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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (49): SOUTH SUDAN
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[1] Upper Nile State
Date: Fri 4 Jul 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/upp ... three-days


Hundreds of people have possibly contracted the disease cholera in Wau Shilluk in Upper Nile State over the past few days, according to a UN report, which said the outbreak caused 7 deaths.

The UN coordination office in South Sudan stated in its regular update today [4 Jul 2014] that 246 suspected cases were reported in the area in a period of only 72 hours. The outbreak in Wau Shilluk prompted a "major alert" by humanitarian health organizations. The area hosts about 39 000 people displaced by earlier conflict. Aid workers have sent additional medical staff to the area, set up oral rehydration stations and hand-washing stations, and distributed soap and hygiene kits.

In total nationwide, 2613 cases of the disease have been reported as of 2 Jul 2014, with 63 deaths, making for a case fatality rate of 2.4 per cent, above the emergency threshold of 1 per cent.

"Though initially largely confined to Juba County [Central Equatoria State], the disease has spread, with outbreaks or alerts reported in 9 of 10 states," stated the UN report. The outbreak has spread quickly in Torit, the state capital of Eastern Equatoria State, and 11 suspected cases were also reported in the UN base in Bentiu [Unity State], where poor sanitary conditions increase the risk of the disease spreading.

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[2] Unity and Upper Nile states
Date: Fri 4 Jul 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/cho ... ile-states


South Sudan's cholera outbreak is worsening with reports of outbreaks in overcrowded and unsanitary camps in Unity and Upper Nile states. There are now hundreds of suspected cholera cases in Bentiu [Unity State], Wau Shilluk [Upper Nile State], and Malakal [Upper Nile State], in addition to the thousands of cases in Juba [Central Equatoria State] and Eastern Equatoria State, according to the latest weekly situation report by the UN's Office for Coordination of Humanitarian Affairs (OCHA).

OCHA reported a possible outbreak in Wau Shilluk, Upper Nile State, where 246 suspected cases were reported in only 72 hours.

Aid agencies set up a cholera treatment center in Wau Shilluk, a small village about an hour downstream of Malakal where about 39 000 displaced people are sheltering, with oral rehydration and handwashing stations and distributed soap and hygiene kits.

Earlier this week [week of 30 Jun 2014], humanitarian agency Oxfam reported one case of cholera in the Malakal UN base. In the Bentiu UN base, there were 11 suspected cholera cases and one death. OCHA said samples are still being confirmed to see if it is indeed cholera.

OCHA said over 100 new latrines were constructed in Bentiu to improve sanitation in the congested camp, though they need nearly 500 more to reach the international standard of one latrine for every 50 people. The report said that cholera response supplies need replenishment in Eastern Equatoria and Upper Nile states, and that there are 9 cholera treatment centers in Juba, where nearly 2000 cholera cases have been reported since May 2014.

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[From its origin in Juba in Central Equatoria State, the cholera outbreak continues to spread east and north in the country. - Mod.LL

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

UNDIAGNOSED ILLNESS - SUDAN (09): (CENTRAL DARFUR), CHILDREN, DONKEYS, SPREAD, REQUEST FOR INFORMATION
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Date: Sun 6 Jul 2014
Source: Radio Dabanga [edited]
https://www.radiodabanga.org/node/76237


A donkey owner reported to Radio Dabanga from Nierteti that last week a mysterious disease broke out in the locality.

"More than 40 donkeys died, 32 around Nierteti town, and 10 at Khor Ramla. Suddenly, the donkeys could not eat or drink anymore and started shivering. After a day or 2, they fell dead," the donkey owner explained.

Veterinary authorities in the locality have confirmed that so far the causes of the disease are unknown. "They said that they would take samples of the infected donkeys to send for tests in Central Darfur's capital of Zalingei."

On 24 Feb [2014], Radio Dabanga reported that an unknown disease had spread among donkeys in the Nierteti South camp for the displaced. Of the then 146 animals infected, 36 died within a week. The symptoms were coughing, weakness, [lack of] appetite, and weight loss. Veterinary authorities advised vaccinating the donkeys, but the displaced could not afford the vaccination costs.

Radio Dabanga reported on 12 Feb [2014] that about 75 percent of the children living in Deleig camp, Central Darfur were infected with a mysterious disease. The disease affected children below the age of 12 years and donkeys. Four days later, 15 children and 47 donkeys had died.

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[The apparent synchronic occurrence of a health problem in children and donkeys could be coincidental; otherwise, a common cause (biological or otherwise) should be sought. One of the etiologies which deserve to be taken into consideration in relation to the signs described in donkeys is botulism.

In any event, in view of the stubborn repetition of such information, investigation by a science-based international body (e.g. representatives in Darfur of FAO? WHO? Doctors/Veterinarians Without Borders?) is certainly clearly needed. - Mod.AS

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/96.]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (52): AFRICA
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[1] Diarrhea - South Africa (North West Province), student camp
Date: Mon 7 Jul 2014
Source: South African Press Association (SAPA) [edited]
http://www.jacarandafm.com/post/nwest-c ... -outbreak/


A winter study camp for matric pupils in Arendsnes near Brits was shut down following a diarrhea outbreak.

"The department regrets to inform parents and learners about the immediate closing of the winter study camp due to unhealthy conditions," said spokesman Brian Setswammung. "Pupils complained about diarrhoea, and we called in health authorities to investigate."

It was discovered that the food prepared for the pupils was below standard and unhygienic, he said. At least 393 pupils were at the camp. 15 were admitted to hospital on Fri 6 Jul 2014 and had since been discharged. A further investigation to determine how the food was procured and prepared was underway, Setswammung said.

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[A ProMED-mail HealthMap is available at http://healthmap.org/promed/p/25492.]

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[2] Cholera - Ghana (Accra)
Date: Tue 8 Jul 2014
Source: Ghana Web [edited]
http://www.ghanaweb.com/GhanaHomePage/h ... ?ID=315893


Dr George Mensah, in-charge of the Accra Metropolitan Health Service, on Mon 7 Jul 2014 advised public health officers to ensure cholera does not spread in the metropolis by enforcing the laws on sanitation. He said that now that it was raining, daily environmental sanitation was necessary, adding that: "Your main focus should be on the food vendors by the gutters." Dr Mensah gave the advice when he met with all health officers in the 11 sub-metros in Accra to deliberate on the outbreak of cholera.

Dr Simpson Anim Boateng, Public Health Director of the Accra Metropolitan Assembly, in an interview with the GNA, expressed happiness that Accra did not record any case of cholera last year [2013] because of the officers' hard work, though one case was recorded recently.

