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CHOLERA, DIARRHEA AND DYSENTERY (61): AFRICA
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
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In this update:
[1] Cholera - Cameroon (Far North Region)
[2] Cholera - Nigeria (Plateau State)
[3] Cholera - Ghana (Eastern Region)

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[1] Cholera - Cameroon (Far North Region)
Date: 6 Aug 2014
Source: UN Office for the Coordination of Humanitarian Affairs [edited]
http://www.irinnews.org/report/100447/c ... n-cameroon


Rains and insecurity caused by Nigerian Islamist militants are aggravating a cholera outbreak in northern Cameroon which has killed at least 75 people and infected some 1400 others since April 2014. Water scarcity, poor public health care, and risky hygienic practices have rekindled the disease, which badly hit the country between 2009 and 2011, experts say. Population movement during the current school holidays could help spread infections to other regions of Cameroon or even to neighboring countries, said Felicite Tchibindat, a UN Children's Fund (UNICEF) representative in Cameroon.

The 1st cholera case was in a Nigerian family who were among a group of refugees fleeing to Cameroon from bombings and attacks by Nigeria's Boko Haram extremist militia in April 2014. Scarcity of safe drinking water, open defecation, and other poor hygienic habits have exacerbated the cholera cases in northern Cameroon, Tchibindat said. More than 26 000 cholera cases have been reported in Nigeria since the start of the year [2014], according to health authorities.

Cameroon's Far North, North, Adamaoua and East regions suffer chronic shortages of health workers. Nationally, there are 1.43 healthcare personnel per 1000 people. In the Far North Region, for instance, the ratio is 0.47 doctors for 1000 people. Most of the staff deployed to the remote regions "feel that it is a punishment," the UNICEF representative said. More than half of the country's health workers are in the Central, Coastal and Western regions, which host the 3 largest cities of Yaounde, Douala and Bafoussam.

"Most hospitals lack facilities to test and treat patients in good time," said Peter Tambe, a health expert in Maroua, the capital of the Far North Region, where 97 percent of the cholera cases have been reported.

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[2] Cholera - Nigeria (Plateau State)
Date: Wed 6 Aug 2014
Source: Daily Independent [edited]
http://allafrica.com/stories/201408060047.html


Three persons have lost their lives following reported cases of a cholera outbreak in Gumbur Ward of Wase Local Government of Plateau State.

The Council Chairman, Mr. Zakari Abdul, told newsmen on Tuesday [5 Aug 2014] in Wase in Southern zone of the state that the disease broke out in the locality last Sun 3 Aug 2014, adding that 34 other persons from the area were suffering from diarrhea.

Abdul said he had reported the matter to the state Ministry of Health for assistance considering the number of persons affected. He called on the people of the affected area and the people of the council to be hygienic so as to prevent the spread of the disease.

The chairman, who spoke through the Director of the Primary Health Care (PHC) Department, Mr. Ayuba Ahuta, said it was the 2nd time the state was experiencing a cholera outbreak in the council. He said 2 persons were killed and 40 affected by last month's [July 2014] outbreak recorded in Gaji, Zak and Wase town.

[Byline: Onoja Audu]

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[3] Cholera - Ghana (Eastern Region)
Date: Tue 5 Aug 2014
Source: Ghana Broadcasting Corporation [edited]
http://www.gbcghana.com/1.1799430


Reports from the Eastern Regional Directorate of Health Services indicate that the region has been hit by a cholera outbreak. For the past 2 weeks, the region has recorded 121 cases of cholera in 6 districts, namely, Nsawam-Adoagyiri, Upper West Akim, New Juaben, Kwahu West, Suhum, Ayensuano and Akwapim North.

The Eastern Regional Disease Control Officer, Emelia Okine, who uncovered this outbreak in an exclusive interview with a Radio Ghana Correspondent in Koforidua, said Nsawam-Adoagyiri Municipality leads with 93 cases, followed by the New Juaben Municipality, which has also recorded 19 cases.

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[A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/6075.]

HEPATITIS E - ETHIOPIA: (GAMBELLA) REFUGEES
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Date: Fri 8 Aug 2014
Source: Outbreak News Today [edited]
<outbreaknewstoday.com/un-agency-works-with-ethiopia-in-hepatitis-e-battle-95287/>


As South Sudanese refugees poured into Ethiopia over the past 2 years, the Ethiopian government has been battling an outbreak of hepatitis E at 3 of the border refugee camps. Ethiopia is home to 247 554 South Sudanese refugees, including more than 185 000 who have fled since fighting broke out in mid-December 2013.

According to data from The Office of the United Nations High Commissioner for Refugees (UNHCR), since April [2014], there have been 367 cases of hepatitis E in Leichuor, Kule, and Tierkidi camps, which are all located in the Gambella region of western Ethiopia, bordering South Sudan. Laboratories in Addis Ababa and Nairobi confirmed that the virus is related to the hepatitis E outbreak reported in neighboring South Sudan. 6 more cases were reported in the refugee hosting communities of Itang and Nyin-yan. There has been 13 fatalities reported.

The UN agency is working with the Ethiopians on containing the viral outbreak. This includes providing safe drinking water, promoting hygiene, distribution of soap, and the building of latrines.

Hepatitis E has been the cause of several outbreaks and sporadic cases over large geographical regions. The hepatitis E virus is contracted and spread through consuming contaminated water. However, people can also contract the virus through contaminated food, transmission from animals to humans, blood transfusions, and from pregnant women to their newborn.

The clinical course of hepatitis E is similar to that of hepatitis A [except in immune suppressed patients - Mod.LL] without a chronic form of the disease. Jaundice, fever, loss of appetite and lethargy are common symptoms.

The fatality rate is low with the exception of pregnant women where it can reach 20 percent among those infected in the 3rd trimester. Liver failure is a frequent outcome with pregnant women. There is no treatment for acute hepatitis E, therefore, prevention is key.

[Byline: Robert Herriman]

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[As noted in the posting, a hallmark of epidemic hepatitis E is a high case fatality rate in pregnant women (especially in the last trimester). Fulminant hepatic failure occurs in this cohort and may be caused by immunological and endocrinological changes occurring in pregnancy. In maternal survivors, infection of the baby occurs often. Deaths can also occur in those with preexisting liver disease of any type.

