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.)
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• Completeness for weekly reporting was 44% for the nonconflict-affected states and 90% for the IDP sites.
• Malaria is the top cause of morbidity in nonconflict-affected areas and IDPs.
• In the 26 (33%) counties affected by malaria; the cases have continued to decline.
• Cholera outbreaks confirmed in nine states. During the week, active transmission continued to be reported in Bentiu PoC where children <2 years and individuals that did not receive oral cholera vaccine.
The European Commission will provide €78 million in emergency aid to help those affected by the South Sudan crisis both within the country and in the region. Over 1 million refugees from South Sudan have fled to neighbouring countries, with the number expected to grow. There are currently 2 million displaced people within the country. The funding was announced today by Commissioner Christos Stylianides who is currently in Uganda, one of the largest refugee and asylum-seekers hosting country in the world.
WFP and FAO warn of impending famine in South Sudan. It is estimated that between 3.7 and 4 million people (more than a third of the total estimated population) are currently severely food insecure. This is a one million increase compared to the same period last year.
The outbreak has caused 44 deaths and spread to nine of South Sudan's 28 states, WHO said
By Magdalena Mis
LONDON, Nov 8 (Thomson Reuters Foundation) - Nearly 3,000 people in war-torn South Sudan have contracted cholera since July, the World Health Organization reported on Tuesday, warning that the outbreak had now spread to a region where conflict is hampering efforts to tackle the deadly disease.
November 7, 2016 (NYAL) – Two children have died and over 30 people admitted following a Cholera outbreak in South Sudan’s Unity state’s Nyal and Ganyliel payams of Payinjiar county, health officials said.
The county health director, Stephen Gatliah described the situation on ground as “worrying”, owing to the lack of Cholera treatment kits.
Of the suspected cases, he said, 21 people tested positive in Nyal and 11 were confirmed to have Cholera in neighbouring Ganyliel.
- Completeness for weekly reporting was 40% for the nonconflict-affected states and 71% for the IDP sites.
- Malaria is the top cause of morbidity in nonconflict-affected areas while ARI is the top cause of morbidity in the IDPs.
- In the 26 (33%) counties affected by malaria; the cases have continued to decline.
- Cholera outbreaks confirmed in nine states. During the week, active transmission was reported from Bentiu PoC where children <2 years and individuals that did not receive oral cholera vaccine are the most affected.
Highlights of the Week
Uganda maintains the target 80% of all health facilities submitting weekly reports.
No district wi th ≤ 40% of their heal th facilities reporting.
Ongoing Cholera outbreak in Northern Uganda
• Since the escalation of South Sudanese refugees fleeing into Uganda in July 2016, a total of 8,165 children (4,122 boys and 4,043 girls) have been registered for integrated early childhood development learning (IECD) in Bidibidi, Pagirinya, Kiryandongo, and Rhino Camp settlements in Yumbe, Adjumani, Kiryandongo and Arua refugee districts respectively.
• 3,059 separated and unaccompanied children (1,766 boys and 1,293 girls) were registered for reunification and foster care between July and 31 October 2016.
South Sudan – IOM is responding to a cholera outbreak at the Bentiu protection of civilians (PoC) site, where 78 suspected cholera cases, with five confirmed, have been reported since 16 October.
“Immediately treating and halting the spread of cholera is critical in this site, where more than 101,500 internally displaced persons (IDPs) are living in very close quarters,” said IOM Health Officer Dr. Andrew Mbala.
Wau PoC site population increases by more than 4,000
IOM supports cholera response and prevention at Bentiu PoC site
Measles vaccination campaigns respond to outbreaks in Abyei and Warrap
Displacement remained a defining feature of the crisis in South Sudan in September 2016, with tens of thousands of people newly internally displaced, and an average of 2,854 people fleeing across the border to Uganda each day, compared to 1,594 in August and 1,727 in July. During the month, the number of South Sudanese refugees in neighbouring countries passed the one million mark.
Fighting displaces populations and exacerbates humanitarian needs in Greater Equatoria, Unity
UN expresses concern regarding ethnic-based threats
WFP delivers emergency food assistance to 1.9 million people in September
This report has been developed collectively with humanitarian partners in the region to inform preparedness and advocacy efforts to mitigate and manage humanitarian risk in the Horn of Africa and Great Lakes region. It presents a four-month trend analysis from June to September 2016 and a humanitarian outlook from October to December 2016. It is the fifth report in the series and updates the previous scenario report which was published in April 2016.
Although the El Niño weather event has passed its impact continues to be felt in the region: food insecurity doubled from 12 million in August 2015 to 23.4 million today. Humanitarian partners are targeting 1.25 million children under five for severe acute malnutrition (SAM) this year, of which nearly 83 per cent are from Ethiopia, South Sudan, Sudan and Somalia. Violence and rising food insecurity in South Sudan and Burundi have displaced nearly 290,000 people (205,541 refugees and 84,459 internally displaced) in the last 3 months alone.
Global Handwashing Day was celebrated on 15 October. UNICEF is supporting the celebration across the country during the month. In Northern Bahr el Ghazal (NBeG), 500 members of 10 school hygiene clubs underwent refresher training in hygiene promotion.