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MALARIA - NAMIBIA: (NORTHERN REGIONS)
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Date: Fri 11 Jul 2014
Source: The Namibian [edited]
http://www.namibian.com.na/indexx.php?i ... egory_id=1


6000 cases of malaria reported in 3 months in Namibia
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As the number of malaria cases rises again, more schools across the country are using mosquito nets to prevent pupils from catching the disease. The use of mosquito nets has become necessary for many Namibians.

Namibia has reported 5966 cases of malaria in Omaheke, Kunene, Erongo, Hardap and Karas regions between January and March this year [2014].

Speaking to The Namibian yesterday [10 Jul 2014], Minister of Health and Social Services Richard Kamwi said this was a concern because in some regions, malaria cases had been eliminated. "I remain concerned that even in regions where we had eliminated malaria, such as Omaheke and Kunene, we have had some confirmed malaria cases," he said.

The majority of the cases were reported in Andara district [Kavango region] with 3163 cases, Rundu District [Kavango region] with 800 cases, Nyangana [Kavango region] with 791 cases and Katima Mulilo [Zambezi region] with 455.

Kamwi said in 2013, the country reported 4733 malaria cases, which translates to a decline above 98 percent when compared to the baseline of 2001 when 583 267 cases were reported.

"I remain extremely concerned that Andara, with a population of 35 108 inhabitants, contributes to an equivalent of the national cases of 2013 just in 3 months time," Kamwi said.

He said malaria outbreaks were not only reported in Namibia, but also in the [other] E8 ["Elimination 8"] front line countries striving to eliminate malaria by 2020: Botswana, South Africa, and Swaziland.

Kamwi added that houses that were not sprayed reported the most cases. "Some people declined for their houses to be sprayed, saying there is no more malaria. Our appeal is that people should work with community leaders when it's time for spraying. Malaria vectors cannot rest in a house that has been sprayed," Kamwi warned. He said all cases have been treated.

Currently in Kavango East, the Ministry of Health and Social Services is holding a malaria outbreak review and planning meeting, which started on Monday [7 Jul 2014] and ends today [11 Jul 2014].

A new report, which was released yesterday [10 Jul 2014], highlights the impact of malaria interventions on maternal, newborn and child health, and stated that malaria in pregnancy exerts a heavy toll and contributes largely to maternal and neonatal mortality.

In Africa, 10 000 women and between 75 000 and 200 000 children under the age of one are estimated to die annually as a consequence of malaria infection during pregnancy.

Malaria is a major cause of anemia in pregnant women, and can lead to maternal death at delivery due to hemorrhage. It is also responsible for stillbirth, pre-term birth, and low birth weight, which increases the risk of death within the 1st days of the infant's life.

[Byline: Tuyeimo Haidula]

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[This is an alarming increase in the number of cases in the northern regions such as Kavango, and as stated in the report, Namibia has been able to reduce the number of cases to less than 5000 in 2012 (see World Malaria Report 2013: http://www.who.int/malaria/publications ... s.pdf?ua=1). The most probable explanation is that malaria is still highly endemic in neighboring Angola with a parasite prevalence per 1000 population greater than 75 annually (World Malaria Report 2013). - Mod.EP]

[For a map of the regions of Namibia, see http://en.wikipedia.org/wiki/Regions_of_Namibia. A HealthMap/ProMED-mail map is available at http://healthmap.org/promed/p/163. - CopyEd.JE]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (53): SOUTH SUDAN (UPPER NILE)
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Date: Sun 13 Jul 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/650 ... es-delayed


More than 650 people have developed cholera in Upper Nile State of South Sudan, with 17 deaths confirmed. The state remains cut off by river and road from relief supplies from elsewhere in the country and is only accessible by air. Approximately 179 000 people are displaced within Upper Nile State, according to the UN, while tens of thousands more have fled from the state into Ethiopia or Sudan.

In an update on Friday, 11 Jul 2014, the UN Office for the Coordination of Humanitarian Affairs (OCHA) in South Sudan stated that the cholera outbreak in Wau Shilluk in Upper Nile resulted in a cumulative number of 652 cases so far, with 17 deaths. Currently, 207 patients are still undergoing treatment at Wau Shilluk, while the others have been discharged. There are also unconfirmed reports of cholera cases elsewhere in the state.

OCHA pointed out that "airdrops remained the only way of delivering supplies to Upper Nile State sites." Food barges hired by the World Food Programme to travel upriver to the area from Juba have been delayed. According to the UN Logistics Cluster, 2 barges that departed Juba on 29 Jun 2014 have halted in Mangella, while another 2 are still at Juba port awaiting repair of the pusher's engine.

OCHA said aid agencies are responding to cholera in Wau Shilluk by providing medical treatment, distributing water purification and rehydration tablets, buckets and soap, and constructing handwashing stations. OCHA also says that food for some 40 000 people was distributed in Wau Shilluk.

In Mandeng, also in Upper Nile State, aid workers launched food distribution and health operations for some 2000 people. Aid workers have also traveled to Kodok, where they estimate there are about 28 300 people in need.

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[The number of cases of reported cholera in the Upper Nile state has increased dramatically in the past week. Bordering on Sudan, the risk of spread to Sudan is increasing. - Mod.LL

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

LASSA FEVER - NIGERIA (07): (EDO)
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Date: Fri 11 Jul 2014
Source: Weekly Epidemiological Report Vol. 4 Week 27 [edited]
http://www.health.gov.ng/index.php/comp ... -epid-news
[last updated Vol. 4 No. 19 of 16th May 2014]


Lassa fever update for week 27 as of 11 Jul 2014
-----------------------------------------
- 17 suspected Lassa fever cases with 0 deaths were reported from Esan
Central and Etsako West LGAs (Edo State) in week 27, 2014 compared
with 23 cases with 0 deaths reported from Esan Central LGA only (Edo
State) at the same period in 2013.

- Between weeks 1-27 2014, 820 Lassa fever cases with 86 lab-confirmed
and 28 deaths (CFR, 3.41 percent) from 29 LGAs (12 States) were
reported compared with 946 cases with 146 lab-confirmed and 26 deaths
(CFR, 2.96 percent) from 23 LGAs (11 States) at the same period in
2013.

- Outbreaks were investigated by the State MOH [Ministry of Health]
and FMOH [Federal Ministry of Health] and are under control. FMOH
received donations of Ribavirin (100mg/ml of 4,110 ampoules) from the
Government of Liberia through the WHO.