Treatment of some cases of hepatitis E virus (HEV) infection, acute or chronic, has been effective using ribavirin monotherapy (1). Additionally, a recombinant vaccine is being studied and appears to be safe and effective (2).

References
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1. Gerolani R, Borentain P, Raissouni F, et al: Treatment of severe acute hepatitis E with ribavirin. J Clin Micribiol 2011; 52(1); 60-2; abstract available at http://www.ncbi.nlm.nih.gov/pubmed/21764632.
2. Zhu FC, Zhang J, Zhang XF, et al: Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults; a large scale, randomised, double-blind placebo-controlled, phase 3 trial. Lancet 2010; 376(9744): 895-902; abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20728932.
- Mod.LL

Maps of Ethiopia can be seen at http://healthmap.org/promed/p/32385 and http://upload.wikimedia.org/wikipedia/c ... region.jpg. - Sr.Tech.Ed.MJ]

RABIES - GHANA: (ASHANTI) HUMAN, FELINE
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Date: Thu 14 Aug 2014
Source: GhanaWeb [edited]
http://www.ghanaweb.com/GhanaHomePage/r ... ?ID=321114


Reports reveal that rabies is suddenly terminating the lives of children in the Ashanti region [Ghana]. Joy News' Seth Kwame Boateng, who reported from the isolation ward of the Komfo Anokye Teaching Hospital (KATH) in the region, said a 10-year-old boy died Tuesday [12 Aug 2014] from rabies. Some other cases have been recorded earlier.

Kwame Boateng further narrated how he saw the lifeless body of the boy lying on a bed with his hands and legs tied up. The body was later wrapped in a bed sheet to be conveyed to the morgue. A doctor, Edward Addo, who attended to him, said, "We had a hard time keeping him calm; we had to isolate him because he could even bite somebody which could spread the infection."

All attempts to treat the rabies proved futile.

Meanwhile, it was not the usual rabies from a dog bite which killed him, but from a 'street' cat, as doctors described it. Dr. Addo said the deceased acquired the disease through scratches from the cat he came into contact with while on his way to a church service with his dad. According to reports, the deceased picked up the cat, suspected to be suffering from the rabies, and after a while, it scratched parts of his body, thereby acquiring the disease. The doctor explained that the boy never told his parents until symptoms of the disease began to show on him and eventually opened up.

Veterinary officials in the region have warned that the spate of deaths from rabies was alarming. Regional Director of Veterinary Services in the Ashanti region, Dr. Kofi Kwansah-Filson, feared many people could die from the disease if funds were not released for the mass vaccination of dogs and cats. He said the situation was alarming because "we are not vaccinating many more pets as we used to do 10-15 years ago. Even the human deaths are very alarming."

Rabies as defined is a viral disease that causes acute inflammation of the brain in humans and other warm-blooded animals. The time period between contracting the disease and the start of symptoms is usually 1 to 3 months. It could also vary from less than one week to more than one year. The time is dependent on the distance the virus must travel to reach the central nervous system. Early symptoms may include fever and tingling, followed by violent movements, uncontrolled excitement, and fear of water or an inability to move parts of the body and confusion followed by loss of consciousness. In both cases, once symptoms appear, it always results in death.

The disease is spread to humans from another animal, commonly by a bite or scratch. Infected saliva, which comes into contact with any mucous membrane, is also a risk factor. Globally, most cases are the result of a dog bite being the cause in more than 90 per cent of cases in countries where dogs commonly have rabies.

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[A map of the regions of Ghana can be accessed at: http://en.wikipedia.org/wiki/Districts_of_Ghana. The Ashanti region is in the southern central part of the country; see: http://www.lib.utexas.edu/maps/africa/ghana_pol96.jpg.

Urban rabies usually involves dogs, but cats, as seen here, can get infected. A cat attacked by a rabid dog will usually not survive the attack, which is why cats more commonly suffer from bat rabies ... sick bats are wonderful toys for cats and super-attractive. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/2774.]

MENINGITIS, MENINGOCOCCAL - ETHIOPIA (02): REQUEST FOR INFORMATION
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Date: Mon 11 Aug 2014
Source: OCHA Weekly Humanitarian Bulletin, Ethiopia [edited]
http://reliefweb.int/sites/reliefweb.in ... August.pdf


Increasing numbers of meningitis cases are being reported from Amhara, Gambella, Oromia, SNNP [Southern Nations, Nationalities and Peoples] and Tigray regions. 26 cases were reported from Amhara and SNNP regions in the 1st week of August [2014] alone. WHO procured 200 000 doses of meningitis vaccines in response to the increasing meningitis caseload and ahead of the meningitis epidemic season starting in October 2014.

--
Communicated by:
Ota Masaki, MD, PhD
<masaki.ota@mb6.seikyou.ne.jp>
<otam@jata.or.jp>

[Maps of Ethiopia can be seen at http://healthmap.org/promed/p/95 and http://en.wikipedia.org/wiki/Ethiopia#m ... region.jpg.

Ethiopia is one of the countries in the WHO African meningitis belt, a region in sub-Saharan Africa stretching from Senegal in West Africa to the Horn of Africa where the incidence rate of meningitis is very high (see map at http://wwwnc.cdc.gov/travel/images/map3 ... -large.png). Outbreaks of meningococcal meningitis are reported in the African meningitis belt each year during the hot, dry season, between December and June (http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx).

_Neisseria meningitidis_ serogroup A is said to be the most commonly isolated pathogen in the African meningitis belt. However, outbreaks have also been caused by other _N. meningitidis_ serogroups, such as serogroup C (http://www.cdc.gov/meningitis/lab-manua ... 2-epi.html), W135 (http://cel.webofknowledge.com/InboundSe ... FullRecord), and X (http://www.sciencedirect.com/science/ar ... 0X13004751), and in March 2012, a serogroup B outbreak occurred in Ethiopia (http://www.afro.who.int/en/clusters-a-p ... 2012-.html). No reports on meningitis were available for Ethiopia for 2013 (http://www.who.int/csr/don/2013_06_06_menin/en/) and we are not told the microbial etiology of the meningitis outbreak in the various regions of Ethiopia, nor the types of meningococcal vaccine being used, in the report above. ProMED-mail would appreciate information on the microbial causes of the meningitis outbreaks in Ethiopia and the meningococcal vaccines being used from knowledgeable sources.

