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Published Date: 2008-11-20 15:00:36
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2008 (45)
Archive Number: 20081120.3662

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (45)
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In this update:
Africa
[1] Cholera - South Africa (Northern Province) ex Zimbabwe
[2] Cholera - South Africa (KwaZulu-Natal) ex Zimbabwe
[3] Cholera - Zimbabwe: USA ambassador statement
[4] Cholera - Zimbabwe (Midlands Province)
[5] Cholera - Zimbabwe (Masvingo)
[6] Cholera - Mozambique (Manica)
[7] Cholera - Congo (Pool)
[8] Cholera - Guinea-Bissau
[9] Diarrhea, fatal - Somalia (Galgadud)
[10] Cholera - Sudan (Northern Bahr el Ghazal)
Asia
[11] Cholera - Philippines (Misamis Oriental)

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[1] Cholera - South Africa (Northern Province) ex Zimbabwe
Date: Thu 20 Nov 2008
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5hYDohP0C_YOEVdPs8EmRkPTTiD4A>

A health official said Thursday [20 Nov 2008], 3 Zimbabweans have
died of cholera in neighboring South Africa, where dozens of people
have come in search of treatment after an outbreak back home.

So far 3 Zimbabwean patients have died since Saturday [15 Nov 2008].
The latest casualty was recorded Wednesday evening [19 Nov 2008],
said Phuti Selobi, spokesman for the health department in the border
town of Musina.

South Africa has identified a total of 72 cholera cases. All but 2 of
them are Zimbabweans, Selobi said.

Zimbabwe is grappling with a cholera outbreak that has killed 73
people in recent weeks, about half of them in the town of Beitbridge,
just across the border from South Africa, according to state media in Harare.

South African health officials have stepped up their efforts to check
for the disease on the border, amid signs the disease is reaching
deeper into the country, Selobi said.

--
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ProMED-mail
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[Musina, in South Africa's Northern Province, is close to the border
with Zimbabwe where there has been a recent flare up of cholera. Its
location can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/southafr.pdf>. - Mod.LL]

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[2] Cholera - South Africa (KwaZulu-Natal) ex Zimbabwe
Date: Wed 19 Nov 2008
Source: IOL (Independent Online, South Africa) [edited]
<http://www.iol.co.za/index.php?set_id=1&click_id=13&art_id=nw20081119180545134C746371>

A truck driver who arrived from Zimbabwe has been diagnosed with
cholera, the KwaZulu-Natal health department said on Wednesday [19
Nov 2008]. Spokesperson Leon Mbangwa said that the man had been
placed in an isolation ward in Durban's Addington Hospital. He said
the man had left Zimbabwe last Thursday [13 Nov 2008] with his
brother and arrived in Durban on Saturday morning [15 Nov 2008].

The truck driver and his brother checked into a local Durban lodge on
that morning. By evening the man was vomiting and suffering from
diarrhea. He was first admitted to City Hospital before being
transferred to Addington Hospital.

"He was in a semi-coma condition at that time, so it was hard to get
information from him. It has emerged that where he was in Zimbabwe
where people were suffering from diarrhea," said Mbangwa. He said
that tests had confirmed that the man had cholera. His brother was
under observation.

--
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[As can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/southafr.pdf>,
Durban in KwaZulu-Natal province is separated from Zimbabwe by
hundreds of miles showing that rapid transportation can introduce the
waterborne disease a long way from the border. - Mod.LL]

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[3] Cholera - Zimbabwe: USA ambassador statement
Date: Thu 20 Nov 2008
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5g7ik0r0b9ihTwOyWT18PBVxmRzFA>

The US ambassador to Harare, James McGee, said Thursday [20 Nov 2008]
that a total of 294 people have been confirmed dead from cholera in
Zimbabwe, amid some 1200 cases of the waterborne disease.

"The water situation, sanitation situation has gone through the
ceiling," McGee told reporters in Washington via a satellite hookup
from Harare.

"There are over 1200 confirmed cases of cholera and another 2500
unconfirmed cases of cholera," McGee said, adding that the death toll
had risen to 294, which is higher than the official toll.

--
Communicated by:
ProMED-mail
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[A map of Zimbabwe can be found at
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>.

Cholera had been reported initially in the northern provinces and
then in the southern province of Matabeleland South (which borders
South Africa as noted above). Cases are now reported in more central
provinces as posted below. - Mod.LL]

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[4] Cholera - Zimbabwe (Midlands Province)
Date: Thu 20 Nov 2008
Source: China View, Xinhua News Agency report [edited]
<http://news.xinhuanet.com/english/2008-11/20/content_10388071.htm>

More people have died of cholera outbreak in Zimbabwe, as an
additional 9 deaths were reported on Thursday [20 Nov 2008] in the
country's central province of Midlands, bringing the total death toll
up to 94 in the country.

