Published Date: 2008-11-14 17:00:36
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2008 (43): Congo DR
Archive Number: 20081114.3597
CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (43): CONGO DEMOCRATIC REPUBLIC
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In this update:
Africa
[1] Cholera - Congo DR: North Kivu, Provincial Epidemiological Unit report
[2] Cholera - Congo DR: WHO report
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[1] Cholera - Congo DR: North Kivu, Provincial Epidemiological Unit report
Date: Thu 13 Nov 2006
From: Prudence Mitangala [edited]
<prudendeb@yahoo.fr>
North Kivu province is actually facing the worst internal population
displacement since the end of the civil war in 2003. Due to fighting
between governmental forces and rebels, more than 800 000 internally
displaced people (IDP) have been forced to leave their homes and
facilities established in the area of Goma. More recently, 33 080
displaced people have escaped around Goma Town from the IDPs camps on
28 Oct 2008, fleeing the fighting area. Some patients suffering from
cholera left health centers with intravenous catheters despite the
ongoing intensive rehydration.
The insecurity and the breakdown of the health structures have led to
the emergence of several cholera and measles outbreaks. By the end of
October 2008, there were approximately 1094 suspected cases of
cholera; 398 of them reported from Rutshuru health zone located 65 km
(40.4 mi) north of Goma. Due to limited access, non-governmental
organizations (NGOs) or other humanitarian missions were not able to
reach this health zone before the last week [from 27 Oct to 2 Nov 2008].
Nevertheless, etiological agents of these high transmissible
infectious diseases have been identified by the Provincial Public
Health Reference laboratory AMI LABO since 4 Oct 2008. Strains
isolated locally were _Vibrio cholerae_ O1, Inaba serotype, sensitive
to the commonly used antibiotics but resistant to
trimethoprim-sulfamethoxazole.
In spite of this extremely difficult situation, the Provincial Health
authority is coordinating health partners, with the logistic support
of the NGO CEMUBAC-Belgium and WHO, in the implementation of specific
control measures in order to monitor infectious diseases outbreaks
and limit their spread to other areas. With limited resources the
health care personnel was able to identify the causative agents of
outbreaks and to manage this critical situation.
These facts highlight the benefit of sustainable epidemiological
surveillance systems and the need of improving laboratory capacities
especially in a conflict region, allowing rapid control measure
implementation. In regard to this situation, authorities should
consider reinforcement of the regional strategic drugs stock to
maintain their reactive response capacity when outbreaks occur.
[Authors: Mitangala P, Baabo D, Mutombo G]
--
Prudence Mitangala MD MPH
Provincial Epidemiological Unit
North Kivu Province, DR Congo
<prudendeb@yahoo.fr>
[ProMED-mail is indebted to Dr Mitangala and colleagues in North Kivu
and to Prof Olivier Vandenberg of the Department of Laboratory
Medicine, Saint-Pierre University Hospital & Jules Bordet Institute
for this first hand report of this awful human tragedy in eastern Congo DR.
The areas mentioned can be found on a map of the area at
<http://www.un.org/Depts/Cartographic/map/profile/eastdrc.pdf>. - Mod.LL]
******
[2] Cholera - Congo DR: WHO report
Date: Fri 14 Nov 2008
Source: ThaiPR, WHO (World Health Organization) press release [edited]
<http://www.thaipr.net/nc/readnews.aspx?newsid=B4437C8445A437691D3E68669F40C815>
The World Health Organization (WHO) and health partners have launched
an intensive operation to prevent and control the increase in the
number of cholera cases, which have tripled in some areas to 150 a
week, amid the recent escalation of violence in the eastern part of
the Democratic Republic of the Congo. Insecurity, massive population
displacement (at least 250 000 people since early August 2008), weak
health services and a lack of safe water and proper sanitation
facilities have caused a marked increase in the number of people with
cholera in North and South Kivu.
As yet no data is available on the number of deaths linked to the
current outbreak, but generally in complex emergencies the case
fatality rate can surpass 30 percent. In 1994, some 50 000 people
died from a combined epidemic of cholera and dysentery linked to the
Rwandan exodus into Goma, the main town of North Kivu.
There has been a tripling of cholera cases since the start of October
2008 to early November 2008 in the Goma health zone, which includes
the area of Karisimbi. From July-August 2008, there was a weekly
incidence of less than 20 cases in Goma. But in the 1st week of
October 2008, there were 40 cholera cases, which increased to about
150 in early November 2008.
"Such an increase of cases in a region that is already endemic for
cholera is an early warning sign of a potentially larger epidemic,
and all health providers are working together to ensure that we do
not see a repeat of 1994," said Dr Eric Laroche, assistant
director-general for WHO's Health Action in Crises cluster.
In all of North Kivu, there have been at least 997 cholera cases
reported in that time, with most recorded in Rutshuru (466), Goma
(263), and Karisimbi (145). In South Kivu during the same period, 855
cholera cases have been reported, with most in Minova (371).
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
The HealthMap/ProMED-mail interactive map of the Democratic Republic
of the Congo is available at
<http://healthmap.org/promed/en?v=-2,25,5>. - CopyEd.MJ]
See Also
Cholera, diarrhea & dysentery update 2008 (42) 20081112.3563Cholera, diarrhea & dysentery update 2008 (41) 20081023.3347
Cholera, diarrhea & dysentery update 2008 (40) 20081014.3253
Cholera, diarrhea & dysentery update 2008 (30) 20080702.2019
Cholera, diarrhea & dysentery update 2008 (20) 20080404.1240
Cholera, diarrhea & dysentery update 2008 (10) 20080212.0563
Cholera, diarrhea & dysentery update 2008 (01) 20080104.0047
2007
----
Cholera, diarrhea & dysentery update 2007 (67) 20071231.4200
Cholera, diarrhea & dysentery update 2007 (60) 20071126.3824
Cholera, diarrhea & dysentery update 2007 (50) 20071023.3450
Cholera, diarrhea & dysentery update 2007 (40) 20070924.3164
Cholera, diarrhea & dysentery update 2007 (30) 20070830.2856
Cholera, diarrhea & dysentery update 2007 (20) 20070511.1509
Cholera, diarrhea & dysentery update 2007 (10) 20070302.0737
Cholera, diarrhea & dysentery update 2007 (01) 20070105.0047
2006
----
Cholera, diarrhea & dysentery update 2006 (52) 20061229.3646
Cholera, diarrhea & dysentery update 2006 (50) 20061215.3528
Cholera, diarrhea & dysentery update 2006 (40) 20061006.2862
Cholera, diarrhea & dysentery update 2006 (30) 20060724.2037
Cholera, diarrhea & dysentery update 2006 (20) 20060512.1352
Cholera, diarrhea & dysentery update 2006 (10) 20060303.0675
Cholera, diarrhea & dysentery update 2006 (01) 20060106.0040
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