ProMED-mail |

Published Date: 2008-01-08 20:00:12
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2008 (02)
Archive Number: 20080108.0104

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (02)
****************************************************
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 this update:
Asia
[1] [2] Cholera - Laos: (Xekong)
Africa
[3] Cholera - Kenya: (Rift Valley province)
[4] Cholera - Uganda: (Arua, Nebbi)
[5] Cholera - Angola: (Cunene)
[6] Cholera - Angola 2007
[7] Cholera - Zimbabwe: (Harare)
*****
[1] Cholera - Laos: (Xekong)
Date: Tue 8 Jan 2008
Source: XinHuaNet [edited]
<http://news.xinhuanet.com/english/2008-01/08/content_7386371.htm>

A major diarrhea outbreak caused by cholera in Laos' southern Xekong
province has, since 25 Dec 2007, affected 254 local people, of whom 3
died, Lao newspaper Vientiane Times reported Tuesday [8 Jan 2008].
Recent tests have shown that the diarrhea outbreak is caused by the
strain called _Vibrio cholerae_ O1 Ogawa, the newspaper quoted
director of the Xekong Public Health Department, Bounpone
Phoxayavong, as reporting.
"We are concerned about the outbreak because this can have deadly
effects on humans in a short space of time. We've heard that in the
past large numbers of people have died within a few days after
contracting cholera because they were not able to obtain treatment in
time," said Bounpone.
Bounpone said the department receives new reports of cases almost
every day. Doctors failed to keep the outbreak under control because
the local authorities were unable to prevent people from traveling in
and out of the affected areas, he noted.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[As a short review, the flagellar (H) antigens of _V. cholerae_ are
shared with many water vibrios and therefore are of no use in
distinguishing strains causing epidemic cholera. The O (somatic)
antigens, however, do distinguish strains of _V. cholerae_ into 139
known serotypes. Almost all of these strains of _V. cholerae_ are
nonvirulent. Until the emergence of the Bengal (O139) strain (which
is "non-O1"), a single serotype, designated O1, has been responsible
for epidemic cholera.
There are 3 distinct O1 biotypes, named Ogawa, Inaba, and Hikojima,
each of which may display the "classical" or El Tor phenotype. The
biotypes are distinguished by their expression of surface antigens A,
B, and C. Ogawa contains antigens A and B, Inaba A, and C) and
Hikojima antigens A, B, and C). The latter serotype is relatively
rare. - Mod.LL]
*****
[2] Cholera - Laos: (Xekong)
Date: Mon 7 Jan 2008
Source: Malaysia Star [edited]
<http://thestar.com.my/news/story.asp?file=/2008/1/7/apworld/20080107165148&sec=apworld>

A cholera outbreak has swept through more than a dozen villages in
southern Laos, killing 2 and sickening nearly 200 with severe
diarrhea, a World Health Organization official said Monday [7 Jan 2008].
The disease was confirmed in the remote province of Xekong, near the
border with Vietnam, after people from 13 villages began falling ill
in December 2007, said Tessa Rintala, the WHO spokeswoman in the
capital, Vientiane. The 2 deaths were attributed to extreme dehydration.
It was the country's 1st cholera outbreak since 2000, Rintala said.
She said tests found that at least one of the rivers in the villages
was contaminated with the cholera bacterium and could be a source of
the outbreak.
--
Contributed by:
ProMED-mail
<promed@promedmail.org>
[Xekong (<http://en.wikipedia.org/wiki/Xekong_Province>) is among the
most remote areas of Laos; even some of its largest villages are
virtually inaccessible by road for at least half of the year. The
eastern districts of Dakchung and Kaleum, in particular, are
characterized by mostly mountainous terrain which is rugged and
difficult to access.
A map of Laos showing the southeastern province of Xekong (spelled
Zekong on the map and also sometimes spelled Sekong) can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/laos.pdf>. - Mod.LL]
*****
[3] Cholera - Kenya: (Rift Valley province)
Date: Mon 7 Jan 2008
Source: Daily Nation [edited]
<http://www.nationmedia.com/dailynation/nmgcontententry.asp?category_id=1&newsid=114167>

Cholera has broken out at a center hosting victims of post-election
violence in Nandi. A total of 3 doctors were tackling the disease at
Kapsabet police station, Nandi North district commissioner Mabeya
Mogaka said. Mr. Mogaka added that the outbreak was occasioned by
congestion, leading to poor sanitation at the station.
He said the Government had evacuated more than 1000 people who had
been displaced. They were among the 2100 who had been camping at the
police station. They were evacuated under tight military security to
safer places in Nakuru and Kisii.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Nandi is located in the Rift Valley province of Kenya which can be
seen on a map at:
<http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf>. - Mod.LL]
*****
[4] Cholera - Uganda: (Arua, Nebbi)
Date: Mon 7 Jan 2008
Source: AllAfrica.com and The Monitor (Kampala) [edited]
<http://allafrica.com/stories/200801071669.html>

