CHOLERA OUTBREAK

Cholera in Sierra Leone

22 AUGUST 2012 - Since the beginning of the year, Sierra Leone has recorded 11 653 cases of cholera, with 216 deaths (Case Fatality Rate of 1.9%). The rate of new cases has accelerated rapidly since the beginning of August: since then, 5 706 cases have been recorded, and two new districts, Bonthe and Kono, have been affected by the epidemic. Ten of the country’s 13 districts are now registering cases and this spread emphasizes the need to rapidly scale up the response.

The two most heavily affected districts are Western Area and Tonkolili.

The President of Sierra Leone has declared the escalating cholera epidemic a “humanitarian crisis”. Consequently, a multi-sectoral approach to the response has been adopted involving the Ministry of Health and Sanitation (MOHS), as well as other line ministries such as finance, information and communication, and local government, together with partners and stakeholders. A National Emergency Task force has been established with sub-committees dealing with surveillance, case management, water and sanitation, logistics and social mobilization. The WHO Country Office (WCO) in Sierra Leone is chairing a weekly meeting of partners and stakeholders to better coordinate harmonize and strategize support.

The MOHS, in partnership with Médecins sans Frontières (MSF), UNICEF, WHO, and other partners, is implementing the following prevention and control activities: epidemiological investigation, surveillance, case management at established cholera treatment centres, water and sanitation control measures, social mobilization and community education.

WHO is supporting Sierra Leone in the areas of epidemiology, social mobilization and surveillance. WHO has deployed two epidemiologists, and three cholera experts from Zimbabwe to support coordination, public information, social mobilization, case management and infection control.

WHO does not recommend that any travel or trade restrictions be applied to Sierra Leone.

OUTBREAK NEWS

Ebola outbreak in Democratic Republic of Congo - update

21 AUGUST 2012 - As of 20 August 2012, a total of 15 (13 probable and 2 confirmed) cases with 10 deaths have been reported in Province Orientale in Eastern DRC. The reported cases and deaths have occurred in 3 health zones as follows: 12 cases and 8 deaths in Isiro, including three (3) health care workers who have died; 2 cases and 1 death in Pawa; and 1 fatal case in Dungu.

The Congolese Ministry of Health has convened a National Task Force and is working with several partners including WHO, UNICEF, Médecins sans Frontières (MSF) Suisse, MSF Belgique and the United States Centres for Disease Control and Prevention (CDC). Similar Task Forces have been established at provincial and district levels to oversee and guide the response.

A joint MoH, WHO and MSF emergency response team is in the field to conduct a detailed epidemiological investigation and support case management. Control activities that are being carried out include active case finding and contact tracing, enhanced surveillance, case management, public information and social mobilization, and reinforcing infection control practices.

WHO is supporting the Ministry of Health in the areas of coordination, surveillance, field epidemiology, laboratory, case management, outbreak logistics, public information and social mobilization. An additional team of epidemiologists, a logistician, an anthropologist and social mobilization officers is being mobilized from the DRC, Republic of Congo, the WHO AFRO regional rapid response team, WHO Inter-Country Support team (IST) based in Gabon, and WHO HQ, for possible deployment in the field.

WHO does not recommend that any travel or trade restrictions be applied to Democratic Republic of Congo.

AVIAN INFLUENZA UPDATE

Avian influenza – situation in Indonesia – update

10 AUGUST 2012 - The Ministry of Health of Indonesia has notified WHO of a new case of human infection with avian influenza A(H5N1) virus.

The case is a 37 year old male from Yogyakarta province. He developed fever on 24 July 2012, was hospitalized on 27 July and died on 30 July.

Epidemiological investigation on the case found that the case had four pet caged birds in his home, which is about 50 metres from a poultry slaughter house and near a farm.

Infection with avian influenza A(H5N1) virus was confirmed by the National Institute of Health Research and Development (NIHRD), Ministry of Health and reported to WHO by the National IHR Focal Point.

To date, the total number of human influenza A(H5N1) cases in Indonesia is 191 with 159 fatalities, 8 (all fatal) of which occurred in 2012.

Ebola in Uganda – update

14 AUGUST 2012 - The Ministry of Health of Uganda (MoH) continues to work with partners including WHO, CDC, Red Cross, MSF, World Vision, PREDICT, among others to control the outbreak of Ebola haemorrhagic fever in Kibaale district. The national and district task forces continue to meet daily to coordinate the response to the outbreak.

To date, 24 probable and confirmed cases including 16 deaths have been reported. 10 cases have been laboratory confirmed by the Uganda Virus Research Institute (UVRI) in Entebbe. The most recent confirmed case was admitted in Kagadi isolation facility on 4 August 2012.

Suspected cases which tested negative during the laboratory investigations have been discarded as Ebola patients, treated symptomatically for their ailments and discharged following recovery. A total of 43 people have been discharged from the isolation facility including one confirmed case. With the support of the psychosocial team, these 43 people have been counselled prior to discharge and reintegrated into the community. Even for the people who were negative for Ebola, psychosocial counselling of the communities to which they are returning, has been very important. It has allayed fears and reduced stigma, enabling them to be accepted back in the community.

All contacts of probable and confirmed cases are followed up daily for 21 days and are monitored for any possible signs or symptoms of illness. All alerts of suspected cases in the other districts have been investigated and are negative for Ebola.

In Kibaale district, the MoH is working in close coordination with Médecins Sans Frontières (MSF) in clinical management of suspected and confirmed cases.

Social mobilization teams comprising Red Cross volunteers and village health teams have reached most of the villages and households in the most affected sub-counties in Kibaale district. These activities are reinforced by the distribution of Information, Education and Communication (IEC) materials, and by the broadcast of health awareness messages on radio and by film vans.

Neighbouring countries

Countries sharing borders with Uganda are taking steps to enhance surveillance for Ebola; at the time of this update, none of them have reported any confirmed cases.

WHO does not recommend that any travel or trade restrictions are applied to Uganda.