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Published Date: 2010-08-27 16:22:46
Subject: PRO/EAFR> Cholera, diarrhea and dysentery update 2010 (39): Africa
Archive Number: 20100827.211728

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (39): AFRICA
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International Society for Infectious Diseases
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In this update:
[1] Cholera - Nigeria
[2] Cholera - Cameroon (North, Far North)
[3] Cholera, acute watery diarrhea - Somalia
[4] Cholera - Kenya (Nyanza)

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[1] Cholera - Nigeria
Date: Wed 25 Aug 2010
Source: Afrique en ligne, Panafrican News Agency (PanaPress) report [edited]
http://www.afriquejet.com/news/africa-news/nigeria:-death-toll-from-nigeria-cholera-outbreak-rises-to-352-2010082555032.html

Death toll from Nigeria cholera outbreak rises to 352
-----------------------------------------------------
The death toll from the cholera outbreak in 11 states in Northern
Nigeria has risen to 352, the Federal Ministry of Health announced
Wednesday [25 Aug 2010].

The ministry's director of public health, Dr Mike Anibueze, said in a
statement that 6347 people had been infected since the disease broke
out in Adamawa state in June [2010].

He said although most of the outbreaks occurred in the Northwest and
Northeast zones, epidemiological evidence indicated that the entire
country was at risk.

In the north, Bauchi and Borno states are the most affected, with 139
deaths between them.

--
Communicated by:
ProMED-EAFR

[A countrywide alert for cholera has been declared in Nigeria as the
outbreaks in the 11 affected states escalate. Preparedness and
preventive activities therefore need to be stepped up countrywide to
prevent the outbreak from spreading to new states.

Maps of Nigeria are available at
http://en.wikipedia.org/wiki/States_of_Nigeria and the
HealthMap/ProMED interactive map at http://healthmap.org/r/01MI. -
Mod.JFW]

******
[2] Cholera - Cameroon (North, Far North)
Date: Wed 25 Aug 2010
Source: PanAfrican News Agency (PanaPress) [edited]
http://www.panapress.com/freenews.asp?code=eng057779&dte=25/08/2010

The death toll in the cholera epidemic is still rising in Cameroon,
where health authorities have reported 271 deaths from 3605 patients,
with 90 new cases reported in a single day in the far north of the
country, about 2000 km from the capital, Yaounde.

The Chairman of the crisis group, Prof Fru Angwafor III, explained
that suspected cholera cases were coming from neighboring countries
for free treatment in Cameroonian health facilities.

Angwafor said the border areas in the Far North region reported a
large number of cases, adding that medical teams would be sent to
those areas to investigate.

The epidemic is also spreading to the North, a region located about
1500 km from Yaounde, where more than two-thirds of districts had
been affected, with a death toll of 15.

According to statistics, more than 50 percent of victims died in
their households, thereby exposing relatives who handle the corpses
to danger.

Faced with the scope of the epidemic, the government has earmarked
CFA 2 billion [USD 3.9 million] for the crisis group to effectively
control and eradicate the disease.

Measures planned include the construction of latrines, boreholes, the
purchase of health equipment, and production of awareness messages in
local languages.

--
Communicated by:
ProMED-EAFR

[The cholera outbreaks in the 2 regions (North and Far North)
continue to increase amidst high community deaths and hence
predisposing the unprotected corpse handlers to further infection. A
comprehensive response needs to be instituted to prevent new
infections and community deaths.

An interactive map showing the regions of Cameroon can be accessed at
http://www.lib.utexas.edu/maps/africa/cameroon_pol98.jpg. The
HealthMap/ProMED mail interactive map of Cameroon can be accessed at
http://healthmap.org/r/00Eh. - Mod.JFW]

******
[3] Cholera, acute watery diarrhea - Somalia
Date: Sun 1 Aug 2010
Source: WHO, Regional Office for the Eastern Mediterranean (EMRO),
Somalia Health Cluster Bulletin July 2010 [edited]
http://www.emro.who.int/somalia/pdf/Somalia%20Health%20Cluster%20Bulletin%20July%202010.pdf

South and Central Somalia
-------------------------
Between epidemiological weeks 27-30 (5 Jul-1 Aug 2010), over 110
sentinel sites of the Communicable Diseases Surveillance and
Reporting Network (CSR) in South and Central Somalia reported 7623
consultations and 17 deaths for 7 health events. Acute watery
diarrhoea (AWD) accounted for 51 percent (3899) of all cases and
acute bloody diarrhoea (ABD) for 17 percent (1284). AWD accounted for
71 percent (12) of all the reported deaths.

Lower and Middle Jubba
----------------------
The integrated disease surveillance and response network (IDSR) in
Lower and Middle Jubba reported a total of 5478 consultations for 14
health events in epidemiological weeks 27-30. Children accounted for
2954 (54 percent) of all consultations. AWD in 607 (11 percent)
cases, including 497 (82 percent) children. In week 27, rumors of an
increase in numbers of AWD and related deaths were reported from
flood-affected villages in Lower Jubba. In response, WHO carried out
outbreak investigation in Kaytoy-Biyomaa, Buulo Abdirahman, Fanoole,
Farah, and Jija, leading to the confirmation that there is no
outbreak. During the visit health education sessions were conducted
and aquatabs distributed. All 9 rectal swabs that were collected
tested negative for cholera using Cholera Smart II (R). WHO and
partners are monitoring the situation. World Vision, SRCS [Somalia
Red Crescent Society], Muslim Aid, SORDES [Somalia Relief and
Development Society], and AFREC [Africa Rescue Committee continue
health education, hygiene promotion, and water chlorination
activities in the districts of Badhaade, Bu'aale, Sakow, Salalge,
Kismayo, Hagar, Dhobley, and Afmadow in Lower and Middle Jubba.