- Actions taken include:
- Ribavirin distributed to some of the affected the States,
- Provision of Personal Protective Equipment (PPE) to Ebonyi and Edo
States,
- A Training of Trainers for clinicians and other health workers on
Ebola, Lassa, Yellow and Dengue fever was conducted by zone between
11-16 Apr 2014 involving all the 36 States and FCT. States are
expected to cascade the training to all clinicians and other health
workers in their States.
- Also, the National Lassa Fever Rapid Response Committee (NLFRRC)
held a meeting on 30 Apr 2014 to offer solutions to the recurrent
Lassa fever outbreaks in the country.
- Biosecurity Engagement Programme (BEP) Training on Dangerous
Zoonotic Pathogens was conducted in Ibadan from 25 Jun-2 Jul 2014.
- Planning meeting for a National Lassa Fever Day was held on 10 Jul
2014.
- An Ebola preparedness plan was reviewed by the National Lassa Fever
Rapid Response Committee (NLFRRC) to include all VHFs.

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[As noted in the 2014 ProMED-mail posts on Lassa fever in Nigeria
cited below, Lassa fever virus is endemic in Nigeria and is now a
serious problem in 23 of the 36 states of that country. As Mod.CP
pointed out in his comment in archived report 20130131.1524034: "In
the countries of Africa, such as Nigeria, where Lassa fever is
endemic, the disease is a significant cause of morbidity and
mortality. While Lassa fever infection is normally mild or has no
observable symptoms in about 80 per cent of people infected with the
virus, the remaining 20 per cent have a severe, multi-system disease.
Exceptionally, Lassa fever is associated with epidemics, during which
the case-fatality rate can reach 50 per cent. There is no preventative
vaccine or treatment. The antiviral drug ribavirin has been used with
success in Lassa fever patients."

The virus is a member of the family _Arenaviridae_ and causes acute
hemorrhagic fever. It is transmitted to humans from contacts with food
or household items contaminated with excreta of multimammate rats
(_Mastomys_ spp.). Virus transmission can occur in houses or in
hospital environments or laboratories in the absence of adequate
infection control measures.

Images of _Mastomys_ mice can be seen at
http://www.ispot.org.za/node/255877.

Maps of Nigeria can be seen at
http://www.ezilon.com/maps/images/afric ... gerian.gif
and http://healthmap.org/promed/p/616. - Mod.TY]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (54): AFRICA
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In this update:
[1] Cholera - Benin (Atlantic District)
[2] Cholera - Nigeria (Bauchi State)
[3] Cholera, possible - Nigeria (Plateau State)

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[1] Cholera - Benin (Atlantic District)
Date: Mon 14 Jul 2014
Source: Slate Afrique, AFP (Agence France-Press) report [in French, machine transl., edited]
http://www.slateafrique.com/496033/beni ... it-7-morts


A cholera epidemic raging in southern Benin killed 7 out of 150 cases recently counted, the Minister of Health Services said Monday, 14 Jul 2014. "The epidemic (cholera) broke out in the health area of Allada-Ze-Toffo [the separate towns in the south] and has unfortunately already killed 7 people (...) of the 150 cases recorded," said Akoko Kinde Gazar to AFP.

"This is a disease that has quickly evolved due to the non-reporting of some cases. But today, 14 Jul 2014, we have taken steps to control the epidemic," Dr Didier Agbozognigbe, Coordinator of the infected health zone, told AFP.

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[2] Cholera - Nigeria (Bauchi State)
Date: Thu 17 Jul 2014
Source: Medecins Sans Frontieres (MSF) [edited]
http://www.msf.org/article/nigeria-msf- ... a-patients


The cholera outbreak which began in January [2014] in Bauchi State, northeastern Nigeria, is now over. More than 15 500 cases were reported, and about 14 000 of those were treated by MSF teams in Bauchi. 14 of the 20 districts of Bauchi State were affected by the cholera outbreak; however, Bauchi district accounted for over 90 percent of all the cases reported (population of Bauchi district is nearly 608 000). 2 weeks after the beginning of the outbreak, MSF intervened, beginning with a cholera treatment unit (CTU) of 30 beds in Kandahar (a suburb of Bauchi town) then a 150-bed cholera treatment center (CTC) at the main teaching hospital of Bauchi Town.

"This outbreak is more significant than the one we faced 4 years ago in the same state. [The] number of cases is higher, but fortunately the case fatality rate remained low at 0.5 per cent, bringing the number of deaths to 83 so far," said Dr Abubakr Bakri, head of mission in Abuja.

Between 40 and 45 per cent of cases were severe, requiring hospitalization for intravenous rehydration. In total, MSF teams treated over 8500 inpatients in the cholera treatment centers. 30 oral rehydration points were set up by MSF in the district to treat non-severe cases.

In this type of epidemic, and especially in a country or a city where the population is in the hundreds of thousands, it is important to contain the outbreak through preventive measures such as targeted hygiene measures to avoid contamination (especially of drinking water). In Bauchi, water supply is mainly from either public or private wells.

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[A HealthMap/ProMED-mail map of Nigeria is available at: http://healthmap.org/promed/p/62.]

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[3] Cholera, suspected - Nigeria (Plateau State)
Date: Mon 14 Jul 2014
Source: AllAfrica, Daily Trust report [edited]
http://allafrica.com/stories/201407141641.html


4 children of the same parents and 2 others have died, while several others are said to have been affected by an outbreak of a disease suspected to be cholera in Dangi town, Kanam Local Government Area of Plateau State.

Deputy Chairman of Kanam Local Government Area, who is also the Supervisory Counselor for Health, Umar Yakubu Albura, told newsmen at the weekend in Jos, that "the recent outbreak of cholera in Kanam has become a source of worry to the health department of the local government, because 3 days ago, 4 children of one family and 2 other adults died of cholera, and many others are already affected."

Albura added: "We are highly disturbed by the spread of profuse diarrhea and vomiting in Dengi and the surrounding villages. Although we received medical support from the state Ministry of Health in order to curtail spread of the disease, a good number of the affected persons prefer patronizing local health workers for treatment, rather than going to hospital, and that has a negative effect in coordinating and controlling the disease."

But Plateau State Epidemiologist, Dr Raymond Juryit, who led an outbreak investigation team and journalists to Dengi, said: "All the patients admitted were affected by malaria, typhoid and other tropical infections that are associated with diarrhea and vomiting, but it is not cholera. We have gone round to hospitals and clinics within Dengi town, including the General Hospital, but we could not establish a single case of cholera. All those we found had malaria, typhoid, shigella and other infections; 3 weeks ago, we received a report from our Disease Surveillance Officer in Dengi, and when we verified, 34 suspected cholera cases were recorded with one dead."