To control an outbreak, WHO recommends mass vaccination with the appropriate meningococcal vaccine in every involved district in an attempt to induce herd immunity, whereby transmission is blocked when a critical percentage of the population has been vaccinated (see http://www.who.int/mediacentre/factsheets/fs141/en/). Meningococcal vaccines will only protect against meningitis due to the meningococcal polysaccharide serogroups that the vaccine contains. Meningococcal disease is most commonly due to serogroups A, B, C, Y, and W135. Rarely, outbreaks of meningococcal meningitis have been related to other serogroups, such as type X, which has occurred in Niger in 2006 and Burkina Faso in 2010.

Serogroup A, B, C, Y, and W135 polysaccharides are immunogenic in humans; serogroup B is poorly immunogenic, presumably because serogroup B polysaccharide resembles the human neural cell adhesion molecule. While effective capsular polysaccharides-based vaccines exist against serogroups A, C, W135, and Y, no similar vaccine is available against disease caused by serogroup B strains. However, a new protein-based, broad-spectrum meningococcal serogroup B vaccine has been developed. - Mod.ML]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (62): AFRICA
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
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In this update:
Africa
[1] Cholera - South Sudan (Upper Nile, Eastern, and Central Equatoria States)
[2] Cholera - Ghana (Greater Accra Region)
[3] Cholera - Ghana (Western Region)
[4] Cholera - Cameroon (Far North Region)

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[1] Cholera - South Sudan (Upper Nile, Eastern, and Central Equatoria States)
Date: Thu 14 Aug 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/cho ... au-shilluk


The UN Children's Agency (UNICEF) reported this week [week of 11 Aug 2014] that health workers have succeeded in slowing down the outbreak of the deadly disease cholera in Wau Shilluk town of Upper Nile State in South Sudan. UNICEF South Sudan, in its 11th situation report on the outbreak, dated 12 Aug 2014, noted, "the rate of new cases has steeply declined in Wau Shilluk." As of 10 Aug 2014 there were 894 cases reported in Wau Shiluk, with 17 deaths.

In order to prevent spread of the disease, aid workers are continuing to chlorinate drinking water supplies in the area, which are fetched from the Nile river. Cholera treatment centres also remain open in the nearby town of Malakal.

UNICEF also reports that the rate of new cases in Juba has slowed, as health education and sanitation campaigns continue. "With fewer new cases in Juba, the Cholera Treatment Centre (CTC) at Juba Teaching Hospital has been handed over to the Ministry of Health and the Gumbo and Nyakuron CTCs have been closed," states the update by the UN Agency. However, the treatment centre in Gurei is being maintained in case of a potential second cholera wave in Juba.

Nationwide so far at least 123 people have died in the cholera outbreak. The disease is still widespread in Eastern Equatoria, and has affected all the payams [administrative division] in Torit County and almost all the counties in Eastern Equatoria. The affected area in Eastern Equatoria is vast, according to UNICEF, noting that there is "movement of people within counties and to/from Juba, in addition to having poor access to safe water and sanitation."

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[Maps of South Sudan can be seen at http://mapsof.net/map/south-sudan-map-states and http://healthmap.org/promed/p/8402. - Sr.Tech.Ed.MJ]

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[2] Cholera - Ghana (Greater Accra Region)
Date: Fri 15 Aug 2014
Source: Agence France-Presse (AFP) [edited]
http://news.yahoo.com/ghana-cholera-out ... 10744.html


A cholera outbreak in Ghana's capital has reached "staggering" levels, an official said Fri 15 Aug 2014, blaming poor sanitation and overcrowded health facilities for the rapid spread of the disease. Cholera has killed more than 40 people in Accra since June 2014 and infected 3100 others, according to the Ghana Health Service.

While the sprawling city has been hit by cholera before, the director of health services for the greater Accra region, Linda Van Otoo, said the current outbreak was "staggering". "It is a total outbreak and the cases in Accra keep increasing daily," Otoo said. "We are in a pandemic situation and doing our best to deal with it."

Otoo puts the blame for the outbreak on poor sanitation in Accra's more impoverished districts.

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[Maps of Ghana can be seen at http://www.ezilon.com/maps/images/afric ... -Ghana.gif and http://healthmap.org/promed/p/53. - Sr.Tech.Ed.MJ]

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[3] Cholera - Ghana (Western Region)
Date: Mon 11 Aug 2014
Source: Spy Ghana, Ghana News Agency (GNA) report [edited]
http://www.spyghana.com/cases-of-choler ... itakoradi/


The Sekondi/Takoradi Metropolis has recorded 23 suspected cases of cholera with 9 confirmed. Dr Emmanuel Tinkorang, the Western Regional Director of the Ghana Health Service, told the GNA that there were only 4 cases last week [week of 4 Aug 2014] but the figures had increased with cases coming from Kojokrom, Adiembra, Kwesimintsim, and Effia-Kuma.

He said it was a dent on the country's image that urban centres were recording cholera cases which is mainly an environmental and sanitation disease and appealed to the public to keep the environment clean as this was one key way of preventing the disease.

Dr Tinkorang said filth and garbage had taken over major cities and towns and called for attitudinal and behavioral change among urban dwellers. Mrs. Margaret Annan, Nurse Manager of Kwesimintsim Hospital confirmed to the GNA that a cholera patient had been treated and discharged at the facility.

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[4] Cholera - Cameroon [Far North Region]
Date: Tue 12 Aug 2014
Source: Reuters, Plan UK report [edited]
http://www.trust.org/item/2014081210501 ... =fiTheWire


Efforts are under way to stop the spread of a cholera epidemic that has already affected hundreds of people in Cameroon, reports global children's charity Plan International. More than 1600 cases have been reported in the Far North region of the country, with 74 deaths.

Plan is working to raise awareness about the importance of hygiene and prevention, as fears grow over the disease. "We're providing drugs to treat cholera, disinfecting public spaces and coordinating awareness campaigns in affected areas," says Felix Addo-Nyarko, Plan's Deputy Country Director in Cameroon.

