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Review
. 2021 Nov 8:13:100346.
doi: 10.1016/j.onehlt.2021.100346. eCollection 2021 Dec.

The One Health approach to incident management of the 2019 Lassa fever outbreak response in Nigeria

Chioma Dan Nwafor  1 , Elsie Ilori  1 , Adebola Olayinka  2 , Chinwe Ochu  1 , Rosemary Olorundare  1 , Edwin Edeh  2 , Tochi Okwor  1   2 , Oyeronke Oyebanji  1 , Esther Namukose  2 , Winifred Ukponu  3 , Michael Olugbile  4 , Usman Adekanye  5 , Nastassya Chandra  6 , Hikaru Bolt  6 , Geofrey Namara  2 , Oladipupo Ipadeola  1 , Yuki Furuse  2 , Solomon Woldetsadik  2 , Adejoke Akano  1 , Akanimo Iniobong  1 , Michael Amedu  1 , Chimezie Anueyiagu  1 , Lawal Bakare  1   2 , Anthony Ahumibe  1 , Gbenga Joseph  1 , Chibuzo Eneh  1 , Muhammad Saleh  1 , Naidoo Dhamari  2 , Ihekerenma Okoli  7 , Mairo Kachalla  7 , Rita Okea  8 , Collins Okenyi  8 , Favour Makava  9 , Catherine Makwe  10 , Nkem Ugbogulu  11 , Fritz Fonkeng  12 , Everistus Aniaku  1 , Emmanuel Agogo  1 , Nwando Mba  1 , Olusola Aruna  13 , Patrick Nguku  14 , Chikwe Ihekweazu  1
Affiliations
Review

The One Health approach to incident management of the 2019 Lassa fever outbreak response in Nigeria

Chioma Dan Nwafor et al. One Health. .

Abstract

Globally, effective emergency response to disease outbreaks is usually affected by weak coordination. However, coordination using an incident management system (IMS) in line with a One Health approach involving human, environment, and animal health with collaborations between government and non-governmental agencies result in improved response outcome for zoonotic diseases such as Lassa fever (LF). We provide an overview of the 2019 LF outbreak response in Nigeria using the IMS and One Health approach. The response was coordinated via ten Emergency Operation Centre (EOC) response pillars. Cardinal response activities included activation of EOC, development of an incident action plan, deployment of One Health rapid response teams to support affected states, mid-outbreak review and after-action review meetings. Between 1st January and 29th December 2019, of the 5057 people tested for LF, 833 were confirmed positive from 23 States, across 86 Local Government Areas. Of the 833 confirmed cases, 650 (78%) were from hotspot States of Edo (36%), Ondo (26%) and Ebonyi (16%). Those in the age-group 21-40 years (47%) were mostly affected, with a male to female ratio of 1:1. Twenty healthcare workers were affected. Two LF naïve states Kebbi and Zamfara, reported confirmed cases for the first time during this period. The outbreak peaked earlier in the year compared to previous years, and the emergency phase of the outbreak was declared over by epidemiological week 17 based on low national threshold composite indicators over a period of six consecutive weeks. Multisectoral and multidisciplinary strategic One Health EOC coordination at all levels facilitated the swift containment of Nigeria's large LF outbreak in 2019. It is therefore imperative to embrace One Health approach embedded within the EOC to holistically address the increasing LF incidence in Nigeria.

Keywords: Emergency operation centre; Incident management system; Lassa fever; One Health.

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Conflict of interest statement

The authors declare there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Map Nigeria showing distribution of confirmed Lassa fever cases in Nigeria, 2019.
Fig. 2
Fig. 2
2019 National Lassa fever IMS structure.
Fig. 3
Fig. 3
Epidemic curve of 2019 Lassa fever outbreak in Nigeria with timeline of key response activities.
See this image and copyright information in PMC

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