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Published Date: 2007-04-13 14:00:02
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2007 (16)
Archive Number: 20070413.1232

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2007 (16)
**********************************************
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International Society for Infectious Diseases
<http://www.isid.org>
In this update:
Africa
[1] Cholera - Comoros
[2] Cholera - Somalia (Middle Juba, Hiran)
[3] Cholera - Somalia (Mogadishu)
[4] Cholera - Somalia (Middle Juba)
[5] Cholera - Kenya (Rift Valley)
[6] Cholera - Angola (Luanda)
[7] Cholera - Angola (Bie)
Europe
[8] Diarrhea, airliner - Greece ex Egypt
Americas
[9] Shigellosis - USA (TX)
[10] Cholera - worldwide: WHO WER notifications
*****
[1] Cholera - Comoros
Date: Fri 13 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: United Nations Children's Fund (UNICEF) / Relief Web [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/LSGZ-728C9S?OpenDocument>

On 26 Feb 2007 the vice-president in charge of
the Ministry of Health and Social Affairs of
Comoros, the National Emergency Unit and the
World Health Organization (WHO) officially
declared a cholera outbreak after confirmation of
several cases by the laboratory of the city
hospital El Maarouf. A total of 39 cases has been
confirmed, a significantly smaller number than
during earlier outbreaks. Approximately 50
percent of the cases that have been reported are
children below the age of 15, and 47 percent are women.
The epidemic broke out in a very densely
populated and vulnerable area of the capital of
Moroni where people live in decayed and
overcrowded houses. Household rubbish is piled up
around the houses, due to the country's poor
waste management system. Distribution of water
also has become more and more problematic, and
the capital's inhabitants do not succeed in
getting their daily ration of drinking water. The
water canal system is broken down and more than
40 percent of the water is lost along the way.
Often the only option left for the population is
to use rainwater collected in unprotected
cisterns, which contributes to the risk of
contamination and spread of the disease.
Cyclone Gamede also contributed to the
overcrowding in houses. People have been
sheltered by neighbors and friends, and the
overcrowding contributes to the risk of diseases outbreaks including cholera.
Past experience in the country concerning the
management of cholera epidemics has shown that
controlling the spread of the disease is
particularly difficult in coastal villages.
People there often do their laundry near the sea,
in pools that are created during high tide. These
tide pools are also sometimes use as toilets. The
poor hygiene practices hinder efforts towards
disease control, and contribute to a rapid spread
of cholera and other infectious diseases.
--
ProMED-mail
<promed@promedmail.org>
[As can be seen on this map
<http://www.lib.utexas.edu/maps/africa/comoros.gif>
the nation of Comoros is a group of islands
located between the continent of Africa and Madagascar. - Mod.LL]
*****
[2] Cholera - Somalia (Middle Juba, Hiran)
Date: Mon 9 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Shabelle Media Network [edited]
<http://www.shabelle.net/news/ne2710.htm>

More than 19 people, mostly children, have died
of diarrhea in settlements situated in provinces
of Middle Juba and Hiran in central and southern
Somalia, government officials said on Mon 9 Apr 2007.
The disease killed 16 people including children
and adults in Anole, Bur-Fulle, Rahole and Barta
villages of Middle Juba (Juba Dhexe) in one day
[9 Apr 2007]. The governor of the Middle Juba
region Hajir Bile Sugal with officials of the
World Vision relief organization made survey on
the health condition in these villages. There is
no medical service in the settlements of central
Somalia at this time of acute diarrhea.
Meanwhile, 3 children among the displaced people
from Mogadishu, the Somalia capital, have been
killed by the cholera-like diarrhea in Beledwein
town, provincial capital of Hiran, according to
Shabelle correspondent Omar Kiyow.
--
ProMED-mail
<promed@promedmail.org>
[Cases of cholera in Somalia are often referred
to as "acute watery diarrhea". A map of the
country showing the provinces as well as
Mogadishsu can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/somalia.pdf>. - Mod.LL]
*****
[3] Cholera - Somalia (Mogadishu)
Date: Wed 11 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Medecins Sans Frontieres (MSF) / Relief Web [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/JBRN-727CJD?OpenDocument>

