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Published Date: 2008-02-18 20:00:19
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2008 (11)
Archive Number: 20080218.0647

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (11)
**********************************************
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] Diarrhea, cholera - Iraq
[2] Cholera - Yemen: (Hajjah)
[3] Diarrhea, fatal - Philippines
Africa
[4], [5] Cholera - Kenya: (Northeastern)
[6] Diarrhea, fatal - Nigeria: (Anambra)
[7] Cholera - Zimbabwe: (Mashonaland East, Mashonaland Central)

*****
[1] Diarrhea, cholera - Iraq
Date: Sun 3 Feb 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, World Health Organization (WHO) report [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/SHIG-7BXDRL?OpenDocument>

This week (28 Jan-3 Feb 2008), all 19 Directorates of Health (DoHs)
submitted reports, Anbar DoH report was limited to Falluja hospital;
Wassit provinces did not report data on number of stool samples
submitted for cholera testing. Data received from Sulaymaniyah and
Diyala DoHs, lacks monitoring of completeness of reporting component.

In total, 5443 acute watery diarrhea cases were reported, but none of
the 2797 samples cultured were positive for cholera.
- Baghdad: reporting is gradually improving from both sides of the province.
- Basra: Basra remains one of the most regular reporting DoHs. This
week, 761 cases of acute watery diarrhea were reported. None of the
586 stool samples tested were culture-positive for cholera.
- Kirkuk: 241 cases of acute watery diarrhea were reported. None of
the 67 samples cultured were positive for cholera. For the 7th week
in a row, no cholera case has been reported from Kirkuk.
- Sulaymaniyah: this week (28 Jan-3 Feb 2008), 291 acute watery
diarrhea cases were reported. None of the 29 samples cultured were
positive for cholera.
- Mosul: 441 diarrhea cases reported, none of the 270 stool samples
cultured were positive for cholera.
- Najaf: 369 diarrhea cases reported, none of the 346 stool samples
cultured were positive for cholera.
- Diyala: 17 diarrhea cases reported, none of the 14 stool samples
cultured were positive for cholera
- Missan: 206 cases of acute watery diarrhea were reported. None of
the 128 samples cultured were positive for cholera.
- Thiqar, Muthana, Tikrit, and Babylon: 843 cases of acute watery
diarrhea were reported. None of the 674 samples cultured were
positive for cholera.
- Total new confirmed cholera cases: 0

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[The full report can be found at
<http://www.reliefweb.int/rw/rwb.nsf/db900sid/SHIG-7BXDRL/$File/full_report.pdf>.

From the report, the following was extracted:

Laboratory-confirmed cholera cases - Iraq 14 Aug 2007-3 Feb 2008
----------------------------------------------------------------
Province / Districts Affected / Date 1st case / Date most recent case
reported / Deaths / Confirmed
Kirkuk / 5 / 14 Aug 2007 / 1 Dec 2007 / 5 / 3007
Sulaymaniyah / 13 / 23 Aug 2007 / 17 Nov 2007 / 14 / 1238
Erbil / 6 / 5 Sep 2007 / 22 Nov 2007 / 0 / 275 (19 new since last report)
Dahuk / 4 / 7 Sep 2007 / 28 Oct 2007 / 0 / 6
Tikrit / 3 / 12 Sep 2007 / 7 Oct 2007 / 0 / 5
Mosul (Ninewa) / 3 / 15 Sep 2007 / 15 Nov 2007 / 1 / 5
Baghdad / 5 / 19 Sep 2007 / 13 Dec 2007 / 3 / 138 (11 new since last report)
Basra / 2 / 19 Sep 2007 / 2 Oct 2007 / 0 / 2
Wasit / 1 / 20 Sep 2007 / 20 Sep 2007 / 0 / 3
Anbar / 1 / 3 Oct 2007 / 3 Oct 2007 / 1 / 2
Diyala / 3 / 3 Oct 2007 / 3 Oct 2007 / 0 / 15

Total confirmed cases: 4696 (increased from 4666 from 27 Dec 2007;
these 30 cases seem to be late reports from Erbil and Baghdad since 2007)

Total deaths reported: 24 (no change from 27 Dec 2007)

Of the 2007 cases, 64 percent were from Kirkuk province, 26 percent
from Sulaymaniyah, 6 percent from Erbil, and 3 percent from Baghdad.