[Byline: Lisa Jones]

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[Maps of Cameroon can be seen at http://www.lib.utexas.edu/maps/africa/c ... _pol98.jpg and http://healthmap.org/promed/p/8958. - Sr.Tech.Ed.MJ]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (63): AFRICA
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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 - Ghana (Greater Accra Region)
[2] Cholera - Ghana (Ashanti Region)

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[1] Cholera - Ghana (Greater Accra Region)
Date: Tue 19 Aug 2014
Source: Ghana Web [edited]
http://www.ghanaweb.com/GhanaHomePage/r ... ?ID=321927


The number of cholera cases reported in the Greater Accra Region has increased from 3600 to 5000 with 45 deaths since July 2014, the Greater Accra Regional Health Director of the Ghana Health Service, Dr Linda Van Otoo, has said. Out of these numbers, the Accra metropolis alone recorded about 2500 cases with about 1000 cases reported in a week.

Dr Otoo made this known when the Minister of Health, Dr Kwaku Agyeman-Mensah, and his Deputy, Dr Victor Bampoe, accompanied by the Greater Accra Regional Minister, Nii Laryea Afotey-Agbo, the Director General of the Ghana Health Service, Dr Ebenezer Appiah Denkyira, and some other officials visited the La General Hospital in Accra Mon 18 Aug 2014.

The visit was for the minister to be abreast with how the hospital was handling the outbreak of cholera in the La community, as well as find ways of assisting health personnel to perform their duties diligently. As of the time of the visit, the hospital had recorded about 790 cholera cases since the 1st outbreak in July 2014.

Dr Otoo said over the years, the region had been recording very high numbers of cholera cases. She said in 2013, there was no case of cholera reported, adding that, "We had about 22 cases of diarrhoea with no deaths." Unfortunately, she said 2014 had come with its own woes, as the number of cases reported in the region was increasing.

Dr Otoo said records available showed that the disease was attacking the productive age groups, while some few cases of children and the aged had been reported. She said the disease attacked more males than females.

In his remarks, the Minister of Heath, Dr Kwaku Agyeman-Mensah, commended all hospital authorities for the efforts they put into alleviating the outbreak of cholera in the metropolis. He described the situation as sad, adding that the deaths could have been prevented if patients had reported to the hospitals early. "45 preventable deaths have been recorded, and this is sad because people are not paying attention to personal hygiene and environmental cleanliness," he said.

Dr Agyeman-Mensah said it was high time the sanitation by-laws were used to deal with those who flouted the laws in order to help reduce the number of people who got infected and died from cholera. He said the ministry would make available all resources that were needed to help curb the cholera epidemic, adding that, "We must all work together and make sure that what has happened is not repeated."

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[2] Cholera - Ghana (Ashanti Region)
Date: Mon 18 Aug 2014
Source: Ghana Web [edited]
http://www.ghanaweb.com/GhanaHomePage/N ... ?ID=321832


Ashanti Region has recorded its 1st cholera death, while 21 others are in critical condition since a renewed outbreak of the disease in parts of the country in recent months. Three districts in the region have recorded more than one case each since the beginning of this month [August 2014], health authorities said.

Public health officials warn that the situation could get worse if sanitation is not improved. This will be the worst cholera outbreak in the region in 4 years. It comes after the Greater Accra Region reported 47 deaths from over 4000 confirmed cases since the outbreak of the disease in June 2014.

Adansi South District, where the infection claimed one life, has recorded 5 cases, while the Kumasi metropolis leads with 7. A chunk of Kumasi's cases were recorded at the Komfo Anokye Teaching Hospital and the Kumasi South Hospital. The death occurred at Kokonteng, where many residents engage in open air defecation. The Komfo Anokye Hospital has treated 10 cases, including 5 Kumasi residents, while the others came from outside the city.

Authorities say conditions and factors that prompted the outbreak in Accra are prevalent in Kumasi and other parts of the region. They cite piled-up refuse, open defecation, and general unsanitary conditions as the causes.

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[The regions of Ghana showing the Ashanti region in south central Ghana can be found at http://www.safewaterghana.org/wp-conten ... on_map.gif. - Mod.LL]

[A ProMED HealthMap is available at http://healthmap.org/promed/p/53.]

HEMORRHAGIC FEVER - SUDAN: (WEST DARFUR) ex CHAD (OUADDAI) REQUEST FOR INFORMATION
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Date: Sun 31 Aug 2014
Source: StarAfrica, Agence Africaine de Presse (APA) [edited]
http://en.starafrica.com/news/sudan-ban ... ebola.html


The minister of health affairs for the Darfur Regional Authority, Firdos Abdel Rahman Yousif denied reports of the deadly Ebola virus disease in El Geneina, capital of West Darfur State.

The Sudan News Agency quoted the minister as saying the suspected case had come from Abeche in Chad. The patient suffered from hemorrhagic fever, began taking treatment from the health center, and was then transferred to a hospital in El Geneina, she claimed.

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[It is important to exclude yellow fever in this case, as the recent epidemic of yellow fever in Darfur was brought from Chad by nomadic herdsmen. See ProMED-mail. Yellow fever - Africa (09): Chad, archive no 20130214.1543009. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/41279.]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (64): GHANA
**************************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Cholera - Ghana (Greater Accra Region)
[2] Cholera - Ghana (Central Region)
[3] Cholera - Ghana (Volta Region)
[4] Cholera - Ghana (Eastern Region)

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[1] Cholera - Ghana (Greater Accra Region)
Date: Sun 31 Aug 2014
Source: Spy Ghana [edited]
http://www.spyghana.com/reported-choler ... -alarming/


Reported cholera cases within the Greater Accra Region have hit a whopping 7800 cases, up from 6179 within a week.

The director of Ghana Health Services (GHS), Greater Accra Region, Dr Linda Van-Otoo, disclosed this yesterday, 30 Aug 2014, in Accra at the launch of a nationwide free waste bin distribution project by the Ministry of Local Government and Rural Development, Ministry of Health, the Accra Metropolitan Assembly (AMA), and Nawabin, a waste management company. The 1st phase of the project would witness the distribution of one million bins within the Greater Accra Region and would be extended to other parts of the country.

According to her, the cases continue to increase exponentially with more than 51 deaths recorded so far. She stated that most of the cases were emanating from Accra and the submetros. "Our hospitals are choked with patients and in some instances some patients are being thrown out, Dr Van-Otoo indicated. "Some of them die before reaching the hospitals due to delay at home," she added, without stating categorically to what extent that the death toll, which stood at 51 as of last Fri 29 Aug 2014, had increased.

The current epidemic is similar to the one that struck the country in 2011 were over 9000 cases were recorded with 72 deaths.