[Byline: Hassan Ibrahim]

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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (55): SOUTH SUDAN
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In this update:
[1] Cholera - South Sudan
[2] Cholera - South Sudan (Upper Nile)

******
[1] Cholera - South Sudan
Date: Sat 19 Jul 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/sou ... era-deaths


100 people have died in the South Sudan cholera outbreak, according to the UN's Office for Coordination of Humanitarian Affairs (OCHA). In its weekly situation report, OCHA said there have been 4418 total cholera cases since May 2014, mainly in Juba, Eastern Equatoria, and Upper Nile [states], with a fatality rate of 2.3 percent, [which is] above the emergency threshold.

The biggest increase of cholera is in Wau Shilluk, a village in Upper Nile downstream from Malakal, where there have been 793 confirmed cases. To deal with the outbreak in Wau Shilluk, OCHA said that clean water access is being ramped up and volunteers are providing the population with cholera prevention and awareness messages. Aid agencies are also providing soap and hand washing stations.

New cholera cases are under investigation in Malakal and Bol, Upper Nile, as well as Kapoeta North, Eastern Equatoria. In Bentiu, Unity State, where there have been suspected but unconfirmed cases, a new site has been prepared for a cholera treatment center.

Rains are severely hampering delivery of aid to affected populations, with 90 percent of main roads in Jonglei impassable and 75 percent impassable in Unity State. Insecurity has also slowed distribution of aid, including food. A food distribution to 37 000 people in Nhialdiu, Unity state, was disrupted on Tuesday, 15 Jul 2014, by clashes between pro- and anti-government forces.

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[2] Cholera - South Sudan (Upper Nile)
Date: Fri 18 Jul 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/cho ... oda-county


Health workers in Fashoda County in South Sudan's Upper Nile State said there have been about 18 cases of cholera with 5 deaths in the last 2 weeks [about 4-18 Jul 2014]. The infected citizens are currently getting medical attention at cholera treatment centers established by Doctors Without Borders [MSF] and South Sudan Society of Red Cross [SSRCS] at Lol and Poul villages.

Dr. Olau Alou, the Fashoda County Medical Services Director, told Radio Tamazuj on Wednesday [16 Jul 2014] that the 5 fatalities and the 18 confirmed cholera cases were from Lol and Poul areas. The official also expressed concern about the spread of the outbreak to the neighboring areas in Upper Nile. He attributed the problem to the movements of infected people to areas where there are no health facilities, which makes it difficult to contain the outbreak.

Alou noted the 13 [remaining] patients are now receiving treatment at therapeutic centers, saying the county headquarters have not recorded any cholera cases so far. "The MSF and SSRCS [South Sudan Red Cross Society] have opened about 3 cholera treatment centers in Lol, Kodok and Poul areas," he explained.

Last week [week ending 13 Jul 2014], a medical assistant in Kodok Payam Hospital told Radio Tamazuj that 4 people died of cholera and about 100 cholera cases were recorded in the Lol area alone.

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[There are 10 states in the nation of South Sudan, as can be seen on this map: http://en.wikipedia.org/wiki/States_of_South_Sudan.

Up to this point, many of the cases have been in the eastern part of the country, both in the south (Eastern Equatoria State) and north (Upper Nile State) but with a few cases in the central eastern state, Jonglei. - Mod.LL

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

TYPHOID FEVER - ZIMBABWE: (HARARE)
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Date: Mon 21 Jul 2014
Source: NewsDay Zimbabwe [edited]
https://www.newsday.co.zw/2014/07/21/ne ... ts-harare/


A typhoid fever scare has hit parts of Harare where 18 new suspected cases were recorded over the past week. According to the latest disease surveillance report released by the Ministry of Health and Child Care, the outbreak was also recorded in Mashonaland and Manicaland provinces.

Typhoid fever is a bacterial disease caused by _Salmonella_ Typhi. It is transmitted through the ingestion of food or water contaminated with human waste from an infected person. Symptoms usually develop from about 3 weeks after exposure and may be mild or severe. They include high fever, malaise, headache, constipation or diarrhoea, rose-coloured spots on the chest, and enlarged spleen and liver. Healthy carrier state may follow acute illness.

The typhoid outbreak comes at a time Harare residents have had erratic water supplies and poor quality tap water. Most research findings have condemned the quality of water supplied by Harare City Council although council officials have insisted that the water had passed World Health Organization standards.

The report also said there has been an increase in diarrhoea-related deaths. "25 diarrhoea deaths were reported within a week in which most cases are attributed to rotavirus infection and mostly in under 5 [year old] children," the report reads. Lately, the government has scaled up its rotavirus vaccinations to curb the outbreak especially among children aged between 6 and 10 weeks.

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[Typhoid fever outbreaks were reported in and around Harare in 2011, 2012, and 2013, with a total number of suspected cases reported to about 5000 (see ProMED-mail post Typhoid fever update 2012 (12): Zimbabwe (HA) 20121209.1443859).

An investigative team from the US Centers for Disease Control and Prevention, in collaboration with Zimbabwe government officials, attributed this outbreak to fecal contamination of drinking water in the overcrowded residential suburbs of Harare, where rural-to-urban migration has outpaced maintenance and expansion of water supply and sewerage infrastructure (Notes from the Field: _Salmonella_ Typhi Infections Associated with Contaminated Water -- Zimbabwe, October 2011-May 2012 CDC. MMWR Morb Mortal Wkly Rep 2012; 61(23); 435. Available at http://www.cdc.gov/mmwr/preview/mmwrhtm ... mm6123a3_e).

Zimbabwe is divided into 8 provinces and 2 cities (Harare and Bulawayo) with provincial status (http://en.wikipedia.org/wiki/Bulawayo_Province). Manicaland province is located on Zimbabwe's eastern border adjacent to the Republic of Mozambique. Mashonaland East, Mashonaland Central, and Mashonaland West provinces surround Harare (http://en.wikipedia.org/wiki/Provinces_of_Zimbabwe).