Age group-wise, 50 percent were in 15-45 year-olds, 20 percent in
those greater than 45 years old, 20 percent in 5-14 year-olds, and 10
percent in those 4 years or less.

A map of the country showing the case distribution can be found at
the full report URL above. - Mod.LL]

******
[2] Cholera - Yemen: (Hajjah)
Date: Mon 18 Feb 2008
Source: Yemen Times [edited]
<http://yementimes.com/article.shtml?i=1130&p=health&a=1>

Cholera is threatening the lives of citizens in Hajjah governorate's
Bani Qais district. Bani Qais locals say they are being threatened by
cholera, with the epidemic having killed 40 area residents since late
2007. Local council member Sheikh Yahya Hafja stated, "This disaster
is a tragedy. I appeal to concerned authorities and both local and
international organizations to intervene quickly to stem this problem."

Although Yahya Ghailan, head of the Epidemic Surveillance Department,
was on vacation, he agreed to comment on the situation, explaining
that the disease first appeared in the district in October 2007,
beginning in Mistaba, northern Hajjah and a district on the
Yemeni-Saudi border, before moving on to Bani Qais and Khairan
districts. "3 children from the same family, ages 5, 8, and 10, died
of cholera on 15 Dec 2007," Ghailan noted, adding that the Bani Qais
Health Department has recorded 16 deaths since the disease's
appearance in the district. "The problem still exists, with the most
recent death being a female on 27 Jan 2008," he added.

A Bani Qais health worker requesting anonymity said 40 deaths have
been observed due to cholera, with the main reason being water
contamination, adding that Health Department records are inaccurate
because several deaths have occurred at home. However, health worker
Ali Ahmed denies the existence of the disease, maintaining that
talking about it will affect tourism in that area.

[Byline: Siraj Al-Deen Al-Muqri]

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[A map of Yemen can be found at
<http://www.un.org/Depts/Cartographic/map/profile/yemen.pdf>. Hajjah
is a region of western Yemen near the Red Sea. - Mod.LL]

******
[3] Diarrhea, fatal - Philippines
Date: Sun 17 Feb 2008 18:46:07 -0900 (AKST)
Source: The Manila Times [edited]
<http://www.manilatimes.net/national/2008/feb/18/yehey/metro/20080218met1.html>

Some 31 Filipinos, mostly children, die everyday from diarrhea due to
poor sanitation, according to a recent study of the World Bank (WB)
and United States Agency for International Development (USAID).

The report cited the Philippines Statistical Yearbook 2008 as stating
high incidence of diarrhea cases of more than 38 million per year
leads to the premature deaths of 31 Filipinos a day.

The report said 27 million Filipinos do not have toilets and are at
risk of ingesting human fecal material. The health impacts of water
pollution and poor sanitation and hygiene come from contact with
human waste through ingestion.

The World Bank report said some 13 million Filipinos do not have
improved water sources, and only 3.3 percent of the households are
connected to sewers leading to the treatment facilities. Access to
basic sanitation is 20 percent lower for low-income households, while
access to water supply is 17 percent lower, said Rahul Raturi, World
Bank sector manager for environment and rural development. The Bank
said more than 95 percent of the wastewater in urban areas is
deposited untreated into groundwater, canals, and waterways.

--
Communicated by:
ProMED-mail
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[A map of the Philippines can be found at
<http://www.lib.utexas.edu/maps/islands_oceans_poles/philippines.gif>.
- Mod.LL]

******
[4] Cholera - Kenya: (Northeastern)
Date: Mon 18 Feb 2008
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://www.irinnews.org/Report.aspx?ReportId=76804>

An outbreak of cholera in Kenya's Mandera district has claimed the
lives of 6 people, with the local hospital reporting that about 130
people had sought treatment at the facility during the past week
[11-17 Feb 2008]. About 60 patients have been admitted to the
hospital, a medical officer from the Mandera District Hospital, who
asked not to be named, said, adding that the hospital had asked for
more cholera treatment drugs from Garissa, the provincial capital of
the Northeastern Province, where Mandera is situated.

