ProMED-mail post

Published Date: 2012-07-16 10:13:05
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2012 (31): Africa, Asia
Archive Number: 20120716.1202434

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2012 (31): AFRICA, ASIA
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In this update:
Africa
[1] Cholera - Guinea
[2] Cholera - Somalia (Jubbada Hoose Province)
[3] Cholera - African Sahel
Asia
[4] Cholera - Philippines (Bicol Region)

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[1] Cholera - Guinea
Date: Tue 10 Jul 2012
Source: Agence France-Presse (AFP) [trans. LM, edited]
http://www.romandie.com/news/n/_Le_cholera_a_fait_une_quarantaine_de_morts_en_Guinee_depuis_fevrier23100720122130.asp

A cholera epidemic broke out in early February 2012 in Guinea, causing at least 41 deaths of 615 cases recorded, a medical source told AFP.

According to a report from the Department of Health and Public Hygiene of which AFP obtained a copy, 6 prefectures in 2 of Guinea's regions, Maritime Guinea (West) and Middle Guinea (North), were particularly hard hit by the epidemic.

The city of Forecariah, 110 km south of Conakry near Sierra Leone, where the 1st case was recorded on 2 Feb 2012, was the most affected with 24 deaths out of 303 registered cases. Next were the towns of Mamou with 7 deaths out of 35 cases recorded, Boffa with 6 deaths of 157 cases, and Boke Dubreka with 3 deaths in 35 cases recorded. In the capital Conakry, there was one death in a total of 82 cases reported by health services.

The report urged the Guinean Red Cross and Action against Hunger (ACF) present in Guinea to distribute chlorine solution and conduct an awareness campaign for drivers, workers in small restaurants, and travelers to avoid a spread of illness.

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[A ProMED-mail HealthMap for Guinea is available at http://healthmap.org/r/1tx-.]

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[2] Cholera - Somalia (Jubbada Hoose Province)
Date: Sat 14 Jul 2012
Source: Voice of America [edited]
http://www.voanews.com/content/world_health_organization_somalia_cholera_al-shabab/1404373.html

The WHO said on Fri 13 Jul 2012 that cholera is on the rise in Kismayo, an al-Shabab-held town in southern Somalia. At one Kismayo health facility, WHO officials say a rapid test found that 6 in 10 patients had cholera, 65 of whom have since been treated.

"It's a worrying sign so far; we will have to see what happens now in the next couple of days," says WHO spokesperson Pieter Desloovere. "But it may be an alert that something more is happening on the ground."

The WHO says Kismayo General Hospital has reported around 650 suspected cholera cases since the beginning of 2012, with 40 cases reported weekly since May 2012.

Islamist al-Shabab militants, who once controlled much of the country in their fight to overthrow Somalia's transitional government, have lost much of their territory to a multi-nation offensive over the past 18 months, but they still control Kismayo. "That particular area is where the opposing forces are sitting," says Desloovere. "They don't really allow chlorination of water, so what water people do use may be contaminated, and people do get sick."

"Cholera remains a global threat to public health and is a key indicator of lack of social development," says Tarik Jasarevic, a WHO spokesperson who calls the disease especially persistent in sub-Saharan Africa and Asia. "The re-emergence of cholera has been noted in parallel with the increasing size of vulnerable populations living in unsanitary conditions."

While official statistics on cholera are difficult to gauge, many cases go uncounted due to inadequate tracking of weak or under-resourced health systems, Jasarevic says some people fear the potential economic consequences of reporting outbreaks. "There is a fear of trade and travel sanctions if cholera is being reported," he says. "So we say the true burden of cholera is estimated at between 3 and 5 million cases every year."

[Byline: Selah Hennessy]

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[A ProMED-mail HealthMap for Somalia is available at http://healthmap.org/r/1Ahv.]

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[3] Cholera - African Sahel
Date: Fri 13 July 2012
Source: PR Web [edited]
http://www.sfgate.com/business/prweb/article/Cholera-Upsurge-Kills-More-Children-in-the-Sahel-3703987.php

As the rainy season unfolds across the Sahel, a recent upsurge of cholera that has killed over 60 people and sickened about 2800 in 2012 is putting more and more people, especially malnourished children, at risk, UNICEF warned today, 13 Jul 2012.

Last week, an outbreak in Northern Mali left 2 children dead and 34 other people sick, including a growing number of children, according to Mali's Ministry of Health. So far in 2012, cholera has killed nearly 700 people in West and Central Africa, and more than 29 000 cases have been reported.