Harare is the largest city and capital of Zimbabwe and has an estimated population of 1 606 000 (2009), with 2 800 000 in its metropolitan area (2006) (http://en.wikipedia.org/wiki/Harare). Harare can be located on the HealthMap/ProMED-mail interactive map of Zimbabwe at http://healthmap.org/promed/p/171. - Mod.ML]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (56): NIGERIA
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Cholera - Nigeria (Kano State)
Date: Sun 20 Jul 2014
Source: Yahoo News, Agence France-Presse (AFP) report [edited]
http://news.yahoo.com/cholera-kills-six ... 42746.html


A cholera outbreak in northern Nigeria's Kano State has killed 6 people and infected scores, the state health commissioner said on Sun 20 Jul 2014, although a local charity put the toll higher. "6 people died out of the 46 cases recorded," Abubakar Labaran Yusuf told AFP [Agence France-Presse] of the outbreak this week in Kafin Dalawa village, 70 km (43 miles) outside the state capital of Kano.

Contaminated water in the area was the most likely cause, he said, adding that teams had been dispatched to clean water sources and supply drugs.

But a local medical charity put the toll higher, saying at least 16 people had died and that the outbreak was threatening to become a pandemic. "We have recorded 16 deaths from the cholera outbreak in the past 6 days, which has so far infected 701 people with 20 severe cases," Surajo Alkassim of ISMA Medicare Initiatives told AFP. He said the organisation had been treating patients in a make-shift hospital in the village since the outbreak. "The outbreak is becoming a pandemic in the area because patients are trooping from neighbouring villages, which is putting a strain on our team and medical supplies," Alkassim said.

Cholera, a highly contagious intestinal infection, is transmitted by water soiled by human waste. The disease leads to diarrhoea, dehydration and death if untreated.

Outbreaks are commonest during the rainy season, which runs roughly rom April to October in Nigeria.

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[Maps of Nigeria can be accessed at http://www.un.org/Depts/Cartographic/ma ... igeria.pdf and http://healthmap.org/promed/p/887.]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (57): GHANA
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******
Cholera - Ghana (Accra)
Date: Wed 23 Jul 2014
Source: Spy Ghana, Myjoyonline report [edited]
http://www.spyghana.com/cholera-hits-ac ... roundings/


An outbreak of cholera has left 2 people dead and 350 more visiting hospitals in Accra. The figures, according to deputy director of health for the Greater Accra Region, Dr John Eleaza, has been recorded in the last 3 weeks in 4 out of Greater Accra's 16 districts. He mentioned that Accra Metro has recorded 274, Ga West, 14, La Dade-Kotopon Municipal Assembly 58, and Ledzokuku-Krowor Municipal District 4 cases.

The outbreak confirms fears expressed by the Ghana Health Service (GHS) in May [2014] that said a breakdown in waste management and increasingly dirty capital could spark an epidemic as the rainy season began. "It is the filth everywhere and the lack of hygiene among our people," the deputy director said, noting that some patients have been victims of the disease despite using pipe-borne water. "Unfortunately we have some of our pipelines going through some of these drains...some of them are broken," he said.

He is advising Ghanaians to be careful and practise proper hygiene to prevent a deterioration of the outbreak. He also advised taxi drivers to disinfect their cars after conveying victims to the hospital.

After reporting a total of 10 628 cases by the close of 2011 and a total of 105 deaths, Ghana was ranked 5th most cholera-endemic country in Africa after Democratic Republic of Congo.

Cholera is an acute diarrhoea illness caused by the bacterium _Vibrio cholerae_ that could result in a profound and rapidly progressive dehydration and death. An untreated person with cholera may produce 10-20 litres of faecal matter a day with fatal results.

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CHOLERA, DIARRHEA AND DYSENTERY UPDATE (58): AFRICA
*******************************************************************
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http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Cholera - Nigeria (Borno State) refugee camps
[2] Cholera - Nigeria (Taraba State)
[3] Cholera - Cameroon (Extreme North Province)
[4] Cholera - Ghana (Accra)
[5] Cholera - South Sudan

******
[1] Cholera - Nigeria (Borno State) refugee camps
Date: Tue 29 Jul 2014
Source: Daily Post [edited]
http://dailypost.ng/2014/07/29/boko-har ... amp-borno/


Cholera has hit the 2 camps in Biu Local Government Area of Borno state, where refugees who fled their homes in Damboa Local Government area of the state as a result of attacks by the Islamic sect, Boko Haram are taking shelter.

DailyPost learned that the 2 camps housing over 11 000 refugees need immediate medical intervention as a result of the spread of the disease. According to reports in Biu, the camps have started witnessing a number of victims of cholera.

Mallam Habu Isa, a resident of Biu told DailyPost that the camp at one of the Primary Schools in Biu and the one at Government Girls' Secondary School in Biu town were begging for immediate assistance from the Borno State Government. He said that some medical personnel from Maiduguri, were at the camps, lamenting that they left after 2 days, but the disease has continued to affect the 2 camps.

[Byline: Maina Maina]

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******
[2] Cholera - Nigeria (Taraba State)
Date: Mon 28 Jul 2014
Source: Leadership [edited]
http://leadership.ng/news/379267/choler ... s-6-taraba


A deputy director of health in the Bali local government of the Taraba State, Mr Adamu Alura, stated yesterday, 27 Jul 2014, during an interview with journalists, that 6 people have already lost their lives from cholera while 27 others are currently receiving treatment at various hospitals in the local government.

He noted that those affected by the disease are from Bali A and B wards of the local government area.

"I have already written to the local government management for money to enable them buy drugs for the treatment of those affected by the disease," he said, adding that they have also written to the concerned authority in the state on the outbreak of the disease, while the state government has directed a senior staff at the state ministry of Environment to sensitise people on the need to observe proper hygiene.

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[The states of Nigeria can be found on a map at http://www.un.org/Depts/Cartographic/ma ... igeria.pdf with Borno in the extreme northeast and Taraba in east-central Nigeria. A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/62. - Mod.LL]

******
[3] Cholera - Cameroon (Extreme North Province)
Date: Tue 29 Jul 2014
Source: Voice of America (VOA) News [edited]
http://www.voanews.com/content/cholera- ... 67266.html


A cholera epidemic has hit northern Cameroon, killing more than 200 people in less than a month. The government of the central African nation and aid agencies say some of the affected persons are refugees fleeing the Nigerian militant group Boko Haram. Cameroon's Far North regional delegate for public health, Dr Rebecca Djao, says the death toll from cholera in hospitals has surged to more than 100 and deaths out of hospital are also estimated at more than 100. The epidemic follows heavy rains that triggered flooding.

Cameroon's Minister of Public Health Andre Mama Fouda told VOA a majority of people infected with the disease are children under the age of 5 and women.