The cholera outbreak was reported to have spread to Gweru, a city
about 300 km (186 mi) south of Harare where 9 people have died while
28 others have been diagnosed as having the disease, The Chronicle reported.

This brings the cholera death toll in Midlands to 13 after 4 others
died in Zvishavane's Murowa area in the province recently, the newspaper said.

--
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[The central province of Midlands can be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>. - Mod.LL]

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[5] Cholera - Zimbabwe (Masvingo)
Date: Wed 19 Nov 2008
Source: The Zimbabwean [edited]
<http://thezimbabwean.co.uk/index.php?option=com_content&task=view&id=16483&Itemid=103>

Poor sanitary facilities, intermittent water supplies and poor refuse
management have led to a cholera outbreak in Masvingo. Although no
deaths have been officially recorded to date, sources spoken to by
RadioVOP indicated that about 5 people have already died due to
cholera and related illnesses. More than 450 cases of cholera have
been recorded in health centres in the province since Friday [14 Nov 2008].

The most affected areas are Rujeko suburbs, Mushandike, and
Mpandawana Growth point in Gutu and Chivi district. Health officers
were on Monday [17 Nov 2008] deployed at Mushandike Resettlement area
where they are said to be treating the victims.

Medical staff at Masvingo General Hospital who spoke on condition of
anonymity said a number of people were being ferried to the
Provincial hospital for cholera treatment.

An official at Rujeko clinic said more than 200 cases of cholera were
recorded since Thursday last week [13 Nov 2008].

--
Communicated by:
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[The southeastern province of Masvingo borders with Midlands to the
north as well as with Mozambique as can be seen at
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>. - Mod.LL]

******
[6] Cholera - Mozambique (Manica)
Date: Tue 18 Nov 2008
Source: AllAfrica, Agencia de Informacao de Mocambique (Maputo) report [edited]
<http://allafrica.com/stories/200811181021.html>

The cholera outbreak in Guro district, in the central Mozambican
province of Manica, which began in late October 2008, has now spread
to new areas surrounding the villages of Chinda, Thanda, Bunga, and
Nhamassonje, but no new deaths were recorded, reports Tuesday's [18
Nov 2008] issue of the Maputo daily 'Noticias'.

Guro district administrator Deolinda Bengula told reporters that
there were 17 people hospitalised at the Cholera Treatment Centre in
Chinda on Monday [17 Nov 2008], while 8 others had been transferred
from Thanda and Bunga to Changara, in neighbouring Tete province.

Guro chief doctor Albertino Zunza, who is in Chinda with the medical
team working in the treatment centre, said that 13 new patients had
been admitted by Sunday [16 Nov 2008], rising to 17 by the next day.

Since the outbreak of the disease in Guro, which is blamed on the
consumption of untreated water, 200 cases have been diagnosed, with a
total of 53 deaths.

--
Communicated by:
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[The area, close to eastern Zimbabwe can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/mozambiq.pdf>. - Mod.LL]

******
[7] Cholera - Congo (Pool)
Date: Thu 20 Nov 2008
Source: Afrique en Ligne, Panafrican News Agency (PANA) report [edited]
<http://www.afriquenligne.fr/news/africa-news/cholera-outbreak-reported-in-southern-congo-2008111916325.html>

At least 26 people are suffering from cholera in the Kinkakassa
Village, in the southern Congolese Pool District, a source close to
the World Health Organisation (WHO) Regional Office for Africa told
PANA here on Wednesday [19 Nov 2008]. The outbreak was first reported
about 2 weeks ago, but no deaths from the disease have so far been reported.

Cholera was diagnosed in Kinkakassa following a dramatic surge of
diarrhea cases in the area. Samples taken by NGO Medecins d'Afrique,
which is working under a socioeconomic rehabilitation and development
project funded by the European Union, were forwarded for analysis to
the Brazzaville national public health laboratory, where the
diagnosis of cholera was confirmed.

--
Communicated by:
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[The Pool region of Congo located west of the country of Congo DR can
be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/congo.pdf>. - Mod.LL]

******
[8] Cholera - Guinea-Bissau
Date: 19 Nov 2008
Source: All Africa, UN Integrated Regional Information Networks
(IRIN) report [edited]
<http://allafrica.com/stories/200811190981.html>

After more than 6 months of battling cholera in Guinea-Bissau the
epidemic is now easing health officials say, though they admit they
have not identified its root causes or put in place measures to
prevent future outbreaks.