Lower Shabelle
--------------
The Cholera Treatment Centre (CTC) of Merka Hospital (Lower
Shabelle), reported additional 82 cases of AWD between
epidemiological weeks 27-30. Of those, 79 percent (65) cases were
children, with no deaths. WHO reiterates the call for partners and
stakeholders in Somalia to remain vigilant and report any unusual AWD
trends in the context.

Mogadishu
---------
In epidemiological weeks 27-30, Banadir Hospital (Mogadishu) reported
313 cases of AWD, including 86 percent (269) children. All the 8
reported deaths (CFR 2.6) were children. WHO and partners continue to
monitor and carry out preventive and case management interventions in
Banadir region as cholera cases remain high. Following an increase in
the number of reported AWD cases, in epidemiological week 28, WHO
collected 7 stool samples from Habeeb CTC [clerical training centre]
in Mogadishu for confirmatory diagnosis, and provided AWD case
management supplies, including 360 litres of ringer lactate and
accessories, antibiotics (erythromycin syrup and tablets) and other
renewable supplies. In July 2010, local NGO WARDI [Wardi Relief and
Development Initiatives] reported a total of 795 consultations,
including 56 percent (445) children from the Hamar Jajab MCH [mother
and child health centre] in Mogadishu. Major causes of morbidity were
AWD in 120 cases of which 66 percent (79) were children, and bloody
diarrhoea in 50 cases of which 72 percent (36) were children.

Middle Shabelle
---------------
During epidemiological weeks 27-30, Medair and local partner SAACID
[Somali women's non-governmental organisation] reported 1102
consultations, including 262 (24 percent) children, from Cadale MCH
(802), Haji Ali HP (53), Geel Bub HP (163), and Ali Guduud HP (84) in
Middle Shabelle. The causes of morbidity included AWD and accounted
for 3 percent (38) of all consultations.

Puntland
--------
Between epidemiological weeks 27-30, 45 sentinel sites of the CSR
[Communicable Diseases Surveillance and Re- porting Network] in
Puntland reported 878 consultations including 6 deaths for 7 health
events. AWD accounted for 81 percent (715) of all cases and ABD for
17 percent (153 cases). AWD accounted for 83 percent (5) of all
reported deaths.

Somaliland
----------
Between epidemiological weeks 27-30, over 50 sentinel sites of the
CSR in Somaliland reported 575 consultations for 7 health events. AWD
accounted for 84 percent (484) of all cases and ABD for 15 percent (88 cases).

--
Communicated by:
ProMED-EAFR

[The cases of acute watery diarrhea remain high in the most of the
regions in Somalia, in addition to the ongoing cholera outbreak in
Lower Shabelle. Partner organizations are supporting the initiation
of preventive and response measures for all priority diseases guided
by the integrated disease surveillance and response strategy (IDSR).
The strategy involves integrating surveillance activities for
selected priority diseases/ conditions and supporting the districts
and national level for detect, report, investigate and respond to
events of priority disease conditions.

Somalia is located in the horn of Africa, and the regions of the
country can be seen at
http://en.wikipedia.org/wiki/Regions_and_Districts_of_Somalia. The
HealthMap/ProMED-mail interactive map of the country can be seen at
http://healthmap.org/r/00aM. - Mod.JFW]

******
[4] Cholera - Kenya (Nyanza)
Date: Wed 25 Aug 2010
Source: Daily Nation (Kenya) [edited]
http://www.nation.co.ke/News/regional/Fears%20of%20cholera%20outbreak%20as%20patients%20jam%20hospitals/-/1070/996938/-/rctmv6z/-/

Medical officers in Migori and Kuria West districts are battling what
is suspected to be a cholera outbreak. About 200 people have been
admitted to hospital in the last week with cholera-related symptoms.

The officers warned on Wednesday [25 Aug 2010] the cases were
increasing daily despite measures to contain them and appealed to
residents to observe hygiene. Wards in public hospitals are
congested, with some patients sleeping on the floor for lack of
bedding.

Kuria West has recorded about 150 admissions in the last 4 days, says
the district medical officer, Dr Solomon Bongo. He spoke as 2 more
people died of cholera, raising the toll to 7. 5 people died last
week [week of 16 Aug 2010] in Mabera and Masaba divisions.

Public health officials have been deployed to villages in Migori to
teach people proper sanitation. Hospitals have reported a high number
of admissions, with most being put on fluids.

Some residents claimed health facilities in the border districts were
"always having drug shortages", with patients being referred to
private hospitals and chemists to buy drugs. "You are always told to
buy drugs from the private facilities for your patient even if you do
not have the money," said Mr John Mosabi. But Kuria West DC James
Mugwe dismissed the claim, saying public hospitals had enough
supplies to deal with the situation.

"We have received enough cholera drugs to combat the situation. Any
resident who is mistreated in any public health facility should
report to my office immediately," he said.

Mr Mugwe directed public health officials to crack down on dirty
eateries and restaurants. He also outlawed hawking of foods.
Residents claim that most hotels in Kehancha, Masaba, Mabera, and
Isebania towns do not have water or toilets.

Tanzanian authorities in the neighbouring Tarime District are
monitoring the situation, lest it spreads across the border.

--
Communicated by:
ProMED-EAFR

[The cholera outbreaks in Nyanza Province are increasing fast yet
laboratory confirmation of the outbreak is still pending and the
affected communities are concerned about the apparent unavailability
of the required drugs to treat cases. It is therefore critical that
laboratory confirmation of the outbreaks is urgently done to guide
the response. In addition, access to free treatment should be
universal to prevent further deaths.

Maps of Kenya are available at
http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf and the
HealthMap/ProMED-mail interactive map at
http://healthmap.org/r/012e. - Mod.JFW]

See Also