South Sudan: Cholera Outbreak - Jul 2016
Overview
South Sudan’s Minister of Health advised partners to treat the recent rise in suspected cholera cases as a cholera outbreak, and respond accordingly. UNICEF’s Cholera Task Force is fully operational, and measures are being taken to enhance water, sanitation, and hygiene – over 100,000 liters of sewage were collected from UN House POC on 18 July. (UNICEF, 18 Jul 2016)
As of 17 November, communities along the River Nile are worst affected and account for 91 per cent of reported cholera cases. A total of 2,874 cases and all 44 deaths from the outbreak have been reported from eight counties straddling the River Nile: Awerial, Duk, Fangak, Juba, Leer, Pageri, Pigi and Terekeka. Rubkona is the only county affected by the outbreak that is not along the Nile. Juba has the highest number of cases (1,990 - 63 per cent of the total), while Terekeka has the highest case fatality rate. (OCHA, 21 Nov 2016)
As of 5 May 2017, cholera outbreaks have been confirmed in 19 counties in South Sudan. The most affected counties are located along the River Nile. This suggests vehicle-borne transmission from contaminated water in affected counties. Cumulatively, 7,735 cholera cases, including 246 deaths (76 facilities and 170 community) (CFR 3.23%), have been reported in South Sudan since the initial case was reported on 18 June 2016. Nine out of 19 counties ever affected since June 2016 are considered to have active transmission, having reported cholera cases in the past four weeks. (WHO, Govt. South Sudan, 5 May 2017)
Cholera transmission has continued to decline countrywide. In the last four weeks [weeks 37- 40] , cholera cases dropped from at least 40 cases in week 37 of 2017 to at least 15 cases in week 40 of 2017. Three counties [Juba, Budi, and Fangak] have registered cholera transmission in the last four weeks [ 37-40]. A total of 135 cases have been reported from the three counties in the last four weeks [37-40]. Most of the cases have been reported from Juba [112 cases] while Budi and Fangak reported 16 cases and 7 cases respectively. (WHO, 6 Oct 2017)
As part of the ongoing cholera response, health partners have deployed cholera vaccines to complement traditional prevention strategies in several high-risk populations and locations. This is the latest step in ongoing efforts to end South Sudan’s longest and deadliest cholera outbreak (OCHA, 18 Jan 2018.)
South Sudan declared the end of its longest and largest cholera outbreak on Wednesday (February 07), with no new cases of cholera reported in over seven weeks. (WHO, 7 Feb 2018.)
Affected countries
Cholera inter-season: In 2018 still no reported cholera cases as per week 14 after the end of the outbreak declaration. In 2016/2017 a total of 20,438 cholera cases with 436 deaths (CFR=2.13%) were reported during 85 weeks of outbreak started on June 2016.
In June last year Medair, one of our member organisations, averted a deadly cholera outbreak in South Sudan by timely response that addressed the needs of communities.
Medair in South Sudan
Medair has been present in Renk since 2011, providing integrated health, nutrition, and water, sanitation, and hygiene (WASH) services. Although Medair works in several communities around Renk through Integrated Community Case Management and Care Groups, the projects are focused on three IDP/returnee settlements; Abayok, Payuer, and Wonthow.
Cholera inter-season:
In 2018 still no reported cholera cases as per week 14 after the end of the outbreak declaration. In 2016/2017 a total of 20,438 cholera cases with 436 deaths (CFR=2.13%) were reported during 85 weeks of outbreak started on June 2016.
2017 at a Glance
South Sudan is a challenging environment; however WHO continues to play its role in ensuring the people of South Sudan have access to health services. Through the support of government, donors, partners and community leaders in dedicating their time and resources the most vulnerable people in South Sudan were reached.