He advised people to drink only potable water and not get their water from rivers, which can carry the disease downstream if infected fecal matter or bacteria is in the water. "I have asked them to boil water from suspicious sources before drinking," he said, "and to stop their children from defecating in bushes and streams, adding that people should not dig pit toilets near water wells." The hardest hit areas are Logone, Chari and Mayo Sava where safe drinking water is usually in short supply.

Fru Angwafor, a senior health official, said some of the patients were refugees fleeing violence in neighboring Nigeria. "It is not possible to stop people from moving so it is entirely possible that somebody that is contaminated is moving from one region to the other and this essentially has been the case. Because of this high mobility of patients we now have the disease in this areas," said Angwafor.

The country's Red Cross movement and the National Order of Medical Doctors have warned that if resources are not deployed to fight the disease, Cameroon may be in for a repeat of the 2010 epidemic, when the country had to deal with 10 000 cases of cholera, more than 80 percent of them in the north. That epidemic killed about 4000 people.

[Byline: Moki Edwin Kindzeka]

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[A map of the provinces of Cameroon can be found at http://www.ephotopix.com/image/africa/c ... ce_map.gif. The Extreme North region shares a border with the Borno State of Nigeria where cholera is also occurring. A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/8958- Mod.LL]

******
[4] Cholera - Ghana (Accra)
Date: Wed 30 Jul 2014
Source: Star Africa, Agence Africaine de Presse (APA) report [edited]
http://en.starafrica.com/news/cholera-t ... ghana.html


Some parts of the Ghanaian capital of Accra are battling an outbreak of cholera which has so far killed 5 people, according to Hospital Administrator at La General Hospital Philip Afeti Korto in Accra. Mr Afeti Korto told reporters on [Tue 29 Jul 2014], over 170 cases had been reported with 5 persons losing their lives in the situation which broke out a week ago. Affected victims are reported to have come from other suburbs in the capital such as Osu, Teshie, and Nugua.

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[A map of Ghana showing the southern location of Accra can be found at http://www.theafricachannel.co.uk/wp-co ... a-map1.jpg. A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/1850. - Mod.LL]

******
[5] Cholera - South Sudan
Date: Wed 30 Jul 2014
Source: Medecins sans Frontieres (MSF) [summ., edited]
http://www.msf.org/article/cholera-clai ... outh-sudan


Communities and displaced populations living in congested camps with poor hygiene and sanitation are at high risk of contracting cholera in South Sudan. Since the beginning of July [2014], Medecins sans Frontieres (MSF) teams in Upper Nile State have treated over 904 patients for cholera. The teams have set up 2 cholera treatment centres in Malakal and Wau Shilluk where they are treating cholera patients from affected areas.

Since April 2014, a total number of 4765 cases of cholera have been reported in South Sudan. 109 people have died of the disease, 19 of them from Upper Nile State. MSF has set up cholera treatment centres in different parts of South Sudan, including Torit and Juba. The organisation is also supporting the Juba teaching hospital with water and sanitation activities.

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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]

RABIES - ZIMBABWE (03): (MASHONALAND EAST & WEST) HUMAN, CANINE, FELINE
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Date: Thu 31 Jul 2014
Source: The Zimbabwean [edited]
http://www.thezimbabwean.co/news/zimbab ... cases.html


Veterinarians for Animal Welfare Zimbabwe (VAWZ) has expressed serious concern at the "increasing" number of rabies cases in the country amid reports the disease has killed a child.

VAWZ, a Harare based animal well-being non-profit organisation, said a dog from Arcturus [Mashonaland East Province] outside the capital and a feral cat from Avondale [suburb of Harare] recently tested positive for rabies.

A young boy from Chegutu [Mashonaland West Province], added VAWZ, succumbed to the deadly disease after a neighbour's dog bit him.

There have also been unconfirmed reports of a mild rabies outbreak in rural Shurugwi.

"VAWZ is deeply concerned with the increasing number of confirmed rabies cases throughout Zimbabwe," said the organisation. It added: "We cannot stress enough the importance of having ALL your pets vaccinated annually against this deadly disease. Should you come into contact with an unknown animal, particularly one displaying unusual behaviour, please seek medical advice immediately." It said children must be warned not to interact with strange animals.

The animal welfare organisation advised people to report sightings of suspect animals to VAWZ on 0778431528 and 0775722449 or the nearest veterinary surgery.

In the absence of early detection and treatment, rabies is about 100 percent fatal.

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[I think we can assume that rabies is presently widespread in Zimbabwe, and only a minority of animal & human cases are being reported. And when that happens there is minimal disease control.

For a map of Zimbabwe, go to: http://www.lib.utexas.edu/maps/africa/z ... o-2002.jpg. Arcturus is in Mashonaland East Province and at: http://www.fallingrain.com/world/ZI/04/Arcturus.html. Avondale is a suburb of Harare and at: http://www.fallingrain.com/world/ZI/04/Avondale.html. Chegutu is in Mashonaland West Province to the south west of Harare, and at: http://www.fallingrain.com/world/ZI/00/Chegutu.html. - Mod.MHJ]

CHOLERA, DIARRHEA AND DYSENTERY UPDATE (59): 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] & [2] Cholera - Ghana (Accra)
[3] Cholera - Nigeria (Borno State)
[4] Cholera - Nigeria (Kaduna State)
[5] Cholera - Congo DR (South Kivu Province)


******
[1] Cholera - Ghana (Accra)
Date: Wed 30 Jul 2014
Source: Xinhua News Agency [edited]
http://news.xinhuanet.com/english/healt ... 520975.htm


The death toll from cholera outbreak in Ghana's capital, Accra, has risen from 5 to 15 out of over 850 reported cases, health officials said Wednesday, 30 Jul 2014. Between June and July 2014, the Greater Accra region has recorded a total of 878 cholera cases, with the Accra Metropolis alone accounting for 604 of the cases and 8 deaths.

Poor sanitation in the metropolis has been cited as the main cause of the outbreak of the disease, thereby bringing pressure on infrastructure at various hospitals and clinics. Health experts had predicted the incidence of the disease and death toll could escalate, primarily with the onset of the rains coupled with poor environmental hygiene and inadequate safe water.

But senior health officials say the disease is not yet at its peak but have cautioned the public to take precautionary measures to avoid contamination, including eating cooked food while it was still hot, boiling drinking water and washing hands with soap before eating. They have also advised the public to report suspected cholera cases to the nearest health facilities since early reporting is very critical to treating the disease.

