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Published Date: 2005-04-15 23:50:00
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2005 (14)
Archive Number: 20050415.1083

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2005 (14)
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In these updates:
Africa
[1] & [2] Cholera - Senegal [3] Cholera - Uganda (Gulu refugee camp)
[4] Cholera - Congo DR (Ituri refugee camps)
[5] Cholera - Mozambique
[6] Cholera - Cameroon (Limbe)
[7] Cholera - Worldwide - WHO WER Notifications
*****
[1] Cholera - Senegal
Date: Mon, 11 Apr 2005
From: ProMED-mail <promed@promedmail.org>
Source: Reuters.com [edited]
<http://www.reuters.co.za/locales/c_newsArticle.jsp;:425b6a79:f0fb93323b>

Cholera outbreak kills 61 in Senegal
------------------------------------
Cholera has killed 61 people and infected 5700 in Senegal in the past
2 weeks, the worst outbreak of the water-borne disease in the West
African nation since the mid-1990s, an official said on Mon, 11 Apr
2005.
The latest outbreak coincided with an annual Muslim pilgrimage which
draws hundreds of thousands of people to Senegal's remote city of
Touba, stretching basic health facilities and making it easier for
diseases to spread.
"Since (the outbreak) started on 28 Mar 2005, we have had a total of
5700 cases and 61 deaths in the whole country," said Babacar Drame,
Senegal's public health director. "Many cases were treated in
hospital facilities and discharged within 48 hours," Drame said,
adding that only 2 deaths had been recorded in Senegal.
In 2004, 11 people died from cholera in Senegal and 1371 cases were
reported, Health Ministry figures said. Across Africa, more than 1600
people died from the disease in 2004, according to WHO figures.
Senegal's previous worst outbreak of cholera was in late 1995 and
1996.
WHO said that neighboring countries should also intensify their
disease surveillance as well as their prevention and preparedness
activities. At least 2 Gambians have died of cholera, and a dozen
cases have been reported since hundreds of people returned to
Senegal's tiny neighbor after making the Touba pilgrimage.
[Byline: Diadie Ba]
******
[2] Cholera - Senegal
Date: Tue, 12 Apr 2005
From: ProMED-mail <promed@promedmail.org>
Source: XinHuaNet.com [edited]
<http://news.xinhuanet.com/english/2005-04/12/content_2818036.htm>

Over 80 killed by cholera in Senegal
------------------------------------
Cholera has killed 81 people and infected more than 6000 in Senegal
in the last 2 weeks, health officials said here Mon, 11 Apr 2005.
The waterborne disease broke out as hundreds of thousands of Muslims
went to Touba, a remote city of Senegal, for a pilgrimage known as
the "grand Magal." The WHO said in a statement on its website last
week that the increased number of cholera cases was associated with
the pilgrimage.
******
[3] Cholera - Uganda (Gulu refugee camp)
Date: Tue, 12 Apr 2005
From: ProMED-mail<promed@promedmail.org>
Source: AlertNet.org and IRIN [edited]
<http://www.alertnet.org/thenews/newsdesk/IRIN/87e9ddef2cefecbd7feba7949d572dae.htm>

