugisha ◽  
Bernadette Basuta Mirembe ◽  
...  
Keyword(s):  
Environmental Assessment ◽  
Stream Water ◽  
Case Fatality ◽  
Control Measures ◽  
Fecal Coliforms ◽  
Watery Diarrhoea ◽  
Suspected Case ◽  
Water Tank ◽  
Cholera Outbreak ◽  
Tank Water

Abstract Background: On 23 February 2018, the Uganda Ministry of Health (MOH) declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement, Hoima District, bordering the Democratic Republic of Congo (DRC). We investigated to determine the outbreak scope and risk factors for transmission, and recommend evidence-based control measures.Methods: We defined a suspected case as sudden onset of watery diarrhoea in any person aged ≥ 2 years in Hoima District, 1 February–9 May 2018. A confirmed case was a suspected case with Vibrio cholerae cultured from a stool sample. We found cases by active community search and record reviews at Cholera Treatment Centres. We calculated case-fatality rates (CFR) and attack rates (AR) by sub-county and nationality. In a case-control study, we compared exposure factors among case- and control-households. We estimated the association between the exposures and outcome using Mantel-Haenszel method. We conducted an environmental assessment in the refugee settlement, including testing samples of stream water, tank water, and spring water for presence of fecal coliforms. We tested suspected cholera cases using cholera Rapid Diagnostic Test (RDT) kits followed by culture for confirmation. Results: We identified 2122 case-patients and 44 deaths (CFR = 2.1%). Case-patients originating from DRC were the most affected (AR = 15/1000). The overall attack rate in Hoima District was 3.2/1000, with Kyangwali sub-county being the most affected (AR = 13/1000). The outbreak lasted four months, which was a multiple point-source. Environmental assessment showed that a stream separating two villages in Kyangwali Refugee Settlement was a site of open defecation for refugees. Among three water sources tested, only stream water was feacally-contaminated, yielding >100 CFU/100 ml. Of 130 stool samples tested, 124 (95%) yielded V. cholerae by culture. Stream water was most strongly associated with illness (OR = 14.2; 95%CI=1.5-133), although tank water also appeared to be independently associated with illness (OR = 11.6; 95%CI = 1.4–94). Persons who drank tank and stream water had a 17-fold higher odds of illness compared with persons who drank from other sources (OR = 17.3, 95%CI = 2.2–137). Conclusions: Our investigation demonstrated that this was a prolonged cholera outbreak that affected four sub-counties and two divisions in Hoima District, and was associated with drinking of contaminated stream water. In addition, tank water also appears to be unsafe. We recommended boiling drinking water, increasing latrine coverage, and provision of safe water by the District and entire High Commission for refugees.

scholarly journals Data-Based Analysis, Modelling and Forecasting of the COVID-19 outbreak

2020 ◽  
Author(s):  
Cleo Anastassopoulou ◽  
Lucia Russo ◽  
Athanasios Tsakris ◽  
Constantinos Siettos
Keyword(s):  
Lower Bound ◽  
Total Population ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Control Measures ◽  
Suspected Case ◽  
Cumulative Number ◽  
Case Fatality Ratio ◽  
Average Value ◽  
Reported Data

AbstractSince the first suspected case of coronavirus disease-2019 (COVID-19) on December 1st, 2019, in Wuhan, Hubei Province, China, a total of 40,235 confirmed cases and 909 deaths have been reported in China up to February 10, 2020, evoking fear locally and internationally. Here, based on the publicly available epidemiological data for Hubei, China from January 11 to February 10, 2020, we provide estimates of the main epidemiological parameters. In particular, we provide an estimation of the case fatality and case recovery ratios, along with their 90% confidence intervals as the outbreak evolves. On the basis of a Susceptible-Infected-Recovered-Dead (SIDR) model, we provide estimations of the basic reproduction number (R0), and the per day infection mortality and recovery rates. By calibrating the parameters of the SIRD model to the reported data, we also attempt to forecast the evolution of the of the outbreak at the epicenter three weeks ahead, i.e. until February 29. As the number of infected individuals, especially of those with asymptomatic or mild courses, is suspected to be much higher than the official numbers, which can be considered only as a subset of the actual numbers of infected and recovered cases in the total population, we have repeated the calculations under a second scenario that considers twenty times the number of confirmed infected cases and forty times the number of recovered, leaving the number of deaths unchanged. Based on the reported data, the expected value of R0 as computed considering the period from the 11th of January until the 18th of January, using the official counts of confirmed cases was found to be ∼4.6, while the one computed under the second scenario was found to be ∼3.2. Thus, based on the SIRD simulations, the estimated average value of R0 was found to be ∼ 2.6 based on confirmed cases and2 based on the second scenario. Our forecasting flashes a note of caution for the presently unfolding outbreak in China. Based on the official counts for confirmed cases, the simulations suggest that the cumulative number of infected could reach 180,000 (with lower bound of 45,000) by February 29. Regarding the number of deaths, simulations forecast that on the basis of the up to the 10th of February reported data, the death toll might exceed 2,700 (as a lower bound) by February 29. Our analysis further reveals a significant decline of the case fatality ratio from January 26 to which various factors may have contributed, such as the severe control measures taken in Hubei, China (e.g. quarantine and hospitalization of infected individuals), but mainly because of the fact that the actual cumulative numbers of infected and recovered cases in the population most likely are much higher than the reported ones. Thus, in a scenario where we have taken twenty times the confirmed number of infected and forty times the confirmed number of recovered cases, the case fatality ratio is around ∼ 0.15% in the total population. Importantly, based on this scenario, simulations suggest a slow down of the outbreak in Hubei at the end of February.

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