Abukar Abdi, public health officer for Mandera, said the outbreak
could be the result of general poor hygiene in Mandera town or the
use of contaminated water from the nearby Dawa River, which forms
part of the border between Kenya and Ethiopia. He said his office had
ordered 25 food kiosks in Mandera town to close down due to poor hygiene.

--
Communicated by:
Coulibaly Sidi
<sidi_couly@yahoo.ca>

******
[5] Cholera - Kenya: (Northeastern)
Date: Mon 18 Feb 2008
Source: Kenya Broadcasting Corporation [edited]
<http://www.kbc.co.ke/story.asp?ID=48267>

Since the outbreak was reported in January 2008, 8 people have died
from cholera in Mandera; 5 of the victims succumbed at Mandera
District Hospital while 3 others perished at Bulla Hawa Hospital on
the Kenya-Somalia border.

Northeastern provincial public health officer Dr Bernard Nyongesa
said the outbreak had spread to Elwak 175 km (109 mi) away. He said
it had become difficult to control the spread of the disease due to
lax immigration checks at Bula Hawa at the Kenya-Somalia and at Suftu
at the Kenya-Ethiopia borders. Dr Nyongesa said the situation was
made worse by the lack of health facilities in the area.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The Northeastern Province can be found on a map of Kenya at
<http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf>. - Mod.LL]

[A similar article was submitted by ProMED-mail rapporteur Joseph
Dudley. - Mod.MPP]

******
[6] Diarrhea, fatal - Nigeria: (Anambra)
Date: Fri 15 Feb 2008
Source: Nigerian Tribune [edited]
<http://www.tribune.com.ng/15022008/news/news9.html>

Following an outbreak of diarrhea with vomiting, 5 children have been
reported dead and over 50 are receiving treatment in various
hospitals at Amafor West area of Nkpor, an outskirts of Onitsha, Anambra State.

A medical practitioner in the area, Ndubuisi Donatus Uzoigwe, who
confirmed the outbreak to newsmen, said there were no primary health
care center or health workers to enlighten the parents on the dangers
of the disease.

Uzoigwe, proprietor of Ndubuisi Health Care Services Centre, said he
had already drawn the attention of various government health agencies
at both local and state levels to the alarming rate of the endemic
outbreak of diarrhea with vomiting which hit the area since January 2008.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The etiology of this outbreak is not stated but Anambra is located
in southern Nigeria not far from where outbreaks of cholera in the
Delta and Cross Rivers states have occurred. The states can be found
on a map of Nigeria at
<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf>. - Mod.LL]

******
[7] Cholera - Zimbabwe: (Mashonaland East, Mashonaland Central)
Date: Fri 15 Feb 2008
Source: AllAfrica, The Herald (Harare) report [edited]
<http://allafrica.com/stories/200802150292.html>

So far, 7 people from Nyamukuyo Village in Mudzi district,
Mashonaland East Province, have died of cholera. The minister of
Health and Child Welfare, Dr David Parirenyatwa, confirmed the
outbreak, which started 2 weeks ago.

Dr Parirenyatwa said a woman who had visited Mozambique was suspected
to have carried the disease to the village. This is the 2nd reported
cholera outbreak in February 2008 after a similar outbreak in
Muzarabani [in Mashonaland Central Province - Mod.LL], where 4 people
died last week [4-10 Feb 2008]. In a separate interview, principal
director for preventive services in the Ministry of Health, Dr Gibson
Mhlanga, attributed the increase of cholera and diarrhea cases in the
country to unsafe water and inadequate sanitation.

--
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[The 2 provinces are in the northern part of Zimbabwe and can be seen
bordering on Mozambique on a map at
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>.

The outbreaks discussed in this update can also be found on the
HealthMap/ProMED-mail interactive map at
<http://www.healthmap.org/promed>. - Mod.LL]

See Also