South Sudan: Cholera Outbreak - Jul 2016Ongoing
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.)
Maps & Infographics
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Situation of Education in the Current Conflict and Humanitarian Context
• More than 45 people were reportedly killed, including six aid workers, in an attack by armed men in Duk County, Jonglei.
• Continued reports of armed clashes in multiple locations of the country in the past weeks, affecting thousands of people.
• Women and girls are experiencing unprecedented levels of violence in South Sudan’s conflict.
• The humanitarian response in the Greater Baggari area, Wau County continues, despite challenges.
• South Sudan’s conflict has left a large number of people with disabilities.
Targeted violence and armed clashes result in aid worker and civilian deaths
WFP convoy transports emergency food assistance from Sudan to Aweil, South Sudan
HUMANITARIAN NEEDS & KEY FIGURES
As the conflict in South Sudan enters its fifth year in 2018, the humanitarian crisis has continued to intensify and expand, on a costly trajectory for the country’s people and their outlook on the future. The compounding effects of widespread violence and sustained economic decline have further diminished the capacity of people to face threats to their health, safety and livelihoods.
People in need of assistance and protection number 7 million, even as more than 2 million have fled to neighbouring countries.
• Nutrition and food security remain critical challenges across South Sudan. About 4.8 million people or around 45 per cent of the total population are severely food insecure with 25,000 in humanitarian catastrophe. This is 1.4 million more than at the same time last year. The post-harvest gains expected during this time have provided little relief.
Cholera transmission reported in two counties [Juba and Budi] in the last four weeks [44- 47, 2017] with a total of 21 new cases including one death (Table 1).
There was no new laboratory confirmed case in week 47 (Table 4).
Large-scale Emergencies continue in South Sudan, Somalia, Yemen, and Ethiopia
Conflict and drought are driving very high assistance needs in East Africa and Yemen, with more than 35 million people likely to require humanitarian assistance by May 2018. Sustained, large-scale humanitarian assistance is needed to protect livelihoods and mitigate the potential for loss of life.
Catastrophe (IPC Phase 5) outcomes likely exist despite ongoing harvest
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 48 events in the region. This week’s edition covers key ongoing events, including:
- Microcephaly in Angola
- Cholera in Zambia
- Dengue fever in Burkina Faso
- Humanitarian crisis in the Democratic Republic of the Congo
- Humanitarian crisis Nigeria
- Yellow fever in Nigeria
HIGHLIGHTS HEALTH SECTOR
The MoH launched a new ‘Treat All’ and HIV Testing guidelines to end AIDS. South Sudan also joins the countries in Africa to have implemented Treat All recommendations among adults and adolescents in more than 50% of treatment sites in the country.
The members of the Panel of Experts on South Sudan, whose mandate was extended pursuant to Security Council resolution 2353 (2017), have the honour to transmit herewith the Panel’s interim report, which was submitted in accordance with paragraph 2 of resolution 2353 (2017), by which the provisions of paragraph 12 (e) of resolution 2290 (2016) were renewed.
The report was provided to the Security Council Committee established pursuant to resolution 2206 (2015) on 27 October 2017.
This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 47 events in the region. This week’s edition covers key new and ongoing events, including:
- Cholera transmission reported in two counties [Juba and Budi] in the last four weeks [43- 46, 2017].
- Out of the 26 samples tested in the week, 16 (62%) were positive by culture. All positive samples were from New Bongo (a new focus of transmission in Juba) (Table 4).
Completeness for IDSR reporting at county level was 61%. Completeness for EWARS reporting from IDP sites was 78%.
A total of 20 alerts were reported, of which 70% have been verified. 1 alert was risk assessed and 1 required a response.
A total of 66 new cholera cases and 0 deaths (CFR 0.0%) were reported. The cumulative total since the start of the current outbreak on 18 June 2016 is 21,520 cases and 441 deaths (CFR 2.0%).