[byline: Melvin Tarlue, Christiana Mpra Agyei]

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[2] Cholera - Ghana (Central Region)
Date: Sun 31 Aug 2014
Source: GhanaWeb, Ghana News Agency (GNA) report [edited]
http://www.ghanaweb.com/GhanaHomePage/h ... ?ID=323644


A cholera outbreak has hit Cape Coast and its environs with 14 out of the 24 cases recorded between Tuesday and Friday, 26-29 Aug 2014, at the Cape Coast Teaching Hospital (CCTH), testing positive. However, one person was brought in dead and had been released to the family for burial.

When the Ghana News Agency (GNA) visited the facility at about 17:00 hours on Fri 29 Aug 2014, other cases were awaiting confirmation. Isolated tents had been mounted with medical personnel wearing protected gear to manage the disease, which broke out in Accra and other parts of the country about 4 months ago and had reached an alarming rate.

Mrs Philomena Afful Mensah, the disease control officer at CCTH, told GNA that the majority of patients who came to the facility were males, with the oldest being 68 and the youngest 7 years. She said many of the cases including the dead person were brought in from Kotokuraba, the business centre of the metropolis, and other suburbs of Cape Coast.

She indicated that patients from surrounding towns such as Ankaful, Moree, Ekon, and Elmina, were also being rushed there, since according to them, the other hospitals had told them they did not have adequate accommodation to handle their condition. She said 10 patients had so far been treated and discharged while samples of other patients had been taken to the laboratory to be tested.

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<promed@promedmail.org>

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[3] Cholera - Ghana (Volta Region)
Date: Tue 26 Aug 2014
Source: Ghana News Agency (GNA) [edited]
http://www.ghananewsagency.org/health/v ... ases-79054


A total of 201 cholera cases have been recorded in the Volta Region, Mr Mathew Drafor, head of Disease Surveillance Unit at the Regional Health Directorate said on Tue 26 Aug 2014. He said the increasing number of cases could be disastrous in the region.

Mr Drafor said this at a public forum organised by the Ho Rotary Club on cholera on the theme: "End Cholera Now." The target group are traders at the Ho central market.

Mr Drafor said it is surprising that from 60 cases on Fri 22 Aug 2014, Ketu-South District recorded 110 cases on Tue 26 Aug 2014 with 2 deaths. He said Nkwanta South recorded 67 cases with 3 deaths, Ho-West, 12 cases, Ketu-North 10 cases and Ho, 2 cases.

--
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******
[4] Cholera - Ghana (Eastern Region)
Date: Mon 1 Sep 2014
Source: Spy Ghana [edited]
http://www.spyghana.com/ghana-grapples- ... f-cholera/


A total of 492 cholera cases have been recorded in the Eastern Region, Mr Mukeila Buhura, the regional health director of Disease Surveillance Unit has told Daily Guide. Mr Mukeila hinted that the reports were gathered from 11 hospitals in the region, out of the 26 districts and municipalities.

According to him, the top 5 health facilities with the highest cholera outbreaks were the Nsawam/Adoagyiri Municipal hospital with the highest figure of 231; Akuapem North had 86 cases; New Juaben with 62; West Akyem-Asamankese recorded 30; and Kwahu West also had 30 cases. The other 6 health centers included Lower Manya Krobo Municipal which recorded 22 cases; Birim Central had 17; Fanteakwa Municipal had 8; while Upper West Akim- Adeiso and Suhum Municipal respectively recorded 9 and 2 cases as the lowest average.

[byline: Daniel Bampoe]

--
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ProMED-mail
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[The outbreak of cholera in Ghana has continued to increase, involving at least 5 of the 10 regions of the country, specifically those in the south.

A HealthMap/ProMED-mail map of Ghana can be accessed at http://healthmap.org/promed/p/53 and a map showing the regions at http://mfa.gov.gh/assets/media/misce-imgs/ghana-map.jpg. - Mod.LL]

DENGUE/DHF UPDATE (52): AFRICA
**********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

*****

Ethiopia
Date: Mon 1 Sep 2014
Source: UN Office for Coordination for Humanitarian Action [edited]
http://reliefweb.int/report/ethiopia/et ... ember-2014


Between 7 Jul and 10 Aug [2014], 46 new cases of dengue fever were reported from Gode area in Shabelle zone, Somali region. No new cases were reported for several weeks prior to these cases.

Dengue fever was confirmed for the 1st time in Ethiopia in Dire Dawa city in mid-September 2013. Cases were later reported in Gode area of Somali region in January 2014 and in Afar region in April 2014. For more information, contact: <who-wro@et.afro.who.int>.

--
communicated by:
Ota Masaki, MD, PhD
<otam@jata.or.jp>

[ProMED-mail thanks Dr Masaki for sending in this report.

Maps of Ethiopia showing the Somali region can be accessed at http://en.wikipedia.org/wiki/Somali_Region and http://healthmap.org/promed/p/32490. - Mod.TY]

HEPATITIS E - SUDAN: (SOUTH DARFUR), DISPLACED PEOPLE CAMP
**********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Wed 3 Sep 2014
Source: Sudan Tribune [edited]
http://www.sudantribune.com/spip.php?article52272


An outbreak of hepatitis at Kalma camp for internally displaced people [IDP] in South Darfur state [Sudan] has led to the death of 150 people and infected 500 others. Hepatitis, an inflammation of the liver, is commonly caused by viral infection. According to WHO, hepatitis E is included among the most concerning iterations of the disease (types A, B, C, D and E) because of its epidemic potential.

The humanitarian affairs officer for the IDP, Essa Salih, told Sudan Tribune on Wednesday [3 Sep 2014] that 150 people, mostly children, pregnant women and elderly, [have] died, while 500 others have been infected with hepatitis due to rapid spread of the disease in the past 2 months [Jul-Sep 2014]. He added that the proliferation of the disease was caused by malnutrition and lack of adequate health services inside the camp, pointing out that most of the infected people died at Nyala Teaching Hospital.

Saleh noted the disease became the biggest threat to IDP in South Darfur state following expulsion of foreign aid groups in 2009. Immediately after the 1st arrest warrant of the International Criminal Court (ICC) against Sudan's president Omer Hassan al-Bashir in March 2009, Sudan expelled 13 aid groups from Darfur, accusing it of collaborating with the war crime courts. Saleh called for the urgent intervention of the health ministry and aid groups to contain the disease in Kalma camp, warning against its spread to other IDP camps. He also pointed to the growing malnutrition diseases among children and elderly in the camps.

