ProMED-mail post

Published Date: 2012-09-26 23:52:36
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2012 (44): Africa, Asia
Archive Number: 20120926.1308678

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2012 (44): AFRICA, ASIA
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In this update:
Africa
[1] Cholera - Sierra Leone
[2] Cholera - Sierra Leone, Guinea
[3] Cholera - Ghana (Greater Accra, Upper East regions)
[4] Cholera - Ghana (Volta region)
[5] Cholera - Somalia (Lower Juba region)

Asia
[6] Cholera - India (Jammu and Kashmir State)

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[1] Cholera - Sierra Leone
Date: Wed 19 Sep 2012
Source: China Central Television (CCTV), Xinhua News Agency report [edited]
http://english.cntv.cn/20120919/101308.shtml

A total of 18 508 cases have been reported in the ongoing cholera outbreak in Sierra Leone as of 16 Sep 2012 since the beginning of 2012, and of these 271 people died, the WHO said Tue 18 Sep 2012. The highest numbers of cases are reported from the western area of the west African country where the capital city of Freetown is located, according to WHO.

The Ministry of Health and Sanitation of Sierra Leone has been stepping up response to the outbreak. Emphasis is being placed on early detection of cases and timely provision of treatment at the district levels in order to reduce deaths, the WHO said. WHO has deployed case management and laboratory experts through the Global Outbreak Alert and Response Network [GOARN] to build capacity among health-care workers and laboratory technicians in case management and laboratory diagnosis.

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[2] Cholera - Sierra Leone, Guinea
Date: Mon 24 Sep 2012
Source: gantdaily.com, UN Integrated Regional Information Networks (IRIN) News [edited]
http://gantdaily.com/2012/09/24/cholera-outbreak-easing-in-guinea-and-sierra-leone/

The cholera outbreak in Guinea and Sierra Leone that has killed 392 people and infected more than 25 000 others since February 2012 is slowing down, say aid groups who also call for sustained measures to wipe out the disease. Between late August 2012 and 16 Sep 2012, new cholera cases per week have dropped from 2110 to 1418 in Sierra Leone and from 1152 to 346 in neighboring Guinea, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said in a report.

"The situation is improving faster in Guinea in terms of new cases and in Sierra Leone in terms of lethality. The number of affected districts remains unchanged: 12 out of 13 in Sierra Leone and 11 out of 33 in Guinea," OCHA said. In Sierra Leone, updates from 84 health centres in the hardest hit Western Area indicated that there were 112 cases and one death in 32 health centers, and no deaths or cases in the rest on 18 Sep 2012, according to the UN Children's Fund (UNICEF).

"I think it doesn't necessarily mean it [the cases] would not go up. It does seem that things are getting better, but we need to be cautious. It's certainly a good sign of the huge amount of work we have been doing," said Nicole Robicheau of the International Federation of Red Cross and Red Crescent Societies.

The outbreak is Sierra Leone's worst in 15 years. The government declared a national emergency in August 2012. The authorities and aid groups have rallied to treat thousands of infected people, educate the population on basic hygiene practices and sanitize water sources. "In the long run cholera prevention is a question of hygiene and sanitation, especially in densely populated areas. Access to safe water and sanitation facilities remains very limited in Sierra Leone," said Angela Griep, UNICEF's external relations chief in Sierra Leone.

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[3] Cholera - Ghana (Greater Accra, Upper East regions)
Date: Mon 24 Sep 2012
Source: GhanaWeb [edited]
http://www.ghanaweb.com/GhanaHomePage/NewsArchive/artikel.php?ID=251228

Over 200 cases of cholera have been recorded within 2 weeks in the Greater Accra region, raising concerns about the sanitation situation in the region's busy centers. Health officials say they are marveled by the increase in the figures and say they intend intensifying their sensitization programs.

Last week [week of 17 Sep 2012], there were reports of an outbreak of the disease in parts of the Upper East Region following the floods in the area.

The Disease Control Officer at the regional Ghana Health Service unit, Ato Ashong told XYZ News some drastic measures will have to be taken to reverse the trend.
According to Mr Ashong, the cases have shot up from double figures to more than 200 cases in the last few days.

He said the unit is not certain about what might have caused the sudden upsurge in the disease but assured that it will be liaising with health centers across the region to handle the cases.

