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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 30: 19 - 25 July 2021
Data as reported by: 17:00; 25 July 2021
...
Lassa fever Liberia
13 Cases
9 Deaths
69.0% CFR
EVENT DESCRIPTION
Confirmed cases of Lassa fever have previously been reported in
Liberia for more than five years. Between 2016 and 2020, a total
of 168 confirmed cases including 70 deaths were reported (case
fatality rate 42.0%) in 7 out of the 15 counties in Liberia. During
the same period, the number of cases per year ranged from 14 in
2016 to 52 in 2020.
The first confirmed case in 2021 was reported in week 3 (ending
January 24) in a 39-year-old male, resident of Phebe Airstrip,
Bong County, who had symptom onset of illness on 10 January
2021. The case was admitted at Phebe Hospital on 11 January
2021, where a specimen was collected and sent to the National
Public Health Reference Laboratory (NPHRL) on the same
day. The case died on 12 January 2021 and a safe burial was
conducted. Laboratory result confirmed him positive for Lassa
virus on 17 January 2021. From this case, 21 contacts including
18 health workers were identified, line-listed and followed up.
The second confirmed case was a 38-year-old female resident of
MIE Field, who presented with red eyes, general body weakness,
poor appetite, sore throat, vomiting, and coughing on 1 March
2021 and was unresponsive to treatment. Based on the suspicion
for Lassa fever, the case patient was admitted and isolated at
Liberia Agricultural Company hospital in Grand Bassa County on
4 March 2021. A specimen was collected on 6 March 2021 and
tested positive on 8 March 2021 following her death on 7 March.
The recent confirmed case was reported on 5 July 2021 from
Nimba County in a 27-year-old female who first exhibited
symptoms on 3 July 2021. She sought medical treatment at
Ganta United Methodist Hospital on the same day, where she
was isolated with complaints of high fever, stomach pains, red
eyes, joint pains nausea and vomiting. The case died on 9 July
2021 and a safe and dignified burial was conducted by the district
health team. Laboratory results were positive on July 12, 2021.
A total of eleven contacts all healthcare workers were listed.
The case had no epi-link to the other confirmed cases neither a
travel history to affected county or attended funeral service of a
confirmed Lassa fever case. A total of 60 contacts from Bong and
Nimba Counties are currently under follow-up.
Confirmed cases reported between 1 January and 18 July 2021
are associated with higher CFR compared to the previous five
years. Within this period, a total of 71 suspected cases were
reported, of which 13 (18.3%) were confirmed, and 9 deaths
among confirmed cases (CFR: 69%). The confirmed cases
originated from four counties; namely Bong (3), Grand Bassa (4),
Montserrado (1) and Nimba (5). Females account for the highest
number of the confirmed cases (7 cases, 54%) compared with
males (6 cases, 46%). Of the 13 confirmed cases, 3 (23.1%)
were within the age range of 0-15 years, 5 (38.5%) cases within
16-30 years, 3 (23.1%) cases within 31-45 years, and 2 (15.4%)
cases 46 years and older.
PUBLIC HEALTH ACTIONS
Upon confirmation of one case, incident management and
emergency operations centres have been activated in all
response counties.
The National Lassa Fever Action Plan (multiple Counties
affected), and national level incident management is being
activated.
Inter-county surveillance meetings with neighbouring
counties are planned by the county health teams.
A total of 60 contacts are currently under follow-up (20
from Bong County and 40 from Nimba County. Of the forty
contacts from Nimba County, 11 are from the current case
and twenty-nine from previous case).
Conducting Infection Prevention and Control (IPC) measures
and also creating line list of high and low contacts including
health workers for follow up.
Specimen collection kits deployed to affected counties and
Samples are safely transported by Riders for Health to the
National Reference laboratory
Intensified active case search using outbreak case definition
continues in all health facilities and communities in affected
counties
Drugs and medical supplies deployed to counties and
replenished rapidly as needed
Health workers are being sensitized and mentored on Lassa
fever prevention including the use of appropriate personal
protective equipment during treatment of viral haemorrhagic
fever cases. Clinical staff were trained on case management
and additional IPC measures
Safe and dignified burial team members have been trained in
preparedness for the burial of highly suspicious unexplained
deaths. Ring approach assessment continues and led by IPC
focal persons based on priority of sites
Community engagement activity is ongoing in the affected
communities with rapid response teams visiting the affected
households and families and providing information on
environmental cleanliness.
Plans are underway to support affected communities to
mount clean-up campaigns.
SITUATION INTERPRETATION
Liberia is one of the West African countries where Lassa fever
is endemic along with Sierra Leone, Guinea, and Nigeria. A total
of 13 cases have been confirmed in the recent outbreak, with 9
deaths recorded. However, the current case fatality ratio (69%)
is greater than that recorded in the past five years. Response
activities, with the support of the NPHRL, the minister of health
and partners, continue in the affected counties albeit with
challenges in all pillars of the response.
PROPOSED ACTIONS
The Ministry of Health and its partners should develop
and implement strategies to strengthen all pillars of the
response to the Lassa fever outbreak, including surveillance,
communication, and case management. Given that Lassa
fever is usually transmitted to humans by rodents, good
“community hygiene” should be promoted by conducting
community engagements on the prevention of Lassa fever,
rodent control measures and hygiene promotion as well as
environmental scanning.
