Towards an effective poliovirus laboratory containment strategy in Nigeria.

BACKGROUND: The Global Commission for the Certification of the Eradication of Poliomyelitis will declare the world free of wild poliovirus transmission when no wild virus has been found in at least 3 consecutive years, and all laboratories possessing wild poliovirus materials have adopted appropriate measures of containment. Nigeria has made progress towards poliomyelitis eradication with the latest reported WPV type 1 on 21 Aug 2016 after 2 years without any case. This milestone achievement was followed by an inventory of biomedical laboratories completed in November 2015 with the destruction of all identified infectious materials. This paper seeks to describe the poliovirus laboratory containment process in Nigeria on which an effective containment system has been built to minimize the risk of virus re-introduction into the population from the laboratories. METHODS: A national survey of all biomedical facilities, as well as an inventory of laboratories from various sectors, was conducted from June-November 2015. National Task Force (NTF) members and staff working on polio administered an on-site questionnaire in each facility. Laboratory personnel were sensitized with all un-needed materials destroyed by autoclaving and incineration. All stakeholders were also sensitized to continue the destruction of such materials as a requirement for phase one activities. RESULTS: A total of 20,638 biomedical facilities were surveyed with 9575 having laboratories. Thirty laboratories were found to contain poliovirus or potentially infectious materials. The 30 laboratories belonged to the ministries of health, education, defence and private organizations. CONCLUSIONS: This article is amongst the first in Africa that relates poliovirus laboratory containment in the context of the tOPV-bOPV switch in alignment with the Global Action Plan III. All identified infectious materials were destroyed and personnel trained to continue to destroy subsequent materials, a process that needs meticulous monitoring to mitigate the risk of poliovirus re-introduction to the population.

Transmission dynamics and control of Ebola virus disease outbreak in Nigeria, July to September 2014.

We analyse up-to-date epidemiological data of the Ebola virus disease outbreak in Nigeria as of 1 October 2014 in order to estimate the case fatality rate, the proportion of healthcare workers infected and the transmission tree. We also model the impact of control interventions on the size of the epidemic. Results indicate that Nigeria's quick and forceful implementation of control interventions was determinant in controlling the outbreak rapidly and avoiding a far worse scenario in this country.

Differentiation of Bwamba and Pongola viruses by agar-gel diffusion and immunoelectrophoretic techniques.

The agar-gel diffusion (AGD) and the immunoelectrophoretic (IEP) techniques were employed in the differentiation of virus strains of the Bwamba-Pongola group. These techniques were found to be more specific than either the complement fixation (CF) or the neutralization (N) test in the differentiation of Bwamba and Pongola viurses. Of 22 virus strains isolated in Nigeria and previously typed as strains of Bwamba virus by CF and N tests, 12 strains of mosquito origin were definitely classified as Pongola viruses and 10 of human origin as Bwamba viruses by the AGD and IEP techniques.

Viral hemorrhagic fever antibodies in Nigerian populations.

Using the immunofluorescence test, a serosurvey for antibodies to five viral agents associated with hemorrhagic febrile infections was conducted with 1,677 human sera from different parts of Nigeria. Three hundred fifty-seven (21.3%) were positive for Lassa virus antibody, while antibodies to Rift Valley fever virus were detected in 42 (2.5%) of the sera. Testing for Rift Valley fever virus antibody was confirmed by plaque reduction neutralization test. Antibodies to Ebola and Marburg viruses were detected in 30 and 29 sera, respectively. Of the 357 Lassa virus antibody-positive sera, 297 (83.2%) were positive for Lassa only. In contrast, sera positive for Marburg were positive in combination with Lassa, Ebola, or Rift Valley fever viruses. Antibodies to Lassa and Rift Valley fever viruses were found in all locations in Nigeria, whereas Ebola and Marburg antibodies were found mainly in the northern savanna zones of Benue and Gongola, but not in the rain forest area of Ondo.

Recovery of a Lassa-related arenavirus in Zimbabwe.

Immunofluorescent antibodies to "Mozambique" virus, a close relative of Lassa virus, were found in 11 of 55 Mastomys natalensis and 1 of 13 Aethomys chrysophilus rodents captured near Que Que and Chiredzi, Zimbabwe. Six strains of Mozambique virus, identified by use of specific monoclonal antibodies to the agent, were recovered from visceral tissues of M. natalensis rodents. All Mastomys having virus or antibodies to this agent were of the chromosomal form 2N = 32 (M. natalensis). These data extend the area of geographic occurrence of this virus, which was initially recognized in Mozambique and which may represent a naturally attenuated antigenic variant of human pathogenic West African Lassa virus.