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******
[2] Cholera - Ghana (Accra)
Date: Fri 1 Aug 2014
Source: GhanaWeb, TV3 report [edited]
http://www.ghanaweb.com/GhanaHomePage/h ... ?ID=319450


Authorities at the La General Hospital in Accra have been forced to turn the out-patient department (OPD) of the hospital into a cholera bay as a result of soaring numbers in recorded cases. TV3 gathers that as of Friday, 1 Aug 2014, 15 new cases of the bacterial disease was recorded at the hospital.

Speaking to our correspondent on Friday, Dr Samuel Asamoah, the hospital's Physician Assistant, said the major challenge facing the hospital is space. "We don't have anywhere to send the patients back," he noted, however. He observed that most of the patients brought to the hospital are from the La municipality, generating worry in the face of an epidemic.

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[A HealthMap/ProMED-mail map showing Accra, Ghana, is available at http://healthmap.org/promed/p/1850.]

******
[3] Cholera - Nigeria (Borno State)
Date: Fri 1 Aug 2014
Source: AllAfrica, CAJ News report [edited]
http://allafrica.com/stories/201408010932.html


A total of 8 people have reportedly died following a cholera outbreak at an internally displaced persons (IDPs) camp located at Biu in Borno State. The Red Cross reported that the epidemic had affected over 100 people out of the 10 000 IDPs at the camp.

A Red Cross official, under the condition of anonymity, told journalists that about 30 persons out of the initial 100 affected by the disease have so far fully recovered. He said others are gradually recovering and responding to treatment being offered by the joint team of the Borno state health workers, National Emergency Management Agency (NEMA) and Red Cross Society of Nigeria at the camp.

According to the official, the situation at the camp was made worse with Borno State not making available inadequate drugs and vaccination on the camp, but the medical team and other auxiliary team at the camp have been doing their best in controlling and treating the cholera outbreak.

Ministry of Health officials declined to comment. Borno State Commissioner of Health, Dr Salma Anas Kolo, could not be reached for comment.

[Byline: Augustine Osayande]

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******
[4] Cholera - Nigeria (Kaduna State)
Date: Sat 2 Aug 2014
Source: Leadership [edited]
http://leadership.ng/news/379756/choler ... ak-kills-7


A total of 7 people have died of cholera in 3 villages of Kudan local government area of Kaduna State, Leadership Weekend has gathered. 6 persons from 2 separate families were the casualties of the cholera outbreak in Hukunyi and Zabin-Kudan villages; 1 person was reportedly killed in Rimi Biso village in the same Kudan local government area. Investigations revealed that the outbreak has led to the hospitalization of over 30 villagers at the Hukunyi General Hospital and Kudan Primary Health Care Centre.

Confirming the outbreak, the chairman of the local government, Alh. Umar Ibrahim, blamed the cholera outbreak on the carelessness of the people. According to him, the outbreak was as a result of lack of toilets and absence of environmental hygiene.

[Byline: Midat Joseph]

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[A HealthMap/ProMED-mail map showing Nigeria can be accessed at http://healthmap.org/promed/p/62.]

CHOLERA, DIARRHEA & DYSENTERY (60): 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] Cholera - South Sudan (Eastern Equatoria State)
[2] Cholera - Burundi (Bururi Province)
[3] Cholera - Cameroon (Extreme North Province)
[4] Cholera - Nigeria (Borno State)
[5] Shigellosis - Egypt (South Sinai Governorate), resort, UK travelers

******
[1] Cholera - South Sudan (Eastern Equatoria State)
Date: Sat 2 Aug 2014
Source: Radio Tamazuj [edited]
https://radiotamazuj.org/en/article/sou ... ases-torit


An outbreak of cholera that has killed at least 118 people is declining in the South Sudanese capital but continues to spread in the town of Torit to the east, according to the South Sudan Red Cross. The UN says that nationwide there have been 5459 cases as of 30 Jul 2014, with a case fatality rate of 2.16 percent.

"Despite the decline in cholera cases in Juba where the 1st cases of cholera were reported, the disease continues to spread to other states," the Red Cross said in an article published on its website on Thu 31 Jul 2014. Marial Mayom, writing for the South Sudan Red Cross noted, "Most new cases are being reported in Torit, Eastern Equatoria, 150 kilometers [93 mi] east of Juba and close to South Sudan's border with Uganda."

The UN coordination office says the cholera outbreak is hard to control. In an update on Fri 1 Aug 2014 the UN said, "Early detection and prevention of new cases in Eastern Equatoria State remains a challenge because many communities are distant from health units and social mobilization activities."

The South Sudan Red Cross says its has trained 45 volunteers in Torit to spread health messages and to distribute oral rehydration salts, purification tablets and soap. They are also showing videos in public places to educate people on how to they can protect themselves from cholera.

Philip Marchelo, the South Sudan Red Cross branch director in Eastern Equatoria said, "I am appealing to the partners to support us particularly during the ongoing operation to curb the cholera outbreak in the state.''

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[The states and counties of the nation of South Sudan can be found on a map at http://mapsof.net/map/south-sudan-map-states. Eastern Equatoria is at the southeastern corner of the country. - Mod.LL

A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/39866.]

******
[2] Cholera - Burundi (Bururi Province)
Date: Sun 3 Aug 2014
Source: Global Post, Xinhua News Agency report [edited]
http://www.globalpost.com/dispatch/news ... -1-burundi


At least 86 persons have caught cholera and one of them has already died in less than 2 weeks when cholera broke out in the Burundian town of Rumonge in the province of Bururi, some 70 km [43.5 mi] south of the Burundian capital Bujumbura, the director of Rumonge Hospital told Xinhua by phone on Sun 3 Aug 2014. "For less than 2 weeks, at least 86 persons from Rumonge neighborhoods came to hospital with cholera symptoms and 1 of them has died," said Dr Lambert Bigirindavyi, Director of Rumonge Hospital.

According to Bigirindavyi, drugs and equipment to control drugs are a "big challenge" because the stock is almost empty. He commended the UNICEF and the Burundi Red Cross for availing drugs and the equipment but called on both organizations and other organizations to provide more medical assistance to control cholera.

Bigirindavyi said, "A week ago cholera was declared in Rumonge town in 2 neighborhoods including Iteba and Nkayamba, but it has now expanded to 6 neighborhoods namely Iteba, Nkayamba, the Swahili neighborhood, Kagongo, Ihwanya, and Nyakarara. "He indicated that 27 cholera patients are still in isolation tents at Rumonge Hospital and added that other people who had cholera have gone back home because they were healed.

