The role of the laboratory in outbreak investigation of viral haemorrhagic fever in Nigeria, 2014

Abstract

On 26th March 2014, a newspaper published an article on the death of a 15 year old female student who attended a private university in Nasarawa state from suspected VHF; presumably Ebola. We investigated to know the cause of death, identified the agent and the source and proposed recommendations. We defined a suspected a case of Viral Haemorrhagic Fever (VHF) as any person with onset of fever and no response to usual causes of fever and at least one of the following signs: bloody diarrhoea, bleeding from gums, bleeding into skin (purpura), bleeding into eyes and urine within and around Abuja from 9th February 2014 to 2nd April 2014. We reviewed the hospital records of the index case and re-tested stored blood samples. We searched actively for contacts with the index case in hospitals where she was treated before her demise. Hospital staff were line listed at the various hospitals. We confirmed one death (index case) a 15 year old female who died on 15th March 2014. Serum sample tested positive for Dengue virus serotypes 1,2,3 and 4 using ELISA and PCR. We implemented VHF detection, management and reporting for health professionals in the country. We recommended sero-surveillance and entomological surveys be done to determine the prevalence of Dengue virus and its vector in Abuja and Nasarawa state. Dengue and other VHFs are emerging diseases that can easily be missed or misdiagnosed in early stages. Equipping laboratories and improving surveillance can help in early detection, management and epidemic aversion.

Keywords

• viral hemorrhagic fever
• dengue
• nigeria
• elisa
• ebola