ProMED-mail post

Published Date: 2008-10-07 15:00:32
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2008 (39)
Archive Number: 20081007.3174

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2008 (39)
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In this update:
Asia
[1] Cholera - Iraq
[2] Cholera - Pakistan (North-West Frontier)
[3] Diarrhea - Pakistan (North-West Frontier)
[4] Cholera - Afghanistan
Africa
[5] Cholera - Congo DR (North Kivu)
[6] Cholera - Nigeria (Kaduna)
[7] Cholera - Nigeria (Sokoto)
[8] Cholera - Senegal (Kaolack)

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[1] Cholera - Iraq
Date: Mon 6 Oct 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), Integrated Regional Information Networks (IRIN) News [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db900SID/PANA-7K6FXU?OpenDocument>

The number of confirmed cholera cases has risen to 418 in central and
southern Iraq, with 6 dead since an outbreak began on 20 Aug 2008, a
government spokesman said on 5 Oct 2008.

"We've registered 418 cholera cases in 10 provinces so far: Babil 222
cases, Baghdad 71, Basra 44, Karbala 34, Qadissiyah 30, Anbar 7,
Najaf 5, Maysan 3, and Diyala and Kut 1 case each," said Ihsan
Jaafar, director-general of the public health directorate and
spokesman for the ministry's cholera control unit.

Jaafar told IRIN that one new cholera-related death, a child under 5
in Qadissiyah Province, had been added to the already registered 5
fatalities: a 10-year-old girl and a 61-year-old man in Babil
Province; a 3-year-old boy in Maysan; and an adult and child in Baghdad.

He said that of the newly registered cases 228 were males and 190
females; in 159 cases the patients' ages were 5-70, with all other
cases being among the under 5.

About 25 km (15.5 mi) to the west of Qadissiyah's capital, Diwaniyah,
residents of al-Kafi village (population 4000), where the new death
occurred, complained about poor public infrastructure and health
services and called for immediate help.

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[The areas affected in central and southern Iraq can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/iraq.pdf>. - Mod.LL]

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[2] Cholera - Pakistan (North-West Frontier)
Date: Fri 3 Oct 2008
Source: eFluxMedia [edited]
<http://www.efluxmedia.com/news_Cholera_Outbreak_in_Pakistans_Violence_Hit_North_West_25712.html>

Health authorities treated hundreds of patients affected by a cholera
outbreak in Pakistan's conflict-ridden Swat mountain district, a
media report said Friday [3 Oct 2008].

At least 600 suspected cases were reported in the past 3 days in
Swat, where security forces have been battling Islamist militants for
nearly a year, the Urdu-language Aaj news channel said.

On Thursday [2 Oct 2008], 2 children admitted to a state-run hospital
in Saidu Sharif died from cholera. The town appeared to be the
worst-affected area as more than 100 patients were registered Friday
[3 Oct 2008].

Scores of people in the adjacent areas of Mingora and Saidu Sharif
also complained of symptoms of the potentially fatal disease, which
is mainly transmitted through contaminated water. The supply of
potable water piped from reservoirs was suspended to most parts of
Swat 2 weeks ago after insurgents blew up a key grid station in
Mingora, forcing a large number of people to use water from streams
and underground sources.

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The area is in the North-West Frontier Province (NWFP), the smallest
of the 4 main provinces of Pakistan. The NWFP borders Afghanistan to
the northwest as can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/pakistan.pdf>. - Mod.LL]

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[3] Diarrhea - Pakistan (North-West Frontier)
Date: Sun 5 Oct 2008
Source: The International News [edited]
<http://www.thenews.com.pk/daily_detail.asp?id=139200>

Our correspondent from Mingora reports that military officials handed
over medicines in huge quantity to Saidu Sharif Hospital Medical
Superintendent Muhammad Khan, as around 1500 people were affected by
gastroenteritis and the hospital was packed with patients of the
water-borne disease.

In a press statement issued here at the media information center,
officials of the Pakistan Army also promised to provide financial
assistance to hospital administration to help them tackle the
situation after the outbreak of gastroenteritis and other water-borne
diseases in the area.

The officials of the Medical Corps of the Pakistan Army are also
giving technical support to the hospital as it lacks the staff to
deal with the influx of the gastroenteritis patients in the last 4 days.

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[It is unclear if this outbreak is the same as the one reported in
the newswire above. It is certainly possible that both cholera and
other enteric diseases are co-circulating. - Mod.LL]

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[4] Cholera - Afghanistan
Date: Tue 7 Oct 2008
Source: UN Office for the Coordination of Humanitarian Affairs
(OCHA), Integrated Regional Information Networks (IRIN) News [edited]
<http://www.irinnews.org/Report.aspx?ReportId=80777>

An outbreak of El Tor cholera in northern, eastern, and southeastern
Afghanistan has killed at least 17 people, mostly women and children,
in the past few weeks, the Ministry of Public Health (MoPH) said on 6 Oct 2008.

Over 1100 people with diarrhoea and vomiting caused by the outbreak
have received treatment at medical facilities in 13 of the country's
34 provinces. The worst affected provinces are Laghman, Nooristan,
and Nangarhar (in the east); Samangan and Faryab (north); and Nimruz
(west), the MoPH said.

"It's not a classic cholera which quickly turns into an epidemic,"
Abdullah Fahim, a spokesman for the MoPH, told IRIN. El Tor (a strain
of the bacterium _Vibrio cholerae_) is less fatal, Fahim said.