Since mid-June 2012, the number of people affected by the deadly highly infectious waterborne disease has shot up in the Sahel, especially in Niger's regions bordering the Niger River, where nearly 3 times as many cholera patients have presented over the 1st half of 2012 compared to the same period in 2011. Niger is home to about 400 000 children who are expected to require life-saving treatment for severe malnutrition in 2012.

Cholera is a recurrent threat throughout the Sahel. In 2011, over 67 000 cholera cases were reported, mainly around the Lake Chad Basin countries (Chad, Cameroon, Nigeria), with 2153 deaths and an average case fatality rate of 3.2 percent. But in 2012, the outbreaks appear to be concentrated further to the west around Niger and Mali, where its impact is aggravated by massive displacement of people fleeing the conflict in northern Mali and puts more strain on the children already affected by an acute nutrition crisis.

While cholera cases appeared in Cameroon, Niger and Nigeria earlier in 2012, several other Sahel countries are now facing significant risks, with a sharp increase of cases expected with the onset of the rainy season.

"Malnutrition, displacement, and now rains in some parts of the Sahel create the ideal breeding ground for cholera, which hits young children hardest," said Tim O'Connor, UNICEF Australia spokesperson. "Unless we step up our efforts immediately, cholera will continue to claim the lives of the most vulnerable families in the Sahel and spread to other populated areas with a devastating impact."

Dr. Guido Borghese, UNICEF Principal Advisor for Child Survival and Development for West and Central Africa, added: "Cholera shows us how closely linked malnutrition is to unsafe water, poor sanitation and hygiene. A child below the age of 5 who has recovered from severe and acute malnutrition will be back for treatment in a matter of days or weeks if he or she is drinking contaminated water."

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[The Sahel (http://en.wikipedia.org/wiki/Sahel) is the ecoclimatic and biogeographic zone of transition between the Sahara desert in the North and the Sudanian Savannas in the south. It stretches across the north of the African continent between the Atlantic Ocean and the Red Sea. The Arabic word sahiil literally means "shore, coast," describing the appearance of the vegetation of the Sahel as a coastline delimiting the sand of the Sahara. The Sahel covers parts of the territory of (from west to east) Senegal, the southern part of Mauritania, Mali, the southern part of Algeria, Niger, Chad, and the southern part of Sudan and Eritrea. It is bordered on the north by the Sahara and on the south by the less arid savannah.

[A ProMED-mail HealthMap for the Sahel region of Africa is available at http://healthmap.org/r/1CnT .]

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[4] Cholera - Philippines (Bicol Region)
Date: Sat 14 Jul 2012
Source: Philippine Information Agency [edited]
http://www.pia.gov.ph/news/index.php?article=771342167638

Cholera cases in Bicol have reached an epidemic level, with 30 deaths and 3158 people affected in 1st half of 2012, an official of the Department of Health said on Fri 13 Jul 2012. Dr. Nestor Santiago, in an emailed report, said there were only 445 cases recorded from January to July of 2011. In 2011, there were only 4 reported deaths due to cholera, the DOH Regional Epidemiology and Surveillance Unit said. Santiago said the data were gathered from various government and private hospitals in Bicol's 6 provinces.

The DOH-RESU said cholera incidence in 2012 was reported high in the province of Catanduanes, with 1831 cases and 14 deaths. It was followed by Camarines Sur with 811 cases and 7 deaths, Sorsogon with 291 cases and 5 deaths; Albay recorded 168 cases and 4 deaths; Camarines Norte had 54 cases and Masbate 3.

The report indicated that except for Camarines Norte, which posted a 36 percent decrease on incidence from 84 cases in 2011 to 54 in 2012, all other 5 provinces had an increasing trend.

The DOH, becoming alarmed by the surging incidence of cholera, prompted health authorities to declare the disease as an epidemic. In connection with the rising health concern, Santiago issued an advisory last 2 Jul 2012 urging provincial, city and town executives to take necessary health interventions to avert the rising incidence of the disease.

[Byline: Marlon A. Loterte]

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[The Bicol Region (http://en.wikipedia.org/wiki/Bicol_Region) or Region V (also known as Bicolandia) is one of the 17 regions of the Philippines. Bicol (also spelled Bikol) is composed of 4 provinces on the Bicol Peninsula, the southeastern end of Luzon island, and 2 island-provinces adjacent to the peninsula. - Mod.LL

[A ProMED-mail HealthMap for the Philippines is available at http://healthmap.org/r/1pq_.]

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