Uganda: Cholera kills 2 in northern IDP camp
----------------------------------------------
At least 2 people have died following an outbreak of cholera at a
camp for internally displaced persons (IDPs) in northern Uganda's
Gulu district, UN officials in the region told IRIN on Mon, 11 Apr
2005.
"2 people died in the community and up to yesterday, Sun, 10 Apr
2005, 25 cases have been recorded," said Vincent Oryem, a doctor
working with the WHO.
"A week ago, there were reports of severe diarrhea and vomiting in
the new [IDP] camp of Jengali," Oryem said. "We sent a team of
medical people there, who took samples from victims, and 2 days later
a cholera epidemic was confirmed," he added.
Located about 16 km north of Gulu town, itself 380 km north of
Uganda's capital, Kampala, Jengali is a pilot IDP camp of about 1600
huts. It has between 6000 and 8000 residents. Jengali was established
to ease congestion in another camp, Pabbo, about 4 km away, which
houses up to 67 000 IDPs.
According to Andrew Timpson of the UN Office for the Coordination of
Humanitarian Affairs in Gulu, the squalid conditions in Pabbo were
quickly becoming a logistical and health nightmare. Timpson told IRIN
that many people were still commuting between Pabbo and Jengali, as
food relief was yet to reach the latter.
According to Oryem, WHO suspected that the epidemic at Jengali could
have been trigged by contaminated water sources, but samples from all
water sources at the camp had been tested and found to be free of
contamination.
"We concluded that some residents carried cholera strains from Pabbo
following the last epidemic there in Oct 2004," the doctor said,
referring to a 2004 outbreak in Pabbo that killed at least 2 people
and put up to 50 others in hospital.
Government statistics put the number of IDPs in Uganda at an
estimated 1.4 million, most of whom were displaced by the war in the
north between government forces and rebels of the Lord's Resistance
Army. Cattle raids in the east of the country have also led to
displacement.
******
[4] Cholera - Congo DR (Ituri refugee camps)
Date: Tue, 12 Apr 2005
From: ProMED-mail <promed@promedmail.org>
Source: UN Mission to DR Congo [edited]
<http://www.monuc.org/news.aspx?newsID=6389>

Cholera in DR Congo camps claims 23 lives, 800 cases
----------------------------------------------------
A cholera outbreak that erupted in camps for the displaced in
northeastern Democratic Republic of Congo at the end of Mar 2005 has
now claimed 23 lives, while more than 800 people are suffering from
the illness, a UN agency said here Tue, 12 Apr 2005.
"We have more than 800 cases of cholera so far, and 23 people have
died, including 3 soldiers of the Congolese army," Modibo Traore, of
the UN office for the co-ordination of humanitarian affairs (OCHA)
told AFP. He added that there had been in recent days "a fall in the
curve of the epidemic".
The first registered cholera case was 26 Mar 2005 in the Kafe camp
for displaced people on the shores of Lake Albert, which holds about
25 000 locals forced from their villages and towns by conflict. The
camp is east of Bunia, the chief town in Ituri region. The outbreak
quickly spread to 2 other displacement camps in the region.
Since mid-Dec 2004, the camps have received scores of Congolese
fleeing a rise in militia attacks against civilians. In Mar 2005, the
camps were host to nearly 100 000 people, according to OCHA.
"Since [then], several hundred families have returned home especially
those living in villages on the banks of Lake Albert whose safety has
been shored up by the Congolese army," Traore said. He was unable to
give latest figures for the camps' populations.
Thousands of UN troops serve in Ituri close to the Ugandan border --
where armed ethnic and political militias have maintained high levels
of unrest and forced scores of thousands of people to abandon their
villages -- as well as in provinces further south where tensions
remain high.
Meanwhile, the UN mission in DRC (MONUC) hopes to complete the
disarmament of militias in Ituri by the end of June 2005, MONUC's
head in Bunia, Dominique McAdams told AFP. So far the program,
launched in Sep 2004, has seen more than 9000 militia disarmed,
including more than 3000 child soldiers. MONUC estimates that less
than 3000 militia still need disarming in the region.
******
[5] Cholera - Mozambique
Date: Tue, 13 Apr 2005
From: ProMED-mail <promed@promedmail.org>
Source AllAfrica.com and Agencia de Informacao de Mocambique (Maputo)[edited]
<http://allafrica.com/stories/200504120364.html>