Less than 24 percent of Afghanistan's estimated 26.6 million people
have access to improved drinking water and only 12 percent have
access to improved sanitation, according to the UN Children's Fund
(UNICEF). A severe drought affecting large swaths of the country has
made life very difficult for many communities, forcing people to use
unsafe water for drinking, washing, and cooking.

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[Formally, the 2 established biotypes of _Vibrio cholerae_, classical
and El Tor, can be distinguished from one another by a number of
phenotypic properties including hemolysis of sheep red blood cells,
agglutination of chicken red blood cells, the Voges-Proskauer
reaction, as well as susceptibility to polymyxin B and to
biotype-specific viral bacteriophages. Hybrid biotypes, so-called
Matlab variants, are also described (Nair GB, Faruque SM, Bhuiyan NA,
et al: New variants of _Vibrio cholerae_ O1 biotype El Tor with
attributes of the classical biotype from hospitalized patients with
acute diarrhea in Bangladesh. J Clin Microbiol 2002; 40(9): 3296-9;
abstract available at
<http://www.ncbi.nlm.nih.gov/pubmed/12202569>.)

A map of Afghanistan can be found at
<http://www.un.org/Depts/Cartographic/map/profile/afghanis.pdf>.
The eastern affected area is close to the areas in Pakistan where
cholera is also active. - Mod.LL]

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[5] Cholera - Congo DR (North Kivu)
Date: Fri 3 Oct 2008
Source: International Herald Tribune (IHT), Associated Press (AP)
report [edited]
<http://www.iht.com/articles/ap/2008/10/03/africa/AF-Congo-Cholera.php>

Medical officials say 37 people have died in 2 weeks from a cholera
outbreak in camps for those fleeing fighting in eastern Congo.

Regional medical inspector Dominique Bahago says at least 300 people
have been infected by the outbreak around the village of Ngungu,
about 100 kilometers (60 miles) northwest of the regional capital of Goma.

Bahago says at least 25 000 people are living in 2 makeshift camps in
the area, which is near UN peacekeeping positions.

Bahago says there has not been enough water for the surge of people
and that continuing fighting in the region has kept the government
from getting to the camps.

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[The area is in the North Kivu district and can be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/drcongo.pdf>. - Mod.LL]

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[6] Cholera - Nigeria (Kaduna)
Date: Tue 7 Oct 2008
Source: Leadership Nigeria [edited]
<http://www.leadershipnigeria.com/product_info.php?products_id=35330&osCsid=aaae820ffefcc2aa3e35262eef556b64>

Following an outbreak of cholera in Zonkwa, headquarters of Zangon
Kataf local government area of Kaduna State, about 9 persons have
reportedly lost their lives within one week.

Leadership source, Kabiru Hassan, said the number might have
increased, saying "We have been receiving reports about deaths [from]
cholera and we are calling on the authorities to expedite action, so
that it will come to an end."

[Byline: Samuel Peter Aruwan]

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[The north central state of Kaduna can be found on a map of Nigeria at
<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf>. - Mod.LL]

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[7] Cholera - Nigeria (Sokoto)
Date: Fri 3 Oct 2008
Source: AllAfrica, Daily Trust (Abuja) report [edited]
<http://allafrica.com/stories/200810030134.html>

No fewer than 21 people have been reported dead in some villages in
Kware and Wamakko local government areas of Sokoto State. The
breakdown from health officials in the affected local government
areas shows that 14 people died in Kware while 7 died in Wamakko
local government area.

Briefing newsmen in Maruda village of Kware local government, the
health official in charge of a camp created for victims in the area,
Malam Aliyu Amadu, said 13 children and an adult died from the
disease while the director of health in Wamakko local government,
Malam Abubakar Mohammed Kaura, confirmed the death of 7 people in the area.

Meanwhile, the state commissioner of information Malam Dahiru
Maishanu has confirmed that only 2 people lost their lives at the
hospital "and that is the only figure we have officially but I am not
overruling a number of deaths outside the hospital."

The commissioner said the outbreak was reported in 12 local
government areas of the state "but only 3 are now having reported
cases." The 3 local governments are, Kware, Dange Shuni, and Wamakko.

[Byline: Aminu Mohammed]

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[Sokoto is in extreme northwestern Nigeria bordering with Niger and
can be seen on a map at
<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf>. - Mod.LL]

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[8] Cholera - Senegal (Kaolack)
Date: Sat 4 Oct 2008
Source: Walf Fadjri [in French, trans. & summ. Mod.LL, edited]
<http://www.walf.sn/societe/suite.php?rub=4&id_art=49896>

A cholera outbreak has been newly declared in villages of Ndoffane
and Kaffrine, which have respectively recorded in recent days 14 and 2 cases.

The last figures noted within the 2 villages, add to the overall
number of now 481 since July 2008. The persons affected are in the
health region of Kasnack in Kaolack.

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HealthMap Alerts via ProMED-mail
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[The area is in the Kaolack region as can be found on a map at
<http://www.un.org/Depts/Cartographic/map/profile/senegal.pdf>. - Mod.LL]

[The outbreaks reported in this update can also be found on the
HealthMap/ProMED-mail interactive map at
<http://www.healthmap.org/promed>. - Mod.LL]

See Also