Arbovirus infections among laboratory personnel in Ibadan, Nigeria.

Laboratory-acquired infections encountered between 1963 and 1977 among personnel of the Virus Research Laboratory, Ibadan, Nigeria, are reported. Two cases of chikungunya infection occurred and one each with Dugbe, Wesselsbron, and dengue viruses. In each case, virus was isolated or development of antibody demonstrated. Among virus and two each to chikungunya and Rift Valley fever viruses, without experiencing any clinically recognized disease.

Does neuroanatomy predict ECT response?

1. Structural neuropathologic abnormalities have been associated with severe psychiatric illnesses, including bipolar disorder, major depressive disorder, and schizophrenia. In the latter, ventricular enlargement has been variably associated with symptom severity and poor treatment response. In patients with severe depressive disorders, the relationship between cortical and subcortical pathology and ventricle enlargement, symptom severity, and response to treatment is far from clear. 2. The present study investigated the relationship between structural CNS pathology, symptom severity and treatment response in patients undergoing ECT. It was hypothesized that patients with greater neuroanatomic abnormalities would demonstrate greater initial symptom severity and poorer response to ECT. 3. The subjects were 57 patients with unipolar or bipolar depression admitted for ECT treatment. Symptom severity was quantified using the Hamilton Depression Rating Scale (HRSD) at baseline and post-ECT. 4. Lateral and third ventricle-brain ratio (LVBR, 3VBR) were determined from CT scans and cortical atrophy was rated by a faculty neuroradiologist. 5. Contrary to our first hypothesis, structural pathology was not associated with baseline symptom severity. In terms of treatment response, the number of treatments required to achieve benefit was correlated with larger 3VBR; CT variables were not related to total post-treatment or change in HRSD score. Third ventricle enlargement may be an index of generalized pathology or regional brainstem abnormalities that influence ECT response rate by limiting individual seizure efficacy or neurochemical responsiveness, thereby necessitating a greater number of ECT treatments, without significant impact on overall response.

Response of Erythrocebus patas monkeys to experimental infection with the orbivirus Orungo virus.

The response of Erythrocebus patas monkeys experimentally inoculated by the intravenous and subcutaneous routes with Orungo virus (family Reoviridae, genus Orbivirus) was studied with reference to development of clinical signs, circulation of virus and antibody response. None of the animals showed clinical disease nor did they circulate virus. However, all the animals developed complement fixing (CF), neutralizing (N) and agar gel (AG) precipitating antibodies between day seven and day 14 post infection (p.i.). The CF antibodies appeared earlier and lasted for a longer period than did the N antibodies. The presence of transient 2-mercaptoethanol (2-ME) sensitive CF antibodies was demonstrated in sera collected between day seven and day 14 p.i. The significance of these findings in the interpretation of serological surveys in man for Orungo virus antibody is discussed.

Circulation of poliovirus among risk groups in Ibadan, Nigeria.

Faecal samples collected from 114 fully vaccinated pre-school children and 32 unvaccinated infants in Ibadan, Nigeria, were assayed for poliovirus in Hep-2 and RD cell cultures. 8 strains of poliovirus type 1 were isolated from 146 samples--3 from 32 unvaccinated children aged less than 40 d and 5 from 114 fully vaccinated children aged between 9 and 60 months. Studies using Sabin and wild monoclonal antibodies and the polymerase chain reaction confirmed 7 of the 8 isolates to be of the wild type, a possible source of infection among vaccinated children.

Yellow fever vaccination and pregnancy: a four-year prospective study.

During an outbreak of yellow fever (YF) in Nigeria in 1986-1987, women at various stages of pregnancy were vaccinated against YF, either because those pregnancies were not known at the time or because they requested vaccination out of fear of acquiring the disease. This offered an opportunity to assess the safety and efficacy of YF vaccine in pregnant women and the effect of this vaccine on their newborn children. Pre-vaccination and post-vaccination serum samples from the vaccinated pregnant women were tested by enzyme-linked immunosorbent assay and by neutralization tests for antibody to YF virus. The results showed that the antibody responses of these pregnant women were much lower than those of YF-vaccinated, non-pregnant women in a comparable control group. Follow-up of these women and their newborn children for 3-4 years showed no abnormal effect that could be attributed to the YF vaccine, which suggests that vaccination of pregnant women, particularly during a YF epidemic, may not be contraindicated.

