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Published Date: 2010-10-27 21:18:18
Subject: PRO/EAFR> Cholera, diarrhea and dysentery update 2010 (51): Africa
Archive Number: 20101028.214604

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (51): AFRICA
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International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Cholera - Uganda (Nakapiripirit)
[2] Cholera - Cameroon
[3] Cholera - Benin
[4] Cholera - Nigeria

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[1] Cholera - Uganda (Nakapiripirit)
Date: Wed 27 Oct 2010
Source: People's Daily Online, Xinhua News Agency report [edited]
http://english.peopledaily.com.cn/90001/90777/90855/7178598.html

A cholera outbreak in the northeastern Ugandan district of
Nakapiripirit has killed 5 people and infected over 100 more since
the outbreak was confirmed last week [week ending 24 Oct 2010], a top
health official said here on Tuesday [26 Oct 2010].

Stephen Mallinga, minister of health, told reporters at a media
briefing that the disease broke out on 18 Oct [2010] after a visitor
from a neighboring district [Amudat] which has had on and off cholera
outbreaks visited a homestead in Nakapiripirit.

"To date, we have had 5 community deaths which have been reported
mainly in Nakapiripirit town," he said, adding that 103 cases have so
far been registered.

He attributed the spread of the disease to poor sanitation noting
that the whole of northeastern Uganda has a poor latrine coverage of
only about 5 percent.

Most people in the region, also known as Karamoja, excrete in bushes
and when it rains, the feces could be washed away into rivers and
ponds where people collect water for drinking. He said despite the
region having a lot of boreholes for safe water, most people prefer
pond or river claiming it tastes better.

"Karamoja is still a very high risk area for cholera," he said.

Cholera is caused by _Vibrio cholerae_ bacteria and it is transmitted
through eating contaminated foods with the pathogens that thrive in
human fecal matter. The common symptoms include rice-watery stool,
abdominal cramps, and rapid dehydration.

According to the World Health Organization, cholera remains a global
threat and is one of the key indicators of social development.

While the disease no longer poses a threat to countries with minimum
standards of hygiene, it remains a challenge to countries where
access to safe drinking water and adequate sanitation cannot be guaranteed.

--
Communicated by:
ProMED-EAFR

[The number of cholera cases has increased by 83 since our last
update (ProMED-EAFR posting 20101023.214414). No new deaths have been
reported since then indicating that response interventions have been
mounted to promptly identify and rehydrate new cases. However, the
pending challenges include mobilizing and educating communities to
construct and use latrines in addition to educating them on the
dangers of using water from unsafe sources.

The HealthMap/ProMED-mail interactive map of Uganda is available at
http://healthmap.org/r/0ect. An administrative map of the country
can be seen at
http://www.coetzee-uganda.com/index_files/District_Map_of_Uganda.htm.
- Mod.JFW]

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[2] Cholera - Cameroon
Date: Mon 25 Oct 2010
Source: Prensa Latina [edited]
http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=232031&Itemid=1

The cholera epidemic that has affected Cameroon since April [2010]
has caused 559 deaths among a total of 8528 affected people,
according to Health Minister, Andre Mama Fouda.

North Rim area suffered most with the prevalence of the disease, with
8227 cases and 542 deaths, followed by the Northern region, with 261
cases and 10 deaths, the Littoral with 173 cases and 5 deaths, and
the Centre, with 27 reported cases and 2 deaths.

According to the minister, the ailment is on the decline, but it is
important to stay vigilant.

Dirty water consumption is considered the main cause of cholera in
the cities of Yaounde and Douala, according to a research by the
Shepherd Center's in Cameroon in collaboration with the Ministry of Health.

This ailment is caused by the bacterium _Vibrio cholerae_ and if
unattended in time it is fatal.

The spread of the cholera epidemic in West and Central Africa is also
related to the deterioration of health standards and survival caused
by floods, which caused 377 deaths and 1.5 million victims in recent
months, released a report by humanitarian organizations.

--
Communicated by:
ProMED-EAFR

[The cholera outbreaks in Cameroon are reported to be on the decline
but authorities have warned response teams and communities to remain vigilant.

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/05Xt. - Mod.JFW]

******
[3] Cholera - Benin
Date: Tue 26 Oct 2010
Source: Irish Times [edited]
http://www.irishtimes.com/newspaper/world/2010/1026/1224282004302.html

Benin is at risk of a major cholera outbreak, an international aid
agency warned yesterday [25 Oct 2010], as the West African nation
reeled from its worst flooding since 1963.

55 000 homes have been destroyed or damaged, and 250 000 people left
homeless by the flooding, leaving many susceptible to the water borne
disease, said Care International.

"The latrines are flooded, so people are bathing, cooking, and
drinking with water that has human waste in it," Helen Hawkins, a
water and sanitation specialist with Care in Benin told The Irish Times.

