Immediate outcomes of technical support for Lassa fever outbreak control in Ondo State, Nigeria, February 2017

Abstract

Introduction : outbreaks of Lassa fever (LF) occur annually in many states such as Ondo in Nigeria. Early treatment with the drug of choice, Ribavirin, accessible treatment centers as well as implementation of prompt and appropriate outbreak control measures should significantly reduce morbidity and mortality. These had however, not been the case in Ondo State before a federal team from the Nigeria Centre for Disease Control (NCDC) and Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP), was deployed to support investigation and control of the outbreak. Methods : outbreak protocol was used which included definitions for suspected and confirmed cases. Updating line lists, active case search, contact tracing and listing was carried out daily. A structured questionnaire was used to assess Infection Prevention and Control (IPC) practices and knowledge of Lassa fever in communities and health facilities. Advocacy at State and LGA levels was done to establish treatment centres and raise capacity for outbreak control. Laboratory confirmation was done at Irrua Specialist Teaching Hospital (ISTH), Edo state. Results : twelve of the 27 suspected cases were confirmed with six deaths; four among confirmed and two suspected. Case fatality rate was 22.2% for all cases but declined for confirmed cases from 75% before our intervention to 33.3% after. With our technical support, interventions included establishment of a treatment centre in Federal Medical Centre (FMC), Owo, Ondo State and reduction in number of referrals to ISTH, Edo State (from 100% to 12.5%). Treatment with Ribavirin now commenced immediately samples were collected rather than after receipt of results. Conclusion : provision of technical support by the federal government and partners improved outbreak response in Ondo State. Prompt and adequate investigation and implementation of control measures also reduced morbidity and mortality. These should be sustained and strengthened.