A survey for antibodies to Lassa virus among health workers in Nigeria.

A study was conducted among 552 health workers at 6 health facilities in Nigeria. Lassa virus immunoglobulin (Ig) G antibody was detected in 12.3%, using an enzyme-linked immunosorbent assay. Antibody prevalence in the 6 health centres ranged from 1.2% to 27.3%. Prevalences were higher in primary and secondary health facilities than in tertiary centres. Seroprevalences ranged from 1.7% to 23.7% among different occupational groups of health workers; the highest observed antibody prevalence was among ward aids. Lassa virus IgM antibody, indicating recent infection, was present in 6 of the health workers, 5 of whom were ward aids and one was a nurse. All of the health workers with specific IgM came from a single facility in Lafia, sampled during an outbreak of Lassa fever.

Urban yellow fever epidemic in western Nigeria, 1987.

A large epidemic of urban yellow fever occurred in April and May 1987 in Oyo State, western Nigeria. The principal vector was Aedes aegypti, breeding in domestic water containers. The 1987 outbreak followed an epidemic of sylvatic yellow fever in eastern Nigeria the previous year, and probably resulted from introduction of the virus by viraemic travellers. The outbreak in Oyo State ended in early July, by which time 805 cases and 416 deaths had been officially notified. However, surveys of 3 villages in the epicentre, a region with over 4 million inhabitants, indicated an infection rate of approximately 20%, a clinical attack rate of 2.9% and a mortality rate of 0.6%, suggesting that the true incidence of cases and deaths far exceeded the official reports. Yellow fever virus was isolated from persons with fully developed yellow fever as well as mild febrile illness. One virus isolate was made from blood of an individual with mild illness, who had received 17D vaccine 5 d earlier; monoclonal antibody analysis showed that the isolate was a wild-type virus. Larval indices of Ae. aegypti were very high; however, low vector competence of the Ae aegypti population may have provided a constraint on spread of the epidemic. In late 1987 a third epidemic appeared in Niger State, northern Nigeria, with 644 reported cases and 149 deaths. The vector(s) involved is (are) unknown.

Progress towards polio eradication: an African perspective.

Despite daunting competing health priorities, Africa has made significant progress in polio control. Northern and Southern Africa appear to be polio-free and may shortly be certified as such; however, polio still remains endemic in West and Central Africa and the Horn of Africa. Countries "in difficult circumstancess", wracked by major civil wars, have particularly low routine vaccine coverage, although NIDS have been carried out during negotiated days of tranquillity. AFP surveillance has also improved, although the quality of stool specimens is still far from ideal. There is, nevertheless, an extraordinary political commitment to the eradication campaign. Lessons from the history of polio in the continent need to be heeded in designing end-game strategies. Obstacles on the path to successful eradication are undoubtedly more formidable on the African continent--perhaps the most serious of all are the continuing wars. International political commitment and focussed and empowering developmental aid are urgently needed.

Clinical, virological and serological response of the West African dwarf sheep to experimental infection with different strains of Rift Valley fever virus.

West African dwarf sheep were inoculated with three different strains of Rift Valley fever virus (RVFV). Using infective mouse serum as the source of virus classical RVFV disease characterised by sudden onset, a sharp but transient febrile response, viraemia, abortions and the development of specific RVFV antibodies in surviving animals was observed. The severity of clinical response was, however, dependent on the strain of virus used, with animals inoculated with Smithburn's neuroadapted strain showing a milder response than those inoculated with either the Nigerian or Lunyo strain. The inoculation of sheep with RVFV infective mouse brain material of the three different strains resulted in a mild febrile response with low level viraemia. Immune sera from sheep inoculated with both the Nigerian and Smithburn's neurotropic strains did not neutralise the Lunyo virus strain in a mouse intracerebral neutralisation test; the reverse, however, was not the case. The findings indicate that the West African dwarf sheep is highly susceptible to RVFV infection and that previous reports of only a mild clinical response following inoculation with the Nigerian strain were due to infective mouse brain rather than infective mouse serum.

Immunological reactions of Rift Valley fever virus strains from East and West Africa.

