4. Case Definition for
Acute Flaccid Paralysis (AFP)
Surveillance
• Any case of AFP in a child <15 years of
age
OR
• Any case of paralytic illness (regardless
of age) in which clinician suspects polio
P O L I O 12
5. Acute Flaccid Paralysis
• Acute:
Sudden onset — as opposed to
chronic
• Flaccid:
Loss of muscle tone, “floppy”
(as opposed to spastic or rigid)
• Paralysis*:
Weakness, loss of voluntary
movement*
P O L I O 11
*May affect any muscle in the body, although primarily seen in those of the arms
and/or legs
6. Partial Differential Diagnosis of
AFP
P O L I O 16
Acute Flaccid
Paralysis
Transverse
Myelitis
Traumatic
Neuritis
AFP
Caused by other
Enteroviruses
(Including Coxsackie's Virus,
Echovirus, etc.)
Poliomyelitis
other
(toxins, metabolic,
snake bite, drug-induced,
etc.)
Guillain-Barré
Syndrome
7. Clues to the Presence of AFP
P O L I O 17
Acute Flaccid
Paralysis
Paralysis:
sudden onset
floppy limb weakness
cannot sit up
cannot walk
cannot move
leg, arm
8. Measles Case Definitions
• Suspected measles clinical case
definition:
– Fever + Rash + either Cough or Coryza or
Conjunctivitis
– Clinician suspects measles
• Lab confirmed:
– Suspected measles case with blood sample [+]
for measles IgM antibody, not recently
vaccinated
(4–8 weeks ago)
• Confirmed by epidemiologic linkage:
– Suspected measles case with no blood sampleM E A S L E S 15
9. Measles Case Definition
to Assist Communities in
Notifying Health Facilities
M E A S L E S 16
ANY PERSON
WITH
FEVER AND RASH
10. Rash +
Fever
M E A S L E S 20
Measles
Dengue Mononucleosis
Other Viral
Exanthems
Kawasaki
Meningococcemia
Toxoplasmosis
Roseola
Infantum
Scarlet Fever
Rubella
11. Meningitis Case Definitions
• Suspected meningitis case : any person
with sudden onset of fever (>38.5 C rectal
or 38.0 C axillary) and one of the following
signs: neck stiffness, altered consciousness
or other meningeal signs .
• Confirmed meningitis case : identification
of the causal pathogen from the CSF of a
suspected case
12. WHO recommanded
Thresholds
• Alert threshold :
– Populations between 30,000 and 100 000 inhabitants: an
attack rate of 5 cases per 100,000 inhabitants per week;
– Populations < 30,000 inhabitants: an incidence of 2 cases
in one week or an increase in the number of cases
compared to the previous non-epidemic years.
• Epidemic threshold :
– Populations between 30 000 and 100 000 inhabitants: an
attack rate of 15 cases per 100 000 inhabitants per week.
When the risk of epidemic outbreak is high, the
recommended threshold is 10 cases per 100 000
inhabitants per week.
– Populations < 30 000 inhabitants: an incidence of 5 cases
in 1 week or, the doubling of number of cases over a 3-
week period.
13. Neonatal Tetanus—Surveillance
I M M U N I Z A T I O N 18
Any neonate with normal ability to suck and cry
during the first 2 days
and
Any child between 3 and 28 days of age who:
cannot suck normally
and
becomes stiff or has convulsions (jerking of
the muscles) or both
(no laboratory confirmation needed)
NT cases reported by physicians are considered
confirmed
CASE DEFINITION
Confirmed:
14. • Suspected:
A case that is characterized by acute
onset of fever followed by jaundice
within two weeks of the onset of the
first symptoms
• Confirmed:
A suspected case that is laboratory-
confirmed or epidemiologically linked to
a laboratory-confirmed case orI M M U N I Z A T I O N 22
Yellow Fever—Surveillance
CASE DEFINITION
15. Guinea Worm Disease
• Any person with a blister or boil and
emergence of Guinea worm from the
blister/boil.
• Every GWD rumour should be
investigated. Investigation of GWD rumour
is a public health emergency and should
be acted upon immediately.
16. HEALTH FACILITY LEVEL
• Immediately notify the LGA DSNO or state epidemiology
by the fastest means. Call the GWD Toll free hotline
0800100-1000.
• Give name and phone number of the informant and
details of the rumour – name, sex, age,village, phone
number
• Immediately make contact with the rumour to:
• - Dress/bandage the wound
• Discourage him from travelling out of the village until the
DSNO examines the patient.