Highlights
UNICEF, in coordination with partners, responded to a suspected Meningitis outbreak (173 suspected cases; 31 deaths reported) in Eastern Equatoria, first reported 15 February. UNICEF supported with case management through the provision of essential drugs/supplies, establishing a treatment center, and community engagement and social mobilization through UNICEF’s partner (South Sudan Red Cross) whose trained volunteers conducted house-to-house sensitizations on meningitis and community surveillance.
Cholera inter-season:
In 2018 still no reported cholera cases as per week 12 after the end of the outbreak declaration. In 2016 / 2017 a total of 20,438 cholera cases with 436 deaths (CFR=2.13%) were reported during 85 weeks of outbreak started on June 2016.
Key Messages
- In the period May to July 2018, an estimated 7.1 million (63% of the population would face crisis (IPC Phase 3) or worse acute food insecurity conditions, of which 155,000 are estimated to be in Catastrophe (IPC Phase 5) in the protracted absence of humanitarian assistance.
Monica RullEmail authorView ORCID ID profile, Sophie Masson, Nicolas Peyraud, Marco Simonelli, Alexandre Ventura, Claire Dorion, Francisco J. Luquero, Florent Uzzeni and Iza Cigleneki
Conflict and Health 201812:11
https://doi.org/10.1186/s13031-018-0147-z© The Author(s). 2018
Abstract
PEOPLE IN NEED IN 2017: 7.6 M
PEOPLE TARGETED IN 2017: 6.2 M
PEOPLE REACHED BY THE END OF 2017: 5.4 M
In 2017, South Sudan’s conflict was in its fourth year, with civilians continuing to bear the brunt of a crisis marked by displacement, hunger and disease. Nearly 4.3 million people – one in three South Sudanese – have been displaced, including more than 1.8 million who are internally displaced and about 2.5 million who are in neighbouring countries. About 700,000 people left South Sudan in 2017.
EMERGENCY MOBILE TEAM INTERVENTIONS
IOM provides life-saving assistance to vulnerable communities, displaced populations and famine and disease affected populations.
Highlights
UNICEF and partners supported the release of 311 children (87 girls) associated with armed groups in Yambio, Western Equatoria state – the first release by any armed group in South Sudan in almost three years. These children are being supported to reintegrate back to their communities. This is the first phase of a process that is expected to see 700 children released from armed groups and forces in Yambio in the coming months.
Executive Summary
Under the Education program, CMD in FY 2017 ran three education projects – (January – December 2017). CMD and the related partners successfully performed these projects.
HIGHLIGHTS
• Aid agencies provide assistance and protection to over 5.4 million of people in South Sudan.
• Renewed fighting in multiple locations of Jonglei and Unity forces thousands of people to flee their homes, with some crossing to Ethiopia as refugees.
• Funding appeal for US$1.5 billion launched to support refugees fleeing the worsening humanitarian situation in South Sudan.
HIGHLIGHTS
Annual lean season begins early across South Sudan
GoRSS declares end of cholera outbreak
Clashes continue despite cessation of hostilities agreement
KEY DEVELOPMENTS
Overview
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 54 events in the region. This week’s edition covers key new and ongoing events, including:
Declaration of the end of cholera outbreak in South Sudan
Humanitarian crisis in Central African Republic
Cholera in Democratic Republic of the Congo
Hepatitis E in Namibia
Cholera in Angola
Highlights
With the confirmation of Rift Valley Fever (RVF), in Yirol East, Lakes State, UNICEF has been providing support in the overall coordination of investigation and response activities being carried out by the Ministry of Health (MoH) and the World Health Organization (WHO) through a multi-sectoral taskforce. UNICEF launched a media and community risk communications campaign people with information on risk factors, symptoms and preventive measures.
Juba, South Sudan, 07 February 2018 – South Sudan declared the end of its longest and largest cholera outbreak on Wednesday (February 07), with no new cases of cholera reported in over seven weeks.
The fight against cholera in South Sudan has involved a range of partners working together to enhance surveillance, deploy rapid response teams to investigate and respond to cases, provide clean water, promote good hygiene practices and treat cholera patients.