The health minister in South Darfur state, Omer Suleiman, for his part confirmed existence of hepatitis E cases, saying he hasn't yet received precise numbers, stressing ongoing efforts to remedy the situation.

Nyala Teaching Hospital suffers from a severe shortage of doctors, particularly specialists, following resignations of significant numbers of them due to government's failure to pay their salary arrears for years.

--
communicated by:
Tony Ellam
retired consultant in communicable disease control
<tonypj@meadlane.freeserve.co.uk>

[ProMED-mail thanks Tony Ellam for this contribution.

Hepatitis E has been a significant issue in Darfur. The following is from WHO regarding the disease (http://www.who.int/mediacentre/factsheets/fs280/en/):

Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, while genotype 3 is usually seen in the developed countries and does not cause outbreaks. Globally, 57 000 deaths and 3.4 million cases of acute hepatitis E are attributable to infection with hepatitis E virus genotypes 1 and 2.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus. Over 60 per cent of all hepatitis E infections and 65 per cent of all hepatitis E deaths occur in East and South Asia, where seroprevalence rates of 25 per cent are common in some age groups. In Egypt, half the population aged above 5 years is serologically positive for the hepatitis E virus.

Transmission
------------
The hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes have been identified, which include:

- foodborne transmission from ingestion of products derived from infected animals;
- transfusion of infected blood products;
- vertical transmission from a pregnant woman to her fetus.

Although humans are considered the natural host for the hepatitis E virus, antibodies to the hepatitis E virus or closely related viruses have been detected in primates and several other animal species.

Hepatitis E is a waterborne disease, and contaminated water or food supplies have been implicated in major outbreaks. The ingestion of raw or uncooked shellfish has also been identified as the source of sporadic cases in endemic areas.

The risk factors for hepatitis E are related to poor sanitation in large areas of the world and shedding of the hepatitis E virus in feces. - Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/27471.]

HEPATITIS E - SOUTH SUDAN: (LAKES), DISPLACED PERSONS CAMP
**********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sun 7 Sep 2014
Source: Sudan Tribune [edited]
http://www.sudantribune.com/spip.php?article52304


Cases of Hepatitis E are on the rise in South Sudan's Lakes state, with about 100 people diagnosed with the disease, the United Nations humanitarian coordination agency (OCHA) said. Two cases of the disease, OCHA said, were initially recorded in April 2014 and 52 in June 2014. At least 4 people have died at Lakes state's Mingkaman internally displaced camp, OCHA said in its latest bulletin.

John Parach, a local administrator, told Sudan Tribune that the disease has affected both the host population and those displaced, forcing them to flee from the area. He said poor sanitation and regular flooding caused by rainwater that destroyed toilets have accelerated the spread of the viral disease. "This place is lowland, and many of the toilets built in February 2014 were not good enough. Most of them went down when heavy rains started; feces went randomly with the water, contaminating people around; this increased the level of infection," Parach said by phone. Those affected, he said, are being handled by Medicines San Frontiers (MSF) at its health center in Mingkaman, with women and children said to be the most affected. "There is no cure for this disease; people died due to liver failure. Nobody has died since July 2014," said Parach.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[The following is from WHO regarding the disease (http://www.who.int/mediacentre/factsheets/fs280/en/):

Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, while genotype 3 is usually seen in the developed countries and does not cause outbreaks. Globally, 57 000 deaths and 3.4 million cases of acute hepatitis E are attributable to infection with hepatitis E virus genotypes 1 and 2.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus. Over 60 per cent of all hepatitis E infections and 65 per cent of all hepatitis E deaths occur in East and South Asia, where seroprevalence rates of 25 per cent are common in some age groups. In Egypt, half the population aged above 5 years is serologically positive for the hepatitis E virus.

Transmission
------------
The hepatitis E virus is transmitted mainly through the faecal-oral route due to faecal contamination of drinking water. Other transmission routes have been identified, which include:

- foodborne transmission from ingestion of products derived from infected animals;
- transfusion of infected blood products;
- vertical transmission from a pregnant woman to her fetus.

Although humans are considered the natural host for the hepatitis E virus, antibodies to the hepatitis E virus or closely related viruses have been detected in primates and several other animal species.

Hepatitis E is a waterborne disease, and contaminated water or food supplies have been implicated in major outbreaks. The ingestion of raw or uncooked shellfish has also been identified as the source of sporadic cases in endemic areas.

The risk factors for hepatitis E are related to poor sanitation in large areas of the world and shedding of the hepatitis E virus in feces. - Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/8402.]

LEISHMANIASIS, VISCERAL - SOUTH SUDAN: (JONGLEI)
************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sun 7 Sep 2014
Source: Sudan Tribune [edited]
http://www.sudantribune.com/spip.php?article52314


The health ministry in South Sudan's Jonglei state has reported an outbreak of kala-azar (visceral leishmaniasis, VL) in its remote Akobo and Nyirol counties.

"We have heard of the upsurge of the disease in Langkien where a big number of people are affected. Other cases were reported in Akobo, but our health team [has] not gained access to those locations," a doctor at Bor civil hospital told Sudan Tribune on Sunday [Sun 7 Sep 2014].

Kala-azar is a chronic and potentially fatal parasitic disease of the internal organs, particularly the liver, spleen, bone marrow, and lymph nodes transmitted by sandfly bites.

The disease is reportedly common in parts of Asia, Africa, and South America, and causes an estimated half million cases per year.

Jonglei's health minister, Angok Kuol confirmed the outbreak of the disease, saying medicines were dispatched to the 2 affected counties.

"Recently there were reports of increasing cases of kala-azar in Nyirol and Akobo counties. So we have sent in medicines, training materials and a consultant has even gone to help health personnel on the ground," said Kuol. Jonglei ministry of health now relies on its partners to deliver health services in the areas controlled by rebels fighting against government.

"We have allowed all our partners who are operating in the counties under rebels to continue delivering health services," said the minister.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Maps of South Sudan can be seen at http://mapsof.net/map/south-sudan-map-states and http://healthmap.org/promed/p/19548. Information about Jonglei State and its location can be found at http://en.wikipedia.org/wiki/Jonglei.