Since cholera was confirmed in Mogadishu on 19
Mar 2007, MSF has treated more than 800 patients.
However, the worsening violence is making it
increasingly difficult for patients to access
MSF's cholera treatment center (CTC), which
opened 2 weeks ago. The violence is also
preventing MSF from reaching other areas of the city.
"So far we have received more than 800 patients,
40 percent are children," says Henry Rodr�ez,
medical coordinator from MSF Spain in Somalia.
"This is more than the total number of cholera
patients MSF has treated in the last years in
Mogadishu, where MSF has worked for 15 years and
responded to 12 different cholera epidemics.
"The cause of this growth is mostly because other
health structures which normally work in other
areas of Mogadishu are not able to do so due to
the violence. It's also impossible to do the
things necessary to try and control the outbreak,
like supply clean water or establish points for oral rehydratation."
The MSF clinic in Mogadishu, which provides care
for more than 100 000 people each year, has
verified that because of the fighting the
population cannot access the scarce health
services (hospitals, health centers) that
continue to function in the Somali capital.
The fighting has caused massive displacement as
people flee towards the outskirts of the capital
and other cities, like Jowhar. There are reports
of tens of thousands of displaced people, who are
being received by extended family or friends.
Many who do are living under trees without
shelter, food or water. The security conditions
impede the operative capacity of MSF and the
result is that these people do not have access to the necessary assistance.
--
ProMED-mail
<promed@promedmail.org>
*****
[4] Cholera - Somalia (Middle Juba)
Date: Wed 11 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Shabelle Media Network [edited]
<http://www.shabelle.net/news/ne2723.htm>

A total of 4 children in a single family has died
of a cholera-like diarrhea in Bu'ale town, the
provincial capital of Middle Juba region in the
south of Somalia, a local official said on Wed 11 Apr 2007.
Local medical sources confirmed to Shabelle Radio
that the 4 children killed by the diarrhea were 2
twin brothers and 2 sisters while their mother was sick of the disease.
There is medical service in Bu'ale as the cases
of diarrhea are increasing. The governor of
Middle Juba region, Hajir Bile Sugaal, told
Shabelle Radio by the phone that he was very
worried about the worsening condition in the region.
"There is shortage of medicine, there are no
relief organizations operating here and the
number of people with the disease is increasing" said Bile.
He urged to the international relief agencies'
health organizations to provide medical supplies
to diarrhea-affected areas to save the victims.
--
ProMED-mail
<promed@promedmail.org>
*****
[5] Cholera - Kenya (Rift Valley)
Date: Wed 11 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Nation (Nairobi) [edited]
<http://allafrica.com/stories/200704110162.html>

A nationwide alert has been sounded following the
death of 10 people from cholera in the expansive
West Pokot district. Local health facilities are
grappling with a high number of patients,
following revelations that 76 people have been
infected with the killer disease in Sigor division.
A total of 10 people is already in Ortum Mission
Hospital, Sigor and Marich Health Centers -
straining medical facilities. There are 4 others
are Ortum, one in Sigor and 4 in Marich. Shocked
by the quick spread of the disease, health
authorities have ordered the closure of all
eating establishments in the area and asked
residents to be very careful about the foods and
drinks they consume. The Health ministry has also
announced plans to conduct an aggressive campaign
to educate people on ways of preventing cholera.
However, acting Rift Valley provincial medical
officer Simon Kibias said cholera had been
confirmed in only one of the admitted patients.
He said specimens had been sent to the ministry
of Health's central laboratory and the Kenya
Medical Research Institute, Nairobi, for further analysis.
Dr. Kibias, who was accompanied by the province's
public health officer, Isaac Ruto, and the West
Pokot district medical health officer, Dr. Evans
Kiprotich, said diarrhea had been detected in
most of the 76 cases. Residents fear that the
deaths will increase since health facilities are
scarce. People travel for more than 100
kilometers (about 60 miles) to get treatment.
The 1st case of the disease was reported on 26
Mar 2007 in the semi-arid area. Getting clean
water in the district is very difficult. Many
villagers depend on the perennial Muruny River.
The area is dry and hot. The residents are mainly
pastoralists. They water their livestock in
Muruny River, besides using it for their own sustenance.
Frequently, people swim and bathe in the river.
Although there are 3 boreholes, 2 of them have
broken down. The one which is functioning is in
Masol village, about 17 kilometers from Marich
where the first case of the disease was reported.
Many residents do not draw water from the
borehole, saying it is located far away. They
entirely depend on the river. The other
non-functional boreholes are in Sigor and Marich trading centers.
[Byline: Peter Ng'etich and Edward Koech]
--
ProMED-mail
<promed@promedmail.org>
[The West Pokot district is in the Rift Valley
province of Kenya, in the west part of the
country bordering Uganda. A map of Kenya can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf>. - Mod.LL]
*****
[6] Cholera - Angola (Luanda)
Date: Thu 12 Apr 2007
From: ProMED-mail <promed@p[romedmail.org>
Source: AllAfrica.com and Angola Press Agency (Luanda) [edited]
<http://allafrica.com/stories/200704120147.html>

