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Published Date: 2007-01-26 00:00:00
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2007 (04)
Archive Number: 20070126.0350

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (04)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail, a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
Africa
[1] Cholera - Tanzania (Zanzibar)
[2] Cholera - Ethiopia
[3] Cholera, diarrhea - Namibia (Kunene)
[4] Cholera - Uganda (Ntungamo, Kampala)
[5] Cholera - Nigeria (Delta State)
[6], [7] Cholera - Kenya (Northeastern Province)
[8] Cholera - Angola (Cabinda)
[9] Cholera - Angola (Luanda)
Asia
[10] Diarrhea - Philippines (Bohol)
[11] Cholera - worldwide - WHO WER notifications
******
[1] Cholera - Tanzania (Zanzibar)
Date: Wed 24 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: IRIN [edited]
<http://www.alertnet.org/thenews/newsdesk/IRIN/5e305479d54b798e3ac2a0fcf31e2175.htm>

Cholera outbreaks in Tanzania's semi-autonomous island of Zanzibar
have continued due to poor hygiene standards, health officials said
on Wed 24 Jan 2007, while announcing renewed efforts to raise public awareness.
"We need to double our efforts of awareness; we also need to
strengthen by-laws to make sure that the islands are kept clean," Dr
Omar Suleiman, an officer in the Ministry of Health, said in Stone
Town, capital of Zanzibar.
Following recent outbreaks in Jambiani village, 35 km south of Stone
Town, where at least 10 people have been hospitalized and one died,
health officials said cholera remained a problem, attributing the
continued outbreaks to unhygienic living conditions and improper or
lack of use of toilets.
"People prefer relieving themselves in the bush and on the beaches;
this has been a major source of cholera in rural areas," Suleiman
said. "In urban areas, the environment is dirty, and both untreated
solid and liquid waste is not controlled."
The African Development Bank is funding a sensitization project,
which involves the construction of at least 100 public toilets and
teaching residents how to use them. "In continued efforts to combat
cholera, we have started educating people on the importance of
toilets and how to use them, and we plan to educate people in about
575 villages," Khalfan Bakar, a coordinator of the project, said. "We
aim to change the people's habits of not using toilets, promote safe
drinking water and keep the environment clean."
The sensitization project has also started in Pemba, the other
island, which together with Unguja, form Zanzibar.
In 2006, cholera killed at least 50 people in Unguja and Pemba
islands. Zanzibar, with a population of a million, has been
repeatedly hit by cholera epidemics since 1998.
--
ProMED-mail
<promed@promedmail.org>
[A map of Tanzania showing Pemba and Unguja islands off the coast
close to the capital of Dar es Salaam can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/tanzania.pdf>.
- Mod.LL]
******
[2] Cholera - Ethiopia
Date: Tue 23 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: BBC News [edited]
<http://news.bbc.co.uk/2/hi/africa/6290373.stm>

Some 570 people have died in Ethiopia during what aid agencies say is
a cholera outbreak. But Ethiopia's health ministry is resisting
pressure to declare it an emergency, despite evidence that the
epidemic is sweeping the country. Officials are instead describing it
as acute watery diarrhea.
A spokesperson for one aid agency said the government would not
declare it was cholera because of the damage it could cause to the
Ethiopian economy. It could mean that cross-border trade would have
to stop and markets close.
International agencies working in the country say 52 500 people have
been infected with cholera, 1st reported in the southwest last April
2006. "It needs to be declared an emergency because unless it is, the
appropriate measures will not be taken. We need extra resources,"
said an aid worker, who did not want to be named.
The disease has seriously affected Amhara, Tigray, Afar, Oromiya and
the Somali Region.
--
ProMED-mail
<promed@promedmail.org>
[A map of Ethiopia can be found at:
<http://www.pnm.my/mtcp/images/maps/Ethiopia-map.jpg>.
- Mod.LL]
*****
[3] Cholera, diarrhea - Namibia (Kunene)
Date: Tue 23 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Namibian (Windhoek) [edited]
<http://allafrica.com/stories/200701230237.html>