For a review of the data on leishmaniasis in Sudan and South Sudan see the comments to the ProMED-mail posting from 16 Sep 2012 (Leishmaniasis, visceral - South Sudan (02): (UY) 20120916.1295988).

Leishmaniasis is highly endemic in Sudan and South Sudan and outbreaks occur regularly and unexpectedly in areas that were previously unaffected. A recent outbreak started at the end of 2009 with thousands of cases, possibly caused by massive population movements and growing food insecurity. This outbreak continued to cause extremely high case numbers in both 2010 and 2011 (Alvar J, Velez ID, Bern C, et al: Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE 2012; 7(5): e35671. (Supplemet 81); http://www.plosone.org/article/info%3Ad ... ne.0035671.

Malnutrition in the population probably contributes to the number of clinical cases of visceral leishmaniasis. An estimated 10 percent of VL cases in Southern Sudan is coinfected with HIV. - Mod.EP]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (65): AFRICA
*******************************************************************
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:
[1] Diarrhea - Sudan (North Darfur), fatalities
[2] Cholera - Ghana, vaccine request
[3] Cholera - Nigeria (Sokoto State)
[4] Cholera - South Sudan

******
[1] Diarrhea - Sudan (North Darfur), fatalities
Date: Thu 4 Sep 2014
Source: Radio Dabanga [edited]
https://www.radiodabanga.org/node/79730


In the 6 Kabkabiya camps in North Darfur, 14 infants aged between one month to 2 years and a half, died within the past 2 weeks of diarrhea and vomiting, a displaced person informed Radio Dabanga.

"There are at least 100 other similar cases in the camps. The children are weak anyhow because of chronic malnutrition," she said.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[The etiology or etiologies of these gastrointestinal illnesses are not clear. - Mod.LL]

******
[2] Cholera - Ghana, vaccine request
Date: Tue 2 Sep 2014
Source: Citi FM Online [edited]
http://www.citifmonline.com/2014/09/02/ ... -for-help/


Government, in a desperate attempt to end the growing number of cholera cases, has initiated discussions with the World Health Organization (WHO) to supply vaccines to help bring the situation under control. Over 10 000 cholera cases have been recorded in 7 regions with over 80 deaths. According to the WHO, Ghana's highest number of recorded cholera cases was 14 160 in 1983. Therefore, the 2014 outbreak with the recorded 10 000 cases could be the 2nd highest.

Speaking to Citi News, Deputy Health Minister Victor Bampoe said the vaccine from the WHO is one of the short-term measures being implemented by government to address the situation. He disclosed that there are 2 potent oral vaccines, and the government is working with the WHO to "see whether Ghana qualifies to use the vaccines in the current epidemic." The minister said they will make a final decision about whether to vaccinate people in the 3 regions of the north or affected areas in the southern part of the country. This is expected to prevent the possible spread of the disease from the south to the northern part of the country.

The vaccines, according to the Deputy Health Minister could also be administered "strategically" to residents in the affected regions to break the transmission of the disease. Dr. Bampoe told Citi News that the WHO has specific guidelines on which category of individuals could be given the oral vaccines. "For one of them, you will give it to children over the age of one, and with the other, you will give it to children over the age of 2," he said.

He pointed out that when the WHO releases the drug, government will decide on how to use it "if indeed we qualify to use [it]." The WHO will send over some officials to undertake some scientific assessments on the cholera situation in Ghana before the vaccines may be released.

[Byline: Efua Idan Osam]

--
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ProMED-mail
<promed@promedmail.org>

******
[3] Cholera - Nigeria (Sokoto State)
Date: Sat 6 Sep 2014
Source: Premium Times [edited]
https://www.premiumtimesng.com/news/top ... QNDxK.dpbs


16 people have been killed in a fresh outbreak of cholera in Sokoto state, while 40 others are on admission in hospitals across the state, a health official has said.

Dr. Bello Dahiru, who has been managing patients at the Primary Health Centre in Kasarawa, a suburb of Sokoto, the state capital, said the deaths and admissions occurred within the last 3 days. The outbreak, officials say, has now lasted days, leaving residents of the state in panic. It is not clear what the state government is doing to halt the epidemic.

[Byline: Auke Apa]

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******
[4] Cholera - South Sudan
Date: Fri 5 Sep 2014
Source: IFRC [edited]
http://www.ifrc.org/en/news-and-media/n ... dan-66993/


South Sudan is currently battling a cholera outbreak. Since mid-May 2014, cholera outbreaks or alerts have been reported in 7 of South Sudan's 10 states with, as of mid-August 2014, 5859 reported cases and 127 deaths. The South Sudan Red Cross has mobilized and trained hundreds of volunteers to spread messages about cholera prevention through home visits and through the use of radio and mobile cinema.

[Byline: Chiran Livera and Marial Mayom]

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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (66): AFRICA
*********************************************************
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 - Ghana (Western Region)
[2] Cholera - Zambia (Central Province)

******
[1] Cholera - Ghana (Western Region)
Date: Fri 5 Sep 2014
Source: Ghana Web [edited]
http://www.ghanaweb.com/GhanaHomePage/h ... ?ID=324395


The Western Regional Health Directorate had recorded one death among the 25 confirmed cases of the cholera disease within the region. So far, a total of 87 suspected cases had been recorded since the 1st case on 27 Jul 2014. Mr. Francis Anliah, Regional Disease Control Officer, told the Ghana News Agency in an interview that the cases were recorded from Ellembelle, Shama, Wassa East, Tarkwa, Axim and Sekondi/Takoradi and said operators of districts facilities have been schooled to do surveillance in controlling the spread of the disease.

He added that the Health Directorate was also carrying out awareness creation and community durbars [formal meetings] to educate Ghanaians on the need for a clean and healthy environment. The Disease Control Officer said the hospitals were up to the task of containing the spread but entreated the public to limit hand shaking and ensure that they properly washed their hands with soap and water.

--
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******
[2] Cholera - Zambia (Central Province)
Date: Tue 9 Sep 2014
Source: Times of Zambia [edited]
http://www.times.co.zm/?p=34280


Two out of the 3 cholera patients admitted to Lukanga Clinic have been discharged. Central Province Deputy Permanent Secretary Ronald Sinyangwe said health personnel were working round the clock to ensure that no new cases were recorded.