Few deaths By cholera this rainy season
---------------------------------------
The Mozambican health authorities have reported just 3 deaths from
cholera, out of the 345 cases diagnosed since the outbreak of the
disease in the central Sofala province in Feb 2005, reports Tuesday's
(12 Apr 2005) issue of the daily paper "Noticias".
Health Minister Ivo Garrido said that this is the lowest number of
cholera deaths during a Mozambican rainy season for about a decade.
The outbreak affected just 2 of the country's 11 provinces, Manica
and Sofala. Of the 3 deaths, 1 was reported in Manica, and the other
2 were in Sofala, more specifically in Marromeu district.
Over the past few years, Maputo has been regularly hit by cholera
epidemics during the rainy season, but this year not a single case
was reported. Garrido attributes this positive development to the
prevention campaign waged by his ministry across the entire country,
and to the experimental vaccination campaign in Beira, usually one of
the worst-hit areas, in Dec 2003 and Jan 2004. This campaign was a
test of the effectiveness of mass application of an oral cholera
vaccine, and showed good results.[The vaccine trial was previously
discussed -Lucas MES, Deen JL, von Seidlein L, et al: Effectiveness
of Mass Oral Cholera Vaccination in Beira, Mozambique. N Engl J Med
2005; 352:757-67- in Cholera, diarrhea & dysentery update 2005 (07)
20050225.0598. - Mod.LL]
Garrido said that, taking into account the reported efficacy, the
health authorities are planning to launch massive anti-cholera
vaccination across the country. The study was carried out by the
Mozambican Health ministry, in coordination with the International
Vaccine Institute.
Sofala provincial chief doctor Flavio Wate said that no patient was
admitted with cholera in Beira, the provincial capital, during the
past week. Marromeu, however, was continuing to record an average of
2 new cases a day. Speaking of the cholera situation across the
country, Garrido said that with the onset of the cool and dry season,
a new outbreak is unlikely, but he stressed that all health units
will remain on the alert.
******
[6] Cholera - Cameroon (Limbe)
Date: Thu, 14 Apr 2005
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Post Buea [edited]
<http://allafrica.com/stories/200504140553.html>

2 die in Limbe cholera outbreak
--------------------------------
2 people from the Mile 4, Bonadikombo neighborhood in Limbe, are
reported to have died from a new cholera outbreak that has hit the
town again, barely a year after an outbreak in December 2003.
Speaking to The Post on Tue, 11 April 2005, at the Limbe Provincial
Hospital, the Director of the Hospital, Dr. Victor Mbome Njie, said
so far, 20 cases have been received at the hospital since Fri, 8 Apr
2005, when the 1st case was brought in. 3 of the 20 cases, he said,
came in on that same day.
Dr. Mbome said of the 20, 2 had on Tue, 12 April 2005, already died.
The 1st case, he said, who came in on that Fri, 8 Apr 2005, died
later. He said the death resulted from the fact that they were
brought in a little too late from when they fell ill. "From what we
gathered, the first patients -- who died later in hospital -- were
kept at home for more than a day before being brought to hospital,"
Dr. Mbome said.
While 2 are already dead, he said the hospital on Tue, 12 Apr 2005,
discharged 3 successfully treated cases. The others, he said, are
still undergoing medical attention in a quarantined ward in the
hospital.
Dr. Mbome said, "It would appear the Mile 4 water is the problem."
3/4 of the cases he said have come in from this neighborhood at the
entrance to Limbe, while 4 came in from New Town and one from the
Mabeta New Layout settlement. He added that they had sent the water
and stool samples from some of the victims to Institut Centre Pasteur
in Yaounde for a thorough clinical examination.
[Byline: Francis Tim Mbom]
******
[7] Cholera - Worldwide - WHO WER Notifications
Date: Fri, 15 Apr 2005
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: WHO Epidemiological Record, 15 Apr 2005 [edited]
<http://www.who.int/wer/2005/wer8015/en>

Notifications of cholera received from 8 to 14 Apr 2005
---------------------------------------------------
country / dates / cases / deaths
Africa
Congo DR 14-27 Mar 2005/358/3
Equatorial Guinea 28 Mar - 3 Apr 2005/290/0
Nigeria 1 Jan - 13 Mar 2005/2 718/19/
Senegal 28 Mar - 3 Apr 2005/3 475/54
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