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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This briefing has been been put together by a significant number of international non-governmental organisations (NGOs) under the leadership of Bond’s Humanitarian and Conflict Policy groups. These NGOs are either actively operational in these contexts or working to raise awareness in the UK of the challenges faced by people experiencing humanitarian disasters, conflict and upheaval.
Cholera transmission declines countrywide, persists in Budi and Juba counties
WFP reaches 4.5 million people with food assistance to date in 2017
Relief actors record 830 humanitarian access incidents from January–September
The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 8-14 October 2017 and includes updates on Legionnaires' disease, influenza, rubella, measles, West Nile fever, chikungunya, cholera and plague.
This weekly bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 44 events in the region. This week’s edition covers key new and ongoing events, including:
Wildlife anthrax in Namibia
Cholera in Zambia
Plague in Madagascar
Dengue fever in Burkina Faso
Humanitarian crisis in the Democratic Republic of the Congo
Humanitarian crisis in South Sudan.
Surveillance Completeness for IDSR reporting at county level was 75% . Completeness for EWARS reporting from IDP sites was 77%.
Alert A total of 22 alerts were reported, of which 14% have been verified. 0 alerts were risk assessed and 0 required a response.
Response A total of 10 new cases including no death (CFR 0%) were reported in week 42.
The cumulative since the start of the current outbreak on 18 June 2016 is 21,043 cases including 387 deaths (CFR 1.84%).
Juba – IOM is currently distributing essential relief supplies to approximately 3,800 families in South Sudan’s Lainya County. The distribution will continue through mid-October 2017.
Thousands had fled from Lainya and neighbouring areas in 2016 as fighting spread south from the country’s Juba toward the Equatoria region, with includes Lainya. While many people crossed the border to refugee camps in neighbouring Uganda, thousands fled to remote areas within South Sudan.
Juba, 13 October 2017: Communicable diseases pose a major public health challenge in South Sudan and cause significant levels of illness, disability, and death for a country also caught in the current conflict.
South Sudan’s weak public health systems aggravate the situation to effectively respond to largely preventable disease outbreaks. Frequent disease outbreaks are driven by multiple factors, including conflict leading to displacement of people and overcrowding and poor environmental conditions.
Cholera transmission has continued to decline countrywide with only three counties [Juba, Budi, and Fangak] reporting cholera cases in the last four weeks [38-41, 2017]. § In week 41, four out of 13 samples from Juba tested positive for Vibrio cholerae (table 2).
During the last four weeks, Juba and Budi have reported the highest number of cholera cases. During the same period, five deaths were reported from Budi (Table1 & Fig.1).
8069TH MEETING (PM)
Sounding the alarm on famine exacerbated by conflict, Secretary-General António Guterres urged the international community to step up efforts to end violence, ensure humanitarian assistance and foster long-term development in South Sudan, Nigeria, Somalia, Yemen and other areas of instability-rooted starvation.
- More sub-optimal coordination in responding to outbreaks
- Limited resources such as water treatment chemicals
- Limited laboratory capacity in some Counties for Cholera confirmation
- Limited capacity in response as majority of the Rapid Response Teams especially at county level are not trained
- Limited