A total of 12 new cases of cholera was reported
from 9-10 Apr 2007, in Luanda's high density
district of Sambizanga, the local Health
delegate, Monteiro Ant�, told Angola Press
Agency. According to the official, the new cases
followed the heavy rains that hit the capital recently.
The rains and poor sanitation in the area are
factors that affect the health authorities'
effort to control the disease, the source also
stated. A total of 686 cases of cholera has been
recorded in Sambizanga since Jan 2007, killing 17 people.
--
ProMED-mail
<promed@promedmail.org>
[A map of Angola showing the provinces of Luanda
in the northwest part of the country and Bie (see
below) in Angola's central part can be seen at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>. - Mod.LL]
*****
[7] Cholera - Angola (Bie)
Date: Thu 12 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Angola Press [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=523938>

Of the 224 people who have been diagnosed with
cholera, 10 died of this disease from Jan 2007 to
today [12 Apr 2007] in the south Bie province.
The director of the Cholera Treatment Center,
Andre Tomas Cassinda, reported this information
to the Angola Press in Kuito city today.
According to the source, most patients affected
by the cholera bacterium reside in the wards of
Cambulucuto, Cantinflas, Catemo, C�ra and
Cangoty, on the outskirts of Kuito city. Some
isolated cases have also been registered in the
districts of Katabola, Kamacupa and Chitembo.
--
ProMED-mail
<promed@promedmail.org>
*****
[8] Diarrhea, airliner - Greece ex Egypt
Date: Tue 10 Apr 2007
From: ProMED-mail <promed@promedmail.org>
Source: Pravda [edited]
<http://english.pravda.ru/news/world/10-04-2007/89446-diarrhea-0>

An Easter holiday trip became a disaster for 60
Greek tourists flying home from Egypt. They were
affected by a mass diarrhea outbreak on a charter
plane, the officials said Tue 10 Apr 2007.
After the Egypt Air flight landed at Thessaloniki
airport, 3 women were briefly hospitalized with
high fever early Tue 10 Apr 2007, officials said.
They were discharged soon afterward.
The plane was carrying 120 Greek holidaymakers
returning from Cairo to Thessaloniki. Doctors
said the outbreak was due to food poisoning, from
a meal consumed before the sufferers boarded the plane.
--
ProMED-mail
<promed@promedmail.org>
*****
[9] Shigellosis, schools - USA (Texas)
Date: Wed 11 Apr 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: KXAN.com [edited]
<http://www.kxan.com/global/story.asp?s=6357930>

The Williamson County Health District reported 34
cases of shigellosis in the area. Last week, 22
absences at Forest Creek Elementary in Round Rock
were attributed to the diarrhea-causing bacterium.
Round Rock Independent School District sent
letters to parents last week, letting them know
about the cases and how to prevent the spread. On
Tue 10 Apr 2007 another letter went to parents of
students at Ridgeview Middle School, where there were 2 confirmed cases.
Three other schools will receive a similar letter
as a precaution. Forest Creek Elementary
custodial staff continued to wipe down surfaces,
especially in the bathroom area, several times a
day. Teachers reminded students to wash their hands often and thoroughly.
--
ProMED-mail
<promed@promedmail.org>
[Schools, especially with younger children, are
not uncommon settings for the spread of
shigellosis. Since, unlike most enteric
pathogens, the spread of shigellosis requires
only a very small number of organisms, it is
easily spread from child-to-child. A map showing
the location of Williamson County in central
Texas can be found at:
<http://en.wikipedia.org/wiki/Williamson_County,_Texas> - Mod.LL
*****
[10] Cholera - worldwide: WHO WER notifications
Date: Fri 13 Apr 2007
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: World Health Organization (WHO) Weekly
Epidemiological Record (WER) [edited]
<http://www.who.int/wer/2007/wer8215/en/index.html>

Notifications of cholera received from 6 to 12 Apr 2007
-------------------------------------------------------
Country / Dates / Cases / Deaths
No new notifications during this period
--
ProMED-mail
<promed@promedmail.org>

See Also