South Sudan: Cholera Outbreak - Jul 2016
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.)
Maps & Infographics
Major Epidemiological Developments W2 2018
• Completeness for IDSR reporting is 57% at county level and 77% for the IDP sites.
• A total of 22 alerts were reported, of which 27% have been verified. 0 alerts were risk assessed and 0 required a response. [Whooping cough alerts - in Yirol East; AWD - 5 cases (01 death) - in Gunyoro (Torit).
• Rift Valley Fever outbreak - Yirol East with 15 suspect human cases including 3 confirmed; 3 probable; 4 none-cases; and 5 pending classification. One confirmed animal case (cow).
Juba, 24 January 2018 –The lack of safe water, functional toilets, hand washing facilities and waste management system in healthcare settings poses significant health risks to patients, healthcare workers and nearby communities.
This assessment is a consolidated effort of the Ministry of General Education and Instruction (MoGEI), the Education Cluster Unit and Cluster partners towards determining the impact of the most recent conflict, economic crisis, food insecurity and cholera epidemic on children’s education in South Sudan.
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 56 events in the region. This week’s edition covers key new and ongoing events, including:
Botulism in Nigeria
Lassa fever in Benin
Lassa fever in Nigeria
Humanitarian crisis in Central African Republic
Suspected Rift Valley fever in South Sudan
Cholera in Angola
Suspected Rift Valley fever in The Gambia
Major Epidemiological Developments W3 2018
• Completeness for IDSR reporting is 59% at county level and 77% for the IDP sites.
• A total of 29 alerts were reported, of which 28% have been verified. 0 alerts were risk assessed and 0 required a response.
• Rift Valley Fever outbreak - Yirol East with 20 suspect human cases including 3 confirmed; 3 probable; 4 none-cases; and 10 pending classification. One confirmed animal case (cow).
In December 2017, fighting between the government and the opposition forces was reported in Koch and Bieh (Unity), and in Raja (Western Bahr el Ghazal), displacing thousands of people. During the armed clashes on Raja-Wau road on 16 December, armed groups held six aid workers from two national and international agencies and displaced thousands of people from their homes to Wau town.
• Conflict, hunger and diseases, among other factors, forced more than 700,000 people to flee South Sudan as refugees to neighbouring countries in 2017.
• In 2017 over 1,159 humanitarian access incidents were reported by humanitarian actors in South Sudan, indicative of increasingly difficult times for aid workers in the country.
• Humanitarian partners working in Malakal PoC site in Upper Nile are stepping up response activities to address the incidence of people attempting suicide.
Armed clashes continue in violation of cessation of hostilities agreement
2018 South Sudan HRP calls for more than $1.7 billion to meet the humanitarian needs of 6 million people
The State of Food Security and Nutrition in the World 2017 (SOFI) has revealed that global hunger is on the rise again after declining for more than two decades. Global hunger rose from 777 million in 2015 to 815 million people in 2016.
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 ongoing events, including:
- Chikungunya in Kenya
- Cholera in Malawi
- Cholera in Zambia
- Suspected Rift Valley fever in South Sudan
- Humanitarian crisis in the Democratic Republic of the Congo
There are no new suspect cases reported since the last update. Surveillance for suspect cases is ongoing and contacts are being followed.
On 28 December 2017, the Eastern Lakes Ministry of Health reported a suspect viral hemorrhagic fever cluster to the National Ministry of Health and WHO. The initial cluster involved three deaths in Thonabutkok village, Yali Payam, Yirol East county with 7 December 2017 as the earliest date of onset.
Over the past year, drought, famine, ongoing conflict and food insecurity have continued to devastate the lives of families across East Africa.
Across South Sudan and Somalia, an estimated 11.2 million people are facing critical levels of food scarcity. With chronic water shortages, livestock and crops are failing. Food prices are rising and with a lack of safe water, communities are also vulnerable to life-threatening illnesses such as cholera, diphtheria and diarrhoea.
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 53 events in the region. This week’s edition covers key new and ongoing events, including:
Epidemic trends and updates
There is no active cholera transmission in any of the 24 counties where cholera has been confirmed in 2017.
Two confirmed cases reported retrospectively in Juba in week 50 and are consistent with sporadic transmission.
Current activities entail – updating cholera plan, catching up on pending second round oral cholera vaccine campaigns, and addressing the underlying risk.
129,727 number of consultations provided in IOM Static clinics in Malakal PoC, Bentiu PoC, Wau PoC and Renk
39,931 number of consultations provided by IOM’s Health Rapid Response Teams (RRT)
275,016 individuals reached with health education
939 Number of births attended by skilled birth attendants
37,746 number of children under 5 screened for nutrition
- IOM teams reach populations in need in Baggari, south of Wau
- Rapid response teams conduct oral cholera vaccination campaigns across the country
- IOM expands fuel-efficient stove initiative in the Bentiu PoC site