AND OTHER EMERGENCIES
Week 30: 19 - 25 July 2021
Data as reported by: 17:00; 25 July 2021
...
Lassa fever Liberia
13 Cases
9 Deaths
69.0% CFR
EVENT DESCRIPTION
Confirmed cases of Lassa fever have previously been reported in
Liberia for more than five years. Between 2016 and 2020, a total
of 168 confirmed cases including 70 deaths were reported (case
fatality rate 42.0%) in 7 out of the 15 counties in Liberia. During
the same period, the number of cases per year ranged from 14 in
2016 to 52 in 2020.
The first confirmed case in 2021 was reported in week 3 (ending
January 24) in a 39-year-old male, resident of Phebe Airstrip,
Bong County, who had symptom onset of illness on 10 January
2021. The case was admitted at Phebe Hospital on 11 January
2021, where a specimen was collected and sent to the National
Public Health Reference Laboratory (NPHRL) on the same
day. The case died on 12 January 2021 and a safe burial was
conducted. Laboratory result confirmed him positive for Lassa
virus on 17 January 2021. From this case, 21 contacts including
18 health workers were identified, line-listed and followed up.
The second confirmed case was a 38-year-old female resident of
MIE Field, who presented with red eyes, general body weakness,
poor appetite, sore throat, vomiting, and coughing on 1 March
2021 and was unresponsive to treatment. Based on the suspicion
for Lassa fever, the case patient was admitted and isolated at
Liberia Agricultural Company hospital in Grand Bassa County on
4 March 2021. A specimen was collected on 6 March 2021 and
tested positive on 8 March 2021 following her death on 7 March.
The recent confirmed case was reported on 5 July 2021 from
Nimba County in a 27-year-old female who first exhibited
symptoms on 3 July 2021. She sought medical treatment at
Ganta United Methodist Hospital on the same day, where she
was isolated with complaints of high fever, stomach pains, red
eyes, joint pains nausea and vomiting. The case died on 9 July
2021 and a safe and dignified burial was conducted by the district
health team. Laboratory results were positive on July 12, 2021.
A total of eleven contacts all healthcare workers were listed.
The case had no epi-link to the other confirmed cases neither a
travel history to affected county or attended funeral service of a
confirmed Lassa fever case. A total of 60 contacts from Bong and
Nimba Counties are currently under follow-up.
Confirmed cases reported between 1 January and 18 July 2021
are associated with higher CFR compared to the previous five
years. Within this period, a total of 71 suspected cases were
reported, of which 13 (18.3%) were confirmed, and 9 deaths
among confirmed cases (CFR: 69%). The confirmed cases
originated from four counties; namely Bong (3), Grand Bassa (4),
Montserrado (1) and Nimba (5). Females account for the highest
number of the confirmed cases (7 cases, 54%) compared with
males (6 cases, 46%). Of the 13 confirmed cases, 3 (23.1%)
were within the age range of 0-15 years, 5 (38.5%) cases within
16-30 years, 3 (23.1%) cases within 31-45 years, and 2 (15.4%)
cases 46 years and older.
PUBLIC HEALTH ACTIONS
Upon confirmation of one case, incident management and
emergency operations centres have been activated in all
response counties.
The National Lassa Fever Action Plan (multiple Counties
affected), and national level incident management is being
activated.
Inter-county surveillance meetings with neighbouring
counties are planned by the county health teams.
A total of 60 contacts are currently under follow-up (20
from Bong County and 40 from Nimba County. Of the forty
contacts from Nimba County, 11 are from the current case
and twenty-nine from previous case).
Conducting Infection Prevention and Control (IPC) measures
and also creating line list of high and low contacts including
health workers for follow up.
Specimen collection kits deployed to affected counties and
Samples are safely transported by Riders for Health to the
National Reference laboratory
Intensified active case search using outbreak case definition
continues in all health facilities and communities in affected
counties
Drugs and medical supplies deployed to counties and
replenished rapidly as needed
Health workers are being sensitized and mentored on Lassa
fever prevention including the use of appropriate personal
protective equipment during treatment of viral haemorrhagic
fever cases. Clinical staff were trained on case management
and additional IPC measures
Safe and dignified burial team members have been trained in
preparedness for the burial of highly suspicious unexplained
deaths. Ring approach assessment continues and led by IPC
focal persons based on priority of sites
Community engagement activity is ongoing in the affected
communities with rapid response teams visiting the affected
households and families and providing information on
environmental cleanliness.
Plans are underway to support affected communities to
mount clean-up campaigns.
SITUATION INTERPRETATION
Liberia is one of the West African countries where Lassa fever
is endemic along with Sierra Leone, Guinea, and Nigeria. A total
of 13 cases have been confirmed in the recent outbreak, with 9
deaths recorded. However, the current case fatality ratio (69%)
is greater than that recorded in the past five years. Response
activities, with the support of the NPHRL, the minister of health
and partners, continue in the affected counties albeit with
challenges in all pillars of the response.
PROPOSED ACTIONS
The Ministry of Health and its partners should develop
and implement strategies to strengthen all pillars of the
response to the Lassa fever outbreak, including surveillance,
communication, and case management. Given that Lassa
fever is usually transmitted to humans by rodents, good
“community hygiene” should be promoted by conducting
community engagements on the prevention of Lassa fever,
rodent control measures and hygiene promotion as well as
environmental scanning.