Mr Sinyangwe disclosed that as of Mon 8 Sep 2014, only one patient was still admitted to the cholera centre and was responding well to treatment. He said more health personnel and fishery officers had been sent to the area to help establish the source of the epidemic.

Mr Sinyangwe added that the government was doing everything possible to ensure that the disease was contained. He said health personnel were carrying out sensitization campaigns in the area as well as distributing chlorine. "Everything is been done to ensure that the outbreak is contained; the health personnel are distributing chlorine and educating the residents on prevention of the disease," Mr Sinyangwe said.

Mr Sinyangwe has since called on the residents to ensure that they treat their drinking water as a preventive measure. Last week, 2 people died of cholera in the area.

[Byline: Kasonde Kasonde]

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ProMED-mail
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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (67): AFRICA
*********************************************************
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 - Ghana (Western Region)
[2] Cholera - Nigeria (Katsina State)
[3] & [4] Cholera - Congo DR (South Kivu Province)
[5] Cholera - Congo DR (Katanga Province)

******
[1] Cholera - Ghana (Western Region)
Date: Thu 18 Sep 2014
Source: Citi FM Online [edited]
http://www.citifmonline.com/2014/09/18/ ... worsening/


Reports reaching Citi News indicate the cholera situation in the Western Region is fast deteriorating as over 120 cases have been recorded within a period of 2 weeks. According to the Western Regional Director of the Ghana Health Service (GHS), Dr. Emmanuel Tengkorang, the situation in the region may worsen if the outbreak in Accra is not contained.

"2 weeks ago, it was 89, and now we are at 120, and we have found out that the situation in Accra is affecting us because a lot of people commute from Accra to Takoradi, and they most of the time come with this condition," he said. Dr. Tenkorang further explained that the commuters, after contracting the disease in Accra, "introduce the infection into the communities."

Citi News' Western Regional correspondent, Obrempong Yaw Ampofo, reported that 7 out of the 22 districts in the region have reported an outbreak of the disease. Out of the 7, the 2 main urban districts, Sekondi-Takoradi Metro Assembly and the Tarkwa Nsuayem Municipal Assembly, have recorded the highest cases so far. The remaining districts are Shama with 10 recorded cases, Wassa East with 8 cases, and Jomoro with 12 cases. Obrempong also reported that 31 new reported cases have been recorded within a period of 2 weeks.

Meanwhile, the Greater Accra Regional Health Directorate has announced that the number of cholera cases being reported daily has significantly reduced. Over 10 000 Ghanaians have been affected by the cholera outbreak, killing more than 80 in 7 regions across the country.

[Byline: Efua Idan Osam]

--
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******
[2] Cholera - Nigeria (Katsina State)
Date: Wed 17 Sep 2014
Source: Daily Trust [edited]
http://allafrica.com/stories/201409170754.html


There are reported cases of cholera outbreak in some communities in Katsina State. Daily Trust gathered that the most affected local government areas are, Ingawa, Faskari and Funtua. Last week, 4 people, including the Peoples Democratic Party (PDP) ward chairman for Dara village, died of cholera, Daily Trust gathered.

At Funtua, our correspondent gathered that many people have died of the disease. A resident of the area, said a neighbor, after developing symptoms of the disease, was rushed to a nearby hospital where he later died. He added that the widow of the deceased also died of cholera.

In Faskari, it was gathered that the outbreak occurred at a camp, where people are taking shelter after attacks by persons believed to be cattle rustlers.

Speaking on the issue, the state Commissioner for Health, Mannir Ibrahim Talba, said the government is on top of the situation, adding that efforts are on to curtail the spread of the disease. He said staff of the Epidemic Control Unit under the Primary Health Agency, have visited the affected areas.

[Byline: Habibu Umar Aminu]

--
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******
[3] Cholera - Congo DR (South Kivu Province)
Date: Fri 12 Sep 2014
Source: Radio Okapi [in French, machine transl., edited]
http://radiookapi.net/en-bref/2014/09/1 ... de-ruzizi/


Approximately 72 cases of cholera have occurred, and 1 death has been recorded, in 3 weeks, in the health area of the Ruzizi River, in the city of Sange, located at more than 70 km [43 miles] south of the city of Bukavu (South Kivu). The nursing supervisor in charge of curative care in this area of health, David Kalekono, has delivered these figures Thursday, 11 Sep 2014 in an interview with journalists.

He indicated that the patients are in the general hospital of the Ruzizi River, thanks to the support of the NGO Doctors Without Borders Holland and Doctors of Africa. According to David Kalekano, these cases of cholera are derived from the localities of Ndunda, Sange and Mikamba, where the inhabitants are struggling to provide safe drinking water.

--
Communicated by:
ProMED-FRA from HealthMap Alerts
<promed@promedmail.org>

******
[4] Congo DR (South Kivu)
Date: Mon 15 Sep 2014
Source: Radio Okapi [in French, machine transl., edited]
http://radiookapi.net/regions/sud-kivu/ ... a-2-deces/


147 cholera cases, including 2 deaths, were recorded in 2 weeks in the cities of Baraka and Kazimiya in the area of health of Fizi in South Kivu. The chief physician of zone, Dr Asende Ehebelo who has delivered this information Sunday, 14 Sep 2014, indicates that the main cause is the lack of [clean] drinking water.

"The entire population relies on Lake Tanganyika for their water supply. We record at least 20 cases of cholera per day. To combat this outbreak, we sensitized the inhabitants of these 2 cities to comply with the rules of hygiene," said Dr Asende Ehebelo.

--
Communicated by:
ProMED-FRA from HealthMap Alerts
<promed@promedmail.org>

******
[5] Cholera - Congo DR (Katanga Province)
Date: Mon 15 Sep 2014
Source: Radio Okapi [in French, machine transl., edited]
http://radiookapi.net/regions/katanga/2 ... u-cholera/


The health infrastructure of Kikondja, in the territory of Bukama, does not have a sufficient quantity of material for water purification and medicines to treat the sick of cholera. The chief physician of this area of health, Dr Rene Doudou, indicates that since the 1st rain that has fallen in the region, the number of patients of cholera has increased significantly.

10 to 30 new patients are registered per day at the center of treatment of cholera of Kikondja center. According to him, the situation is very disturbing, especially in the areas of health located at the edge of Lake Kisale.

--
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