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[4] Cholera - Ghana (Volta region)
Date: Thu 20 Sep 2012
Source: GhanaWeb [edited]
http://www.ghanaweb.com/GhanaHomePage/health/artikel.php?ID=250925

Information reaching Today indicates that 10 people have died from the cholera outbreak in some parts of the Volta Region. According to the sources, 5 of the deaths were recorded in Akatsi South while the 6th death was recorded in Adidome, and 4 were recorded at the Battor-Aveyime Traditional area in the North Tongu District.

Insiders revealed that about 14 electoral areas in the Akatsi District and North and Central Tongu Districts in the region are all battling with the disease, for which several people have been hospitalised at Battor Roman Catholic Hospital, Akatsi, and Sogakope Government Hospital in the region. Speaking on various media networks to confirm the deaths of the people in the region, the Assemblyman for the Wute Electoral Area, Sammy Wuadi, said the cholera outbreak did not come as a surprise and that the people are being reminded to keep their surroundings clean.

Environmental Health Assistant in the Akatsi South District, who pleaded anonymity, told Today that residents in the region are being advised to desist from drinking from the Tordji River, which is believed to have been contaminated. "We suspect that that is the source of the cholera outbreak and we are also educating them to be careful with the food they eat," they said.

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[5] Cholera - Somalia (Lower Juba region)
Date: Tue 18 Sep 2012
Source: AllAfrica, UN Integrated Regional Information Networks (IRIN) News [edited]
http://allafrica.com/stories/201209181341.html

A suspected cholera outbreak has killed about a dozen people in the southern Somali village of Hoosingo, in the district of Badade in Lower Juba, say government and health officials. "One of the biggest problems we have is that we do not [know] what this disease is," Adan Ibrahim Dhaqane, the Hoosingo Village commissioner, told IRIN by telephone. "Schools, madrasas [schools or colleges for the study of the Islamic religion], [and] restaurants are all closed to prevent the disease from spreading," he said.

Dhaqane said that at least 19 people had died since the outbreak started on 5 Sep 2012, with 12 others sick. "We call [on] the aid agencies to help us in the following areas: provision of a steady supply of medicine, [the] identification of the disease, and the setting up of health centres. We have no hospital, no MCH [maternal and child health centre], and no other health facility, simply tents."

According to a recent Somalia emergency health update by the WHO, some 12 deaths and 107 cases of the disease were reported between 5-13 Sep 2012, the majority of them being children above the age of 5.

Hoosingo is located about 100 km [62 mi] from the Kenya-Somalia border town of Liboi and is not served by any health facilities, notes the WHO update, which expresses concern about the increased risk of a widespread cholera outbreak in Lower Juba Region and along the Kenya-Somalia border.

"Suspected cases have [also] been reported from Waraq, some 70 km [43.5 mi] from Liboi. These areas [Hoosingo and Waraq] are transit points into Kenya, hence the risk of cross-border transmission," stated the emergency health update.

Insecurity in parts of the Lower Juba region has rendered some areas inaccessible. "With the ongoing conflict and subsequent population displacement and disruption of the existing health service access points in the region, the risk of sporadic cholera outbreaks in the Southern zone cannot be excluded," notes the WHO update, urging health and water and sanitation partners to remain vigilant and report any suspected cases of the disease.

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[6] Cholera - India (Jammu and Kashmir State)
Date: Mon 24 Sep 2012
Source: Greater Kashmir News [edited]
http://www.greaterkashmir.com/news/2012/Sep/25/238-diagnosed-with-cholera-in-north-kashmir-73.asp

In a matter of grave concern for health officials in the Kashmir Valley, at least 238 patients were diagnosed with cholera in north Kashmir's Baramulla district with Public Health Authorities saying that all the water samples collected from the areas are "grossly contaminated" and tested positive for fecal matter.

"We have treated over 500 patients for different water-borne diseases in Baramulla and 238 patients were declared as cholera cases after clinical suspicion by the doctors in various district hospitals. They mostly live in Tangmarg, Kunzer, and Pattan areas," sources told Greater Kashmir. The clinical suspicion emerged from the microbiological analysis by the public health officials in the district.

[Byline: Manzoor-Ul-Hassan]

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