Three people have died from cholera in the Kunene Region, where more
than 200 cases of diarrhea and gastroenteritis have been reported
since early December 2006, The Namibian established yesterday, 22 Jan
2007. Another 3 people have died from dehydration resulting from
diarrhea and gastroenteritis, which are caused by dirty water and
poor sanitation.
The Chief Medical Officer of Kunene Region, Dr Ebong Akpabi, said
that the diarrhea outbreak in the region had became a problem and
needed to be addressed "as an emergency," according to the Nampa news
agency. Akpabio was speaking at a Regional Emergency Unit (Remu)
meeting held at Opuwo, Nampa reported.
Yesterday [22 Jan 2007], Dr Norbert Forster, Under Secretary in the
Health Ministry said, "It came from Angola last October [2006], where
cholera is a problem in the Cunene Province of our neighboring
country," Dr Forster told The Namibian. "We only have about one case
(of diarrhea) reported daily now, quite a bit down from 3 or 4 each
day in November and December [2006]," Foster added.
The diarrhea and gastroenteritis outbreak started on 7 Dec 2006, with
a case reported at the border post clinic at Otjimuhaka, which serves
people from Angola and Namibia. It is believed that the disease was
brought into the country by an Angolan citizen who was treated at
Otjimuhaka. The outbreak rapidly spread to other parts of Kunene, and
by 18 Jan 2007, some 229 cases had been reported to the State
hospital at Opuwo.
[Byline: Brigitte Weidlich]
--
ProMED-mail
<promed@promedmail.org>
[A map of Namibia showing Opuwo near its northern border with Angola
can be found at:
<http://media.maps.com/magellan/Images/NAMIBI-W1.gif>.
- Mod.LL]
******
[4] Cholera - Uganda (Ntungamo, Kampala)
Date: Tue 23 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Monitor (Kampala) [edited]
<http://allafrica.com/stories/200701221595.html>

An outbreak of cholera in Ntungamo district has left 7 people dead.
27 others have been admitted at Rubaare Health Center and other
private clinics.
District Director of Health Services William Karikwija on Sun 21 Jan
2007 said the epidemic is severe in Rwikiniro, Kayonza and Rubaare
sub-counties. "By Thu 18 Jan 2007, 7 people had died," he said.
Mr Karikwija said they suspect the disease could have been contracted
from someone who had died of the disease in Kampala but was
transported for burial in Ntungamo on 8 Jan 2007. "We suspect the
disease to have originated from a not properly managed funeral of a
cholera case from Kampala," he said. "After a few days, 3 family
members and other people who attended the funeral developed diarrhea."
In Kampala district, a cholera outbreak left more than 10 people dead
and 150 hospitalized. The disease intensified between November and
December 2006 following heavy rains that flooded certain parts of the
city suburbs.
--
ProMED-mail
<promed@promedmail.org>
[Ntungamo can be found in southwestern Uganda bordering Rwanda,
whereas the capital Kampala area is in the south central part of the
country bordering Lake Victoria. This can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/uganda.pdf>.
- Mod.LL]
******
[5] Cholera - Nigeria (Delta State)
Date: Tue 23 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: Daily Sun [edited]
<http://www.sunnewsonline.com/webpages/news/national/2007/jan/23/national-23-01-2007-06.htm>

At least 5 persons have been confirmed dead in Bomadi local
government area of the Delta State following an outbreak of cholera
in the area last week. The Sun gathered yesterday, 22 Jan 2007, that
several others were on a danger list at the various health centers in
the council area as a result of the disease.
Unless the state government deploys more medical personnel, more
deaths are likely to be recorded this week, health authorities
warned. Investigations revealed that health officials in the council
area could not cope with the large numbers of patients arising from
the cholera outbreak.
Dr Emmanuel Enegbere confirmed the outbreak of the disease,
explaining that all the patients brought to the center had cholera.
He said 5 persons were brought to the health center already dead,
while several others were lying critically ill in various health
centers in the council area.
--
ProMED-mail
<promed@promedmail.org>
[Nigeria's Delta State can be found in the southern part of the
country east of the capital Lagos area at:
<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf>.
- Mod.LL]
******
[6] Cholera - Kenya (Northeastern Province)
Date: Thu 25 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: Shabelle Media Network Somalia [edited]
<http://www.shabelle.net/news/ne2158.htm>

At least 10 people including children and elderly people have
reportedly died from watery diarrhea related diseases in the Somali
inhabited settlements that lie in the Kenyan northeastern provincial
town of Mandhera near the Somali town of Baled Hawo.
Ahmed Omar Salahi, Shabelle reporter in Gedo province, said many
children were sick, as the disease, which doctors in the area have
not declared cholera, could spread into Somalia, where floods and
repeated wars have already had bad impacts on the livelihood of the
pastoral community in southern Somalia.
He said 6 children under the age of 5 were among the dead. Doctors in
Mandhere were endeavoring to treat the sick, urging people to clean
their environment and keep the sanitation of their houses.
Health warnings were also given by medical people in southern Somalia.
[Byline: Aweys Osman Yusuf]
--
ProMED-mail
<promed@promedmail.org>
[Mandhera (or Mandera) is located at the northeastern tip of Kenya's
Northeastern Province, as seen on the map linked to in the following
posting. The bordering Gedo Province in Somalia can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/somalia.pdf>.
- Mod.LL]
******
[7] Cholera - Kenya (Northeastern Province)
Date: Sun 21 Jan 2007
From: SK Sharif <sksharif@africaonline.co.ke>