• Complete the case based form (IDSR001A)
17. LGA Level
• Immediate investigation of case. Materials needed include
methylated spirit, IDSR case investigation form-guinea worm
disease
• Verify case according to case definition
• If suggestive of GWD, inform state and call GWD toll free hotline
0800100-1000
• Preserve the worm specimen in spirit and label it properly.
• Order daily visits and dressing by nearest HF
• Discourage suspect from entering any water source or travelling out
of the village until investigated.
18. IDSR Form 002-Weekly (Dataflow/Deadlines)
LGA (IDSR 002)
STATE (IDSR 002)
NATIONAL (IDSR 002)
LGA report of previous
week (Mon-Sun)
should reach STATE
by Tuesday of following
week
State report of previous
week (Mon-Sun) should
reach National/Partners
Office by Wednesday of
following week
Note: Data is expected to be sent via electronic means
Feedback
Feedback should be
sent between 3-7 days
after receipt of
data/report.
However, immediate
response could be
demanded sometimes
where urgent.
Sometimes, where
weekly
newsletter/bulletins are
published, which is
rare, there may be a
slight delay in
feedback.
HFs (IDSR 002)
HFs report of previous
week (Mon-Sun)
should reach LGA by
Monday of following
week
19. IDSR Form 003-Monthly (Dataflow/Deadlines)
HFs (IDSR 003)
LGA (IDSR 003)
NATIONAL (IDSR 003)
State (IDSR 003)
HFs report of previous
month should reach
the LGA by day 7
(1wk) after month-end
LGA report of previous
month should reach
State by day 14 (2
wks) after month-end
State report of
previous month should
reach National level
latest by day 21 (3
wks ) after month-end
Note: Data is expected to be sent via electronic means
Feedback
Feedback should be
sent between 1-2
wks after receipt of
data/report.
However, immediate
response could be
demanded
sometimes where
urgent.
Sometimes, where
monthly bulletins are
published there may
be a slight delay in
feedback
20. If a case is Suspected,
What Should a Health Provider
Do?• Manage case
• Collect a blood specimen in the case of
measles and Yellow fever. In AFP and
other cases sensitise for samples
collection
• Fill out the immediate case reporting
form
• Report case to Focal Person and/or
District Health Office
M E A S L E S 13
21. IDSR Form 001A (Immediate case-based reporting form)
Immediate/Case-based surveillance reporting form
REPORTING HEALTH FACILITY REPORTING LGA REPORTING STATE
IDENTIFICATION NUMBER IDSR 001A
Immediate/ Case-based Reporting Form
From Health Facility/Health Worker to LGA health team
Cholera Dracunculiasis Neonatal
Tetanus
Measles Meningitis Influenza
A/H5N1
Viral Hemorrhagic
Fever e.g. Lassa
fever
Yellow
Fever
Diahrroea with
Blood
/shigella(Under5)
Others/specify*
e.g. Dengue,
SARS etc
Date form received at SMOH or the national level: / / (Date/Month/Year)
Name of Patient:
Date of Birth (DOB): / /
(Day/Month/Year)
Age (If DOB unknown): Year Month (if
<12)
Day (NNT only)
Sex: M=Male F=Female
Patient’s Address: Urban Rural
Settlement/Village
Ward
LGA State:
Exact residential address:
If applicable or If the patient is neonate or child, please write full name of mother and father of the patient
Date Seen at Health Facility: / / Date Health Facility notified
LGA/:
/ / Date of Onset: / /
Number of vaccine doses received: 9=unknown
For cases of Measles, NT (TT in mother), Yellow Fever, and Meningitis (For Measles, TT, YF- by card & for
Meningitis, by history)
Date of last vaccination: / /
(Measles, Neonatal Tetanus (TT in mother), Yellow Fever, and Meningitis only)
Close contact with infected poultry 1=Yes 2 =No
Close contact with suspected or
confirmed case of Avian influenza
1= Yes 2 =No
Associated with an outbreak? 1=Yes 2=No
In/Out Patient 1=Inpatient 2=Outpatient
Outcome 1=Alive 2=Dead 9=Unknown
Final Classification of case 1=Confirmed 2=Probable 3=Discarded 4=Suspect
Final Classification for Measles 1= Laboratory
Confirmed
2= Confirmed by
Epidemiological linkage
3=Clinical
Compatible
4=Discard 5=Suspect with lab pending
Person completing form Name:
Title: Address:
Signature:
Date form sent to LGA/: / / (Date/Month/Year) Date Form Received at LGA: / / / Signature
IDSR 001 A
22. Contact Telephone Numbers
1. H/F FOCAL POINT 08069092492
2. LGA DSNO 08167571975
3. ALIYU BUNZA state Epid.
08161700083
4. DR. BONOS 08034444349
5. DR. AUDU M. I. 08037005376