Fresh cholera cases have been registered in the West Nile districts
of Arua and Nebbi, despite efforts to contain the disease in late
2007. Arua District Health Officer Patrick Anguzu confirmed that
cases of cholera had been reported in the districts. He said it was
impossible to confirm the total number of deaths as the health team
had not delivered reports from the affected areas.
"It is true that the disease is again there and we have cases
reported already in some health centers," Mr Anguzu said. But some
sources say 3 people have so far died in Madi Okollo and Offaka
sub-counties. According to health reports from Offaka HC III, 2 of the
cholera victims died at home while the 3rd died at the center. 2
people have also reportedly died of cholera in Nebbi town.
[Byline: Warom Felix Okello]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Arua and Nebbi are located adjacent to each other in northwestern
Uganda as can be seen on a map at:
<http://www.un.org/Depts/Cartographic/map/profile/uganda.pdf>. - Mod.LL]
*****
[5] Cholera - Angola: (Cunene)
Date: Mon 7 Jan 2008
Source: AllAfrica.com and Angola Press Agency (ANGOP Luanda) [edited]
<http://allafrica.com/stories/200801070572.html>

A total of 38 new cases of cholera have been reported from the
central hospital of Ondjiva, southern Cunene Province, from 1 to 5
Jan 2008, ANGOP has learnt. According to the official in charge of
the cholera assistance sector, Anatercia Ndahambelela, with the
notification of these cases in Ondjiva hospital, the current total
rises to 68.
Ndahambelela also revealed that these new cases are due to
poor hygienic conditions and the nonobservation of the preventive
measures published by the health authorities.
--
Contributed by:
ProMED-mail
<promed@promedmail.org>
[Angola's province of Cunene borders to its south with Namibia. The
provincial capital and the province itself can be seen on a map at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>. - Mod.LL]
*****
[6] Cholera - Angola 2007
Date: Mon 7 Jan 2008
Source: Angola Press ANGOP [edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=586613>

Some 515 people, out of 18 390 cases recorded countrywide in 2007,
died of cholera, ANGOP learned.
The Angola's deputy Health minister, Jose Van-Dunem, quoted the
provinces of Luanda and Benguela as reporting the highest numbers,
with 6806 (37 percent) and 4173 (23 percent), respectively. On the
other hand, the coastal Kwanza Sul province recorded the highest
number of deaths, with 173, corresponding to 12 percent, followed by
Malanje and Zaire [provinces], with 8 percent each.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The provinces of Angola mentioned can be seen on a map at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>. - Mod.LL]
*****
[7] Cholera - Zimbabwe: (Harare)
Date: Fri 4 Jan 2008
Source: The Zimbabwean [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/EMAE-7AJR5D?OpenDocument>

With a cholera death toll in Zimbabwe's capital [Harare] rising to 9,
the UN Children's Fund (UNICEF) has provided US 210 000 dollars to the
Ministry of Health for urgent measures to control the spread of the
epidemic, sparked by drinking tap water left untreated by the Zimbabwe
National Water Authority (Zinwa). Since December 2007, 500 people have
been affected in the populous suburbs of Mabvuku and Tafara by the
waterborne disease, which is spread by poor sanitation.
The death toll for the epidemic, which is centered in the 2 ghettos,
home to more than 50 000 people, rose from 3 to 9 in a week after 6
people died last weekend [5-6 Jan 2008].
A statement from UNICEF said the funds would be used to bring in
epidemiologists within the Ministry of Health and Child Welfare to
strengthen cholera control activities, including awareness programs.
UNICEF would also provide 5 water bowsers [a bowser is a tanker truck
- Mod.LL] and environmental disinfectants to improve access to safe
water.
"These efforts will go a long way towards controlling the epidemic
and ensuring that the epidemic does not spread to neighboring areas,"
said the UNICEF representative in Zimbabwe.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Mabvuku (<http://en.wikipedia.org/wiki/Mabvuku>) is a high density
suburb some 17 km [10.5 miles] east of Harare, the capital city of
Zimbabwe. It is classified as a suburb or township of Harare, with
the Harare City Council constituting local government. It encompasses
in particular the townships that include Old Mabvuku and New Mabvuku,
and more generally Old Tafara, and New Tafara (the latter 2
constituting Tafara, properly speaking).
A map of Zimbabwe showing the location of Harare can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>.
The outbreaks discussed in this update can also be located on the
HealthMap/ProMED-mail interactive map at:
<http://www.healthmap.org/promed>. - Mod.LL]

See Also