The District Medical Officer of Health of Mandera District of
Northeastern Province has confirmed an outbreak of cholera in the
district. A family of 5 was admitted to the hospital with history of
bloody diarrhea on 14 Jan 2007. Samples taken to Nairobi confirmed
cholera. There have been 2 deaths, while the other 3 were treated and
discharged. No new cases of cholera have been reported since 14 Jan 2007.
--
Dr. SK Sharif
Chief Medical Specialist
Ministry of Health, Kenya
<sksharif@africaonline.co.ke>
[ProMED thanks Dr. Sharif for his continued contributions. A map of
Kenya showing the Northeastern Province can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf>.
As noted in the post preceding this one, the municipality of Mandera
(also spelled Mandhera) is on the border with Somalia. - Mod.LL]
******
[8] Cholera - Angola (Cabinda)
Date: Fri 19 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=503067>

14 cases of cholera were registered in the past 24 hours in the
Provincial Hospital of Cabinda, ANGOP learned this Fri 19 Jan 2007
from the head of the department of public health and control of
endemic diseases, Razao Simao. 40 patients are currently hospitalized
in one of the 2 units specialized for the treatment of cholera.
Since the 1st case in May 2006, about 1580 cases were registered,
from which 40 resulted in death, mainly adults, due to the fact that
most refused to drink treated water, claiming that it tasted bad.
--
ProMED-mail
<promed@promedmail.org>
[The Province of Cabinda can be found on a map of Angola at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>.
As can be seen, the Province is not adjacent to the other parts of
Angola but rather north of them, bordered by Congo and Congo DR.
- Mod.LL]
******
[9] Cholera - Angola (Luanda)
Date: Tue 23 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and Angola Press Agency (Luanda) [edited]

Over 200 cases of cholera, including 5 deaths, were reported from 1
to 22 Jan 2007 in Luanda, the provincial director for public health,
Isilda Neves, said on Tue 23 Jan 2007. The health director added that
the number might increase due to the last rains that fell in the
Angolan capital.
Health Deputy Minister Jose Van-Dunem said that in order to face the
situation, authorities will increase the supply of drinkable water to
residents in rain-hit areas.
--
ProMED-mail
<promed@promedmail.org>
[Luanda is the capital of Angola, on the coast, see map at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>. - Mod.JW]

*****
[10] Diarrhea - Philippines (Bohol)
Date: Tue 23 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: Sun Star [edited]
<http://www.sunstar.com.ph/static/net/2007/01/24/polluted.water.kills.2.downs.132.in.bohol.html>

A diarrhea outbreak in Loon, Bohol claimed the life of a 3-year-old
girl and caused some 150 residents to be admitted to the provincial
and district hospitals. Health officials are looking at the town's
water source as a possible reason, as the water may be contaminated.
Loon Mayor Cesar Lopez told Sun Star Cebu in a phone interview that
the heavy rains from the latter part of December 2006 to the 1st part
of January 2007 could have caused the contamination.
As of 10:30 a.m. Tue 23 Jan 2007, Department of Health Assistant
Regional Director Lakshmi Legaspi said 112 victims were admitted at
the Loon District Hospital, while there were 4 admissions at the
Gallares Memorial Hospital, a provincial hospital. There were other
victims who were already discharged.
A team from the Regional Epidemiology Surveillance Unit (Resu) in
Central Visayas of the DOH headed by Renan Cimafranca was sent to
take water samples. A team from the DOH-National Epidemiology Center
(Nec) was also at the area. Lopez expects the results Wed 24 Jan 2007.
At least 20 barangays are being served by the water system, but the
victims were from 8 barangays only. DOH Central Visayas, through
Legaspi, is concentrating on 4 barangays -- Basak, Coco-Norte,
Poblacion and Sandingaw Island -- where more victims were noted.
As far as Lopez is concerned, there was no other outbreak this big in
Loon except in 1975, when a cholera outbreak affected the island of Cabilan.
--
ProMED-mail
<promed@promedmail.org>
[Bohol is an island province of the Philippines located in the
Central Visayas region. To the west of Bohol is Cebu, to the
northeast is the island of Leyte and to the south, across the Bohol
Sea is Mindanao. It can be found on a map at:
<http://en.wikipedia.org/wiki/Bohol>.
- Mod.LL]
******
[11] Cholera - worldwide - WHO WER notifications
Date: Fri 26 Jan 2007
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: WHO Epidemiological Record [edited]
<http://www.who.int/wer/2007/wer8204/en/index.html>

Notifications of cholera received from 19 to 25 Jan 2007
-----------------------------------------------
Country / Dates / Cases / Deaths
Africa
Angola / 1-14 Jan 2007 / 2191 / 52
Zambia / 1-19 Jan 2006 / 113 / 2
--
ProMED-mail
<promed@promedmail.org>

See Also