On 20 Jun 2014, Burundian Public Health and AIDS Control Minister Dr Sabine Ntakarutimana officially declared a cholera outbreak in some parts of the east African country's western lowlands.

The town of Rumonge, which is Burundi's 4th biggest town after the capital Bujumbura, Gitega, and Ngozi, had also been warned to be watchful about cholera attack.

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[A map of Burundi showing the province of Bururi in the southwest can be found at http://www.emapsworld.com/burundi-provinces-map.html. - Mod.LL

A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/17210.]

******
[3] Cholera - Cameroon (Extreme North Province)
Date: Sat 2 Aug 2014
Source: Thomson Reuters Foundation [edited]
http://www.reuters.com/article/2014/08/ ... EE20140802


A cholera epidemic in northern Cameroon has killed at least 65 people and probably infected about 1300 people in 2 months, as international attention has been diverted to fighting Ebola in West Africa, health experts said on Sat 2 Aug 2014. They said the insurgency by Islamist sect Boko Haram was also hampering efforts to control the outbreak.

Some 185 suspected cholera cases were recorded last week alone in the outbreak focused on the Mogode, Hina, and Bourha districts on the turbulent Nigerian border. The death toll is expected to climb as more cases are confirmed by laboratory testing. Atilio Rivera-Vasquez, public health adviser in the region for International Medical Corps, said Cameroonian health authorities were diverting resources to impose checks at border crossing and airports for Ebola, after it killed more than 700 people in Guinea, Sierra Leone, and Liberia. "This is distracting from an appropriate and fast response to this cholera epidemic," Rivera-Vasquez said.

He added that the violent activities of Boko Haram in neighboring northern Nigeria partly explained why the outbreak was not being brought under control.

Cameroon has some 100 000 double-doses of an oral cholera vaccine that showed high efficacy in a 2012 trial in Guinea. However, insecurity in the north has deterred the government from immunizing. The cholera outbreak has shown a worrying increase in mortality in the last few months, he said, rising to 4.8 percent or more than double the 2 percent maximum cited in WHO guidelines.

Julian Schlubach, from the European Union's aid agency, ECHO, said the situation was alarming because the rainy season -- the worst time for cholera -- still lay ahead.

The 1st 3 cases in Cameroon were reported in late April [2014] in the Far North region after a Nigerian family crossed the border to receive treatment. The UN refugee agency (UNHCR) said some 60 000 refugees have fled into Cameroon, Niger, and Chad from northern Nigeria, where fighting between the government and Boko Haram has killed thousands in the last 6 months. Some of them are carrying the disease.

"People in northern Nigeria cannot get to health clinics in time due to the awful security situation and that's one reason why they come across the very porous border where they have family or tribal ties," said Rivera-Vasquez. Some 24 683 cholera cases have been reported in Nigeria since the beginning of 2014, according to the Assessment Capacities Project, a consortium of international NGOs which check humanitarian needs in emergencies and crises.

In Cameroon, a country of 22 million people, outbreaks of the disease cause alarm because of poor sanitary conditions, particularly in rural areas. According to a 2011 government survey, 54 percent of rural households have only cesspools or open holes, whilst 50 percent use drinking water from unprotected wells or surface water.

A similar outbreak in Cameroon killed more than 4000 people in 2011/12. The current outbreak is the first major epidemic since then.

[Byline: Misha Hussain, Tansa Musa]

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[A map of the provinces of Cameroon can be found at http://www.ephotopix.com/image/africa/c ... ce_map.gif. The Extreme North region shares a border with the Borno State of Nigeria where cholera is also occurring. - Mod.LL

A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/8958.]

******
[4] Cholera - Nigeria (Borno State)
Date: Mon 4 Aug 2014
Source: This Day Live [summ., edited]
http://www.thisdaylive.com/articles/cho ... mp/185319/


The Borno State Commissioner for Health, Dr Salma Anas Kolo, yesterday said 27 persons had so far died of cholera in one of the Internally Displaced Persons (IDPs) camps in Biu. The commissioner who spoke on phone from Biu where she had proceeded from Maiduguri to monitor the case of cholera outbreak in 1 of the 2 camps established by the National Emergency Management Agency (NEMA) for over 10 000 displaced persons from Damboa, said 16 persons died in the camp and 11 others died at the hospital where they were taken to for treatment. She also revealed that the total number of cholera cases at the camp came to about 375 with about 30 of them hospitalised.

The commissioner narrated that the victims contacted the disease as a result of the poor hygienic condition at the camp, adding that the state government in conjunction with UNICEF and the Red Cross had moved in to improve the condition in the camp and equally provided medical services.

To prevent further spread of water borne diseases, Anas-Kolo said: "Antiseptics for disinfecting all possible sources of infection have also been supplied for distribution to the resettlement camps that holds over 10 000 displaced persons from Damboa and its environs.

[Byline: Michael Olugbode]

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[A map of Nigeria's states can be found at http://en.wikipedia.org/wiki/States_of_Nigeria. Borno is at the extreme northeastern corner bordering on the northern aspect of Cameroon where cases in refugees are also occurring - Mod.LL

A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/33088.]

******
[5] Shigellosis - Egypt (South Sinai Governorate), resort, UK travelers
Date: Sun 3 Aug 2014
Source: Mirror [summ., edited]
http://www.mirror.co.uk/news/world-news ... sh-3976704


[Poor hygiene and shigellosis] have been blamed for a sickness sweeping the 4-star Coral Sea Waterworld complex in Sharm el Sheikh, Egypt. Up to 100 British tourists have fallen ill at the Egyptian holiday resort. Several were still on intravenous drips in their hotel rooms last night [2 Aug 2014].

Angry holidaymakers blamed the virulent bug on dirty buffet food containers, utensils and tables, and poor hygiene. It has spread so fast that resort bosses have had to draft in extra doctors to cope with the sickness outbreak.

[Byline: Andy Lines, Simon Lennon]

--
Communicated by:
Dr Tony Ellam
Consultant in Communicable Disease Control (ret)
United Kingdom
<tonypj@meadlane.freeserve.co.uk>

[South Sinai is the least populated governorate of Egypt. It is located in the east of the country, encompassing the southern half of the Sinai Peninsula and can be found on a map at http://en.wikipedia.org/wiki/South_Sinai_Governorate. The resort is at the governorate's southern tip.

A HealthMap/ProMED-mail map can be accessed at http://healthmap.org/promed/p/15013.

ProMED-mail thanks Dr Ellam for this shigellosis report - Mod.LL]