Thus far, 221 people have died and 13 921 have been infected,
according to the Ministry of Health.

"All the factors that cause cholera remain unaddressed: poverty,
deficient sanitary services, lack of drinking water," Umaro Ba, head
of the cholera unit at the capital Bissau's Simao Mendes hospital,
told IRIN. "And more importantly in the future we need to put in
place a strong prevention programme."

At the epidemic's peak in the final week of September 2008, 1376 new
cholera cases were registered and 19 people died, according to the
ministry of health, but from 9 to 16 Nov 2008 just 128 new cases and
no deaths were reported.

A decrease in cholera cases is partly due to the end of the rainy
season, according to Ba, as the disease is spread by bacteria in
contaminated water.

The strong mobilization from UN agencies, communities, local and
international NGOs, and donors also helped contain the disease,
according to Johannes Mooij, technical adviser at the Simao Mendes hospital.

Health Ministry officials say cholera broke out in May 2008 in the
southern region of Tombali, but they still do not know how it spread
to the capital, home to the highest number of victims. Nor do
epidemiologists understand why the isolated Bijagos Islands had the
highest per capita caseload.

--
Communicated by:
ProMED-mail
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[The West African country of Guinea-Bissau is south of Senegal and
north of Guinea (also called Guinea-Conakry and can be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/guineabi.pdf>. - Mod.LL]

******
[9] Diarrhea, fatal - Somalia (Galgadud)
Date: Tue 18 Nov 2008
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN)
report [edited]
<http://allafrica.com/stories/200811190648.html>

At least 100 people have died in the past 4 weeks after an outbreak
of acute watery diarrhea (AWD) in and around the town of Abudwaaq, in
Galgadud region of central Somalia, medical sources said on 18 Nov 2008.

"Since 3 Oct 2008, 100 people have died in Abudwaaq town; there are
some people who have died in the villages around it but we don't have
numbers for them," said Mohamed Jama, the only doctor in the area.
"This is the highest mortality rate I have witnessed in my career."

Jama said that so far 500 cases of AWD had been registered in the
hospital, where a treatment centre was set up. "These are the ones
who made it here. We are getting reports of people dying in the
outlying villages, but unfortunately we cannot reach them."

He blamed the outbreak on contaminated water drawn from wells and
"barkads" (water catchments).

--
Communicated by:
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[AWD is an often used term to be used instead of cholera, which is
likely to be the cause of this outbreak. The location of Galgadud
(spelled Galguduud on the map) can be found at
<http://www.un.org/Depts/Cartographic/map/profile/somalia.pdf>. - Mod.LL]

******
[10] Cholera - Sudan (Northern Bahr el Ghazal)
Date: Wed 19 Nov 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Miraya FM report [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db900SID/MUMA-7LK56V?OpenDocument>

The minister of health in Northern Bahr el Ghazal, Akon Bol Akok,
told Miraya FM that more than 10 people died of cholera and
waterborne diseases following the recent floods, which hit the state
recently. Akon added that the number of patients is on the increase,
especially in Eastern Aweil County, Fariang, Akwem-Nhom, and Piu-Chiok.

The minister referred to more than 240 cases of cholera and watery
diarrhea registered during the last week.

--
Communicated by:
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[The area mentioned in the semiautonomous region of South Sudan can
be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/sudan.pdf>. - Mod.LL]

******
[11] Cholera - Philippines (Misamis Oriental)
Date: Wed 19 Nov 2008
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5g-58Lan87mTnxLBrQuIv5cvoffdA>

At least 2 people have died and more than 1500 are hospitalized
following a suspected outbreak of cholera in the southern
Philippines, health officials said Wednesday [19 Nov 2008].

National Epidemiology Centre chief Eric Tayag said the patients "were
showing cholera symptoms" and most came from the settlement of
Tagoloan in southern Misamis Oriental, where heavy rains has caused
minor flooding which could have contaminated the drinking water supply.

A Red Cross official in Manila told AFP the charity's chapter in
Misamis Oriental had confirmed that 2 people had died and that 9 out
of the 10 villages in Tagoloan were reporting suspected cholera cases.

--
Communicated by:
ProMED-mail
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[Misamis Oriental province is located on the Philippines' southern
island of Mindanao and can be found on a map at
<http://en.wikipedia.org/wiki/Misamis_Oriental_province>.

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

See Also