Three strains of Rift Valley fever virus, namely Nigerian (NIG), Smithburn's neurotropic (SNT), and Lunyo variant (LUN) were compared by complement fixation (CF), neutralisation (N), haemagglutination/haemagglutination-inhibition (HA/HI) and agar gel diffusion (AGD) tests. They showed reciprocal cross-reactivity in CF tests. In N tests, using immune sheep sera, there was reciprocal cross-neutralisation between the NIG and SNT strains, but not with the LUN strain, the antiserum of which neutralised both NIG and SNT antigens whereas the reverse was not the case. When hyperimmune mouse ascitic fluid was employed in N tests, there was cross-reactivity between the three strains. Both the NIG and SNT strains yielded haemagglutinins, but not the LUN strain. Furthermore, by the antibody absorption and AGD techniques, the NIG and SNT strains were found to be identical and distinct from the LUN variant strain. The techniques found most useful in distinguishing between the three strains were HA and AGD. Laboratory neuro-adaptation of the classical pantropic virus did not appear to affect its haemagglutination activity.

Experimental Rift Valley fever in West African Dwarf sheep.

West African Dwarf sheep were challenged with a low mouse brain-passaged Rift Valley fever virus (Ib-AR 55172) isolated from Nigeria. Viraemia, mild febrile reaction and neutralising antibodies were demonstrated in inoculated animals.

Detection of Mokola virus neutralising antibodies in Nigerian dogs.

Five hundred healthy Nigerian dogs were randomly selected and bled for serological detection of antibodies to lyssa-viruses, including Mokola, Lagos bat and Duvenhage viruses. The canine sera were screened for virus neutralising antibodies by a modification of the rapid fluorescent focus inhibition technique. Three serum samples were seropositive to Mokola virus but all were negative to Lagos bat and Duvenhage viruses. The three seropositive Mokola samples were also negative for rabies virus neutralising antibodies. This finding may explain occasional rabies-like canine mortalities within one year of antirabies vaccination in Nigeria.

Rift Valley fever in Nigeria: infections in domestic animals.

Between 1986 and 1989, 2,255 sera collected from six domestic animal species in Nigeria were tested for antibodies to Rift Valley fever (RVF) virus. In addition, a longitudinal study was carried out from July 1987 to December 1988, using ten sentinel flocks on four farms at Ibadan and Ile-Ife, to determine the activity of RVF virus (RVFV). All samples were tested for haemagglutination-inhibiting antibodies and positive sera were further screened, using the plaque reduction neutralisation test. Of 2,255 samples, 259 (11.5%) had haemagglutination-inhibiting and neutralising antibodies, as follows: sheep (18.7%), goats (10.4%), cattle (10.2%), horses (9.8%) and camels (3.3%). The highest prevalence of RVFV antibody was found in the plateau area (18.4%). Animals aged three years or more had a higher prevalence of antibodies to RVFV. Longitudinal studies showed seroconversion to RVFV in ten of the 210 animals which were kept under observation (4.8%). All seroconversions occurred during the wet season. The results of this study indicate that the infection of animals with RVFV is widespread in Nigeria.

Rift Valley fever in Nigeria: infections in humans.

Between 1985 and 1989, a total of 3,121 human sera collected from different population groups in six ecological zones of Nigeria were tested for the presence of antibodies to Rift Valley fever (RVF) virus by the haemagglutination-inhibition test. All reactive sera were further tested by the plaque reduction neutralisation test and specific RVF immunoglobulin M (IgM) assay. A total of 461 sera (14.8%) demonstrated haemagglutination-inhibiting antibody and 390 of the 461 initially reactive sera (84.6%) revealed neutralising antibodies. A significantly higher exposure to the virus was found among livestock workers and wildlife rangers than in other categories of people tested. The rate of positive reactions was higher in adults of 30 years or more than in younger age groups. Of 461 sera tested for specific RVF IgM, 107 gave positive results (23.2%). The highest prevalence of RVF IgM was found among livestock and forestry workers. In the longitudinal survey, an RVF virus infection rate of 6.7% was demonstrated. The infection rate was significantly higher during the wet season than during the dry season of the same year.

Detection of rabies virus antibodies in fruit bats (Eidolon helvum) from Nigeria.

Fruit bats (Eidolon helvum) were collected from three different localities in Western Nigeria: Oti, Ibadan and Idanre. Fifty serum samples were analyzed using a modified rapid fluorescent focus inhibition technique against rabies, Mokola, Lagos bat and Duvenhage viruses. Twenty-five brain samples were screened for rabies and related lyssavirus antigens by direct fluorescent antibody microscopy and by an indirect fluorescent antibody technique with rabies anti-nucleocapsid monoclonal antibodies. All brain samples were negative. Two serum samples had relatively high anti-rabies activity; no neutralizing activity was detected against Mokola, Lagos bat or Duvenhage viruses.