"Some people have obviously stayed in their homes to protect their
belongings but that means they are living in flooded homes surrounded
by water. So there is quite a risk of a possible outbreak." So far,
846 cases of cholera and 7 deaths from the disease have been recorded.

Several months of heavy rain have engulfed two-thirds of the country,
with 55 of Benin's 77 municipalities affected by the flooding, said
the United Nations. So far 56 people have been killed and 680 000
affected, as the UN began an emergency airlift of 3500 tents and
started distributing hygiene kits and mosquito nets to those worst hit.

In the past week, 360 000 litres of clean water have been issued to
20 000 people by UNICEF, which said that it has 2.7 million aquatab
water purification tablets, enough to last the next month [November
2010]. It also had 89 000 bars of soap but said that 170 000 were needed.

Aid agencies said getting clean drinking water to people was
essential, as once cholera got into the community it spread quickly.
The government has allocated 450 million CFA (?7 million) to the
municipalities and distributed bedding materials to areas affected.

Benin is one of the poorest countries in the world, dropping from
153rd to 161st place in the UN's human development index between 2001 and 2009.

[Byline: Jody Clarke]

--
Communicated by:
ProMED-EAFR

[The humanitarian situation caused by flooding and eventually cholera
continues to escalate with up to 67 percent of the country affected.
Additional resources are required to control the outbreak and provide
the essential necessities to affected communities.

An interactive map showing the 12 departments of Benin can be
accessed at
http://en.wikipedia.org/wiki/Benin#Departments_and_communes. The
HealthMap/ProMED mail interactive map of Benin can be accessed at
http://healthmap.org/r/016k. - Mod.JFW]

******
[4] Cholera - Nigeria
Date: Tue 26 Oct 2010
Source: The Guardian (UK) [edited]
http://www.guardian.co.uk/world/2010/oct/26/cholera-nigeria-floods-outbreak-disease

Cholera has killed more than 1500 people and infected nearly 40 000
in Nigeria in the country's worst outbreak for nearly 2 decades, the
UN has warned.

The lethal waterborne disease has spread to Nigeria's west African
neighbours Cameroon, Chad, Niger, and Benin, where it has thrived
because of severe rains and flooding.

According to UN figures, 1555 people have died from cholera in
Nigeria since January [2010] and 38 173 cases have been reported. The
figure is more than 4 times the death toll the government reported in
August [2010].

UN officials said the numbers were based on the latest reports from
the World Health Organisation (WHO), the Red Cross, and government agencies.

"The rains this year [2010] have been very severe ... [The outbreak]
is considerably worse this year," Paula Fedeski, a spokeswoman for
UNICEF in Nigeria, told Reuters.

The current outbreak is the worst in Nigeria since 1991, when 7654
people died, according to WHO statistics.

The highest death tolls were in the northern states of Borno,
Katsina, and Bauchi, comprised mostly of small Muslim villages that
have been hit by heavy rains. But there were also cases in southern
states, including Rivers and Cross River in the Niger Delta, the
heartland of Nigeria's oil industry.

The number of reported cases so far this year [2010] is almost 3
times the number for the whole of 2009, although Fedeski said that
was partly because of improved data collection. The Red Cross
estimates that women and children account for 80 percent of this year's cases.

Heavy rains and flooding in rural areas, where safe drinking water
and sanitary facilities are scarce, have fueled the outbreak, which
is generally spread through food and water contaminated with bacteria.

In many villages, sewage flows down dirt paths during the rainy
season, allowing faeces to contaminate communal wells. Almost half
the country's 150 million people lack access to clean water and
proper sanitation, even though the government earns billions of
dollars a year as one of Africa's top oil exporters, the WHO says.

Chris Cormency, a Senegal-based UNICEF official who is monitoring the
epidemic, said poor basic education among rural villagers and a lack
of staffed clinics and hospitals allowed the disease quickly to claim lives.

"Most people have heard of cholera but have never been touched
directly by cholera," Cormency added. "Next year [2011], it might
come up in the same state but in a different region."

Officials hope Nigeria will see fewer cases in the coming weeks as
the dry season approaches and local governments attempt to warn
people of the danger.

[Byline: David Smith]

--
Communicated by:
ProMED-EAFR

[The floods that have affected most of West Africa including Nigeria
have been blamed for the spate of cholera outbreaks in areas deprived
of access to safe water and sanitation facilities. The increasing
frequency and severity of floods in the region therefore calls for
better preparedness planning for the effects of climatic change
especially in sub-Saharan Africa.

Maps of Nigeria are available at
http://en.wikipedia.org/wiki/States_of_Nigeria and the
HealthMap/ProMED-mail interactive map at
http://healthmap.org/r/007*. - Mod.JFW]

See Also