ProMED-mail post

Published Date: 2007-08-19 23:03:59
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2007 (27)
Archive Number: 20070819.2708

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (27)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
Africa
[1] Cholera - Guinea
[2] Cholera - Sudan (Gedaref)
[3] and [4] Cholera - Ghana (Northern Region)
[5] and [6] Cholera - Angola
[7] Cholera - Comoros Islands (Grand Comoros)
Asia
[8] Cholera - India (Tamil Nadu)
[9] and [10] Diarrhea - Bangladesh
******
[1] Cholera - Guinea
Date: Tue 14 Aug 2007
Source: Reuters [edited]
<http://africa.reuters.com/wire/news/usnL1448707.html>

Cholera has killed dozens of people in Guinea since seasonal rains
arrived a few weeks ago, taking the death toll to 47 since the start
of 2007, the health ministry said.
Cholera is spread via water or food contaminated with feces and
becomes more common in West Africa's rainy season, during the
northern hemisphere's summer.
"In the last few days, there have been several deaths from cholera,"
Dr Emmanuel Rolland Malano, head of the health ministry's cholera
unit, told Reuters. "Of 1240 cases registered in hospitals and health
centres in Guinea (since 1 Jan 2007), there have been 47 deaths," he said.
The worst hit locations were the southeastern area around the remote
town of Gueckedou, where 17 people had died, and the coastal capital
Conakry, some 800 km (500 miles) away, where the disease claimed 14 lives.
Most of Guinea's 10 million people scrape by in poverty despite
living on top of 1/3rd of the world's known reserves of bauxite, the
ore used to make aluminum.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[A map of the country of Guinea can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/guinea.pdf>.
Conakry can be found in Kinida, in the southwest, and Gueckedou in
Nzerekore, in the southeast. - Mod.LL]
******
[2] Cholera - Sudan (Gedaref)
Date: Tue 14 Aug 2007
Source: Reuters [edited]
<http://africa.reuters.com/wire/news/usnL14783281.html>

A cholera outbreak in eastern Sudan, which has spread due to
devastating floods across the region, has killed 49 people and
affected some 710 others, a World Health Organisation (WHO) official
said on Tue 14 Aug 2007.
In 2006, a cholera outbreak throughout Sudan killed 700 people and
affected 25 000. It was the 1st time in many years the waterborne
disease had been reported in Africa's largest country.
WHO official Mohamed Abder Rab said all the recent cases had been
reported in the eastern Gedaref state and Kassala town, with the 1st
reported on 19 Apr 2007.
"The situation in Gedaref is not yet under control ... Flooding is
spreading the waterborne disease," Rab told Reuters before traveling
to the east to verify conditions in the region hit by the worst
flooding in living memory in Sudan. "Latrines are flooded ... houses
are destroyed. People are living on the fringes. They don't have
proper drinking water or latrine facilities, and hygiene is
compromised," he added.
Rab said Sudan's government had been reluctant to announce the
outbreak. "Historically most governments don't want to admit cholera
because of the international ramifications and local ramifications,"
he said, adding it could affect tourism.
The little tourism Sudan has is mainly to its Red Sea diving resorts
in the east or for Sudanese honeymooners to the picturesque Kassala town.
He said governments are required to report contagious diseases such
as cholera. "There are certain diseases that have a potential for
international spread, cholera being one of them, and they have to be
reported," he added. Sudan borders 9 African countries, with Eritrea
and Ethiopia to the east.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
A map of Sudan showing the eastern state of Gedaref can be found at:
<http://www.un.org/Depts/Cartographic/map/profile/sudan.pdf>.
In 2006, many of the cholera cases were in the southern states. - Mod.LL]
******
[3] Cholera - Ghana (Northern Region)
Date: Tue 14 Aug 2007
Source: My Joy Online [edited]
<http://www.myjoyonline.com/health/200708/7598.asp>

13 people in the Nalong electoral area in the Tamale metropolis are
reported dead following a suspected outbreak of cholera. An Assistant
Director at the Tamale metropolitan assembly, Iddrisu Karim, who
disclosed this to Joy News says the victims experience vomiting and
diarrhea in 3 areas of the metropolis: Bayon-Waya, Lamashegu and Nalong.
Mr Karim said the assembly was liaising with the metropolitan health
directorate to deal with the problem and has also informed Ministry
of Health in Accra for assistance.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[The city of Tamale is the capital of the Northern Province of Ghana
and can be found on a map of the country at:
<http://www.un.org/Depts/Cartographic/map/profile/ghana.pdf>.
- Mod.LL]
******
[4] Cholera - Ghana (Northern Region)
Date: Fri 17 Aug 2007
Source: The Statesman [edited]
<http://www.thestatesmanonline.com/pages/news_detail.php?newsid=4476§ion=1>

A cholera outbreak has been detected at Nalon Fong, a suburb of the
Tamale metropolis in the Northern Region. 19 people have died so far,
2 yesterday [16 Aug 2007], since the outbreak was reported last week.
According to the Acting Northern Director of the Ghana Health
Service, Seidu Kokor, poor environmental management compounded by the
recent rains in the metropolis caused the outbreak. He noted that,
for the past months pipes in the area have been locked, therefore the
people depend on an unhygienic source of water located in the area
for various usages, including drinking and cooking, among others.
Meanwhile, residents in the outbreak area, who attributed the cause
of deaths to witchcraft, nearly lynched an alleged witch to death.
The woman (name withheld), believed to be in her 50s, was found
unconscious when the Assemblyman and other residents intervened.
[Byline: Hamza Lansah Lolly]
--
Communicated by:
ProMED-mail Rapporteur Brent Barrett
******
[5] Cholera - Angola
Date: 14 Aug 2007
Source: AllAfrica.com and Angola Press Agency [edited]
<http://allafrica.com/stories/200708141003.html>

Nine cases of cholera and 4 deaths were registered last week in the
provinces of Luanda, Malanje and Benguela, ANGOP has learned from a
document of the Health Ministry. According to the communication, 78
percent of the cases were registered in the southern Benguela
province, while 22 percent were shared by the northern provinces of
Luanda and Malanje.
According to the document, there was a reduction of cases compared to
the previous week.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[The mentioned provinces can be found on a map of the country of Angola at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>.
- Mod.LL]
******
[6] Cholera - Angola
Date: Mon 13 Aug 2007
Source: News24 [edited]
<http://www.news24.com/News24/Africa/News/0,,2-11-1447_2164190,00.html>

Almost 420 people have been killed by cholera in Angola since the
start of 2007, according to figures released on Mon 13 Aug 2007 by
the World Health Organization (WHO) in Luanda.
A total of 16 320 cases were reported in 16 out of the country's 18
provinces, with Luanda, the nation's capital, recording the highest
figure of 6692 cases, followed by Benguela and Cabinda provinces,
which recorded 3681 and 1721 cases respectively, the WHO said.
The highest number of deaths, 102, was recorded in Kwanza Sul
province, followed by Luanda with 77 and Malange with 46.
The easily treatable waterborne disease broke out in Luanda's
northern slum of Boa Vista in February 2006. It then spread across a
country whose infrastructure has been ravaged by civil war and where
drinking water and proper sanitation are luxuries.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[The mentioned provinces can be found on a map of the country of Angola at:
<http://www.un.org/Depts/Cartographic/map/profile/angola.pdf>.
- Mod.LL]
******
[7] Cholera - Comoros Islands (Grand Comoros)
Date: Mon 13 Aug 2007
Source: UN Integrated Regional Information Networks (IRIN) [edited]
<http://allafrica.com/stories/200708131151.html>

Until the traditional wedding season kicked off in July 2007 on Grand
Comore, largest of the 3 islands that make up the Comoros
archipelago, cholera was almost under control.
"This is an outbreak; we have seen over 800 cases, and 14 people have
died since February 2007," Josefa Marrato, country representative for
the UN's children fund (UNICEF), told IRIN. Grand Comore, with 300
000 people, is home to almost half the Indian Ocean archipelago's
total population.
Cholera is not new to the Comoros: there were epidemics in 1975, 1998
and 2000, said Abderamane Maiga, Officer in Charge at the World
Health Organisation (WHO) on Grand Comore (or Grand Comoros), adding
that since the current outbreak started in February 2007, July and
August have seen a dramatic spike in new cases.
Poor sanitation, crumbling sewage systems, streets filled with
garbage and a lack of potable water are the root causes of the
outbreak, but food served at traditional wedding parties has been
blamed for spreading the disease so rapidly.
"Cases have gone up due to the festivities; people get together, eat
together, but are not taking the appropriate hygiene measures," said
Marrato. "Cholera had been almost under control until July 2007, when
the 'Grand marriage' festivities started."
Elaborate and expensive public weddings marked by copious consumption
take place throughout the islands during July and August. The timing
coincides with the European holiday season when the Comoran diaspora
-- mainly resident in France -- returns for 'Grand Marriage,'
literally, 'great wedding'. The county's economy is heavily dependent
on migrant remittances from the 150 000 Comorans estimated to be living abroad.
Cholera had been almost under control until July, when the 'Grand
marriage' festivities started.
Having a 'Grand Marriage', which can cost up to 30 000 USA dollars
and last from one to 3 weeks, is usually reserved for the wealthy but
is attended by all, and the host family often feeds entire
communities. "They involve the whole village and the neighboring
villages," Maiga said.
In a communication last week, the government warned of the
significance of the Grand Marriage festivities and their apparent
link to the outbreak. "The government asked people not to have them
[festivities] and to restrain from eating together," Marrato said.
But calling off or postponing a traditional occasion that has
required years of planning and a lifetime of scrimping and saving is
often not considered an option.
Measures have also been taken to ensure that the disease does not
spread to the other islands, Anjouan and Moheli, by informing
travelers about the disease and the hygiene measures they can take to
protect themselves.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[Grand Comoros is the largest and most northern and western of this
island nation, which is located in the Indian Ocean between
Madagascar and the African continent. The islands can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/comoros.pdf>.
- Mod.LL]
******
[8] Cholera - India (Tamil Nadu)
Date: Sun 19 Aug 2007
Source: New Kerala [edited]
<http://www.newkerala.com/july.php?action=fullnews&id=54749>

As many as 17 students of a private missionary school were admitted
to the government headquarters hospital here with symptoms of cholera.
Official sources said a section of students of the Sacred Heart
Higher Secondary School Hostel at Usilampatti suffered from vomiting
and diarrhea and were rushed to the hospital.
The sources said already about 40 people from different parts of the
district had been admitted to the hospital with similar complaints.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[A map of India showing the location of the southern state of Tamil
Nadu can be found at:
<http://www.maps-india.com/images/india-map.jpg>.
- Mod.LL]
******
[9] Diarrhea - Bangladesh
Date: Wed 15 Aug 2007
Source: USA Today [edited]
<http://blogs.usatoday.com/ondeadline/2007/08/53000-in-bangla.html>

Widespread flooding has killed nearly 500 people in Bangladesh, and
more than 53 000 others have life-threatening diarrhea caused by
water-borne infections, according to Reuters.
Yesterday, 14 Aug 2007, one facility in Dhaka treated 1100 people for
severe cases of diarrhea. "We suspect the flow will increase
further," Dr. Azharul Islam Khan tells the wire service.
In Pakistan, the International Federation of Red Cross and Red
Crescent Societies reports that flood victims "are resorting to
drinking filthy, green ditch water" after monsoon rains that
destroyed farmland and devastated parts of the country's infrastructure.
The World Health Organization reports that diarrhea is thought to
have killed 2.2 million people in 1998.
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[A map of the country of Bangladesh showing the location of its
capital, Dhaka, can be found at:
<http://www.pnm.my/mtcp/images/maps/Bangladesh-map.jpg>.
- Mod.LL]
******
[10] Diarrhea - Bangladesh
Date: Sun 12 Aug 2007
Source: Xin Hua Net [edited]
<http://news.xinhuanet.com/english/2007-08/13/content_6519671.htm>

Paramedics are pushing trolleys inside one after another, and doctors
are running and pushing intravenous saline to patients coming from
flood affected areas. It is Sunday morning in the specialized
International Center for Diarrheal Diseases and Research, Bangladesh
(ICDDRB), the main hospital for treating patients of diarrhea and
cholera in the country, which is located in capital Dhaka.
"You see we are in a difficult situation now. We have not seen such a
situation since 1962 when the hospital was founded," acting chief of
the hospital Dr. Pradip Kumar Bhandari told Xinhua on Sun 12 Aug
2007. Bhandari said a total of 7200 diarrhea patients have been
admitted to the hospital since 1 Aug 2007, and on Fri 10 Aug 2007,
they received 1000 diarrhea patients. Both figures are the highest in
45 years. On Sat 11 Aug 2007, the number was 900, compared to the
normally 250 diarrhea patients seen each day before the flooding.
Doctors said the patients are pouring into the hospital from
different parts of the country, particularly from eastern part of the
capital affected by the flood. Bhandari said the hospital has a
capacity of 350 patients at a time, and now they have opened 2
makeshift camps on the campus with 350 additional beds to receive
more patients, as diarrhea broke out in an epidemic form in the
flood-hit areas.
Bhandari said if situation demands, his hospital will set up one more
makeshift camp. "Our priority is now to save life. We are doing our
best to save all the patients admitted here," Bhandari said. "To
tackle the situation, we have recruited over 100 doctors and
paramedics," he said.
However, Dr. Nurul Islam of the control room of Health Directorate
under the Health Ministry told Xinhua that around 1000 people, mainly
children, die of diarrhea out of 2.2 million affected by the disease
across the country each year.
--
Communicated by:
ProMED-mail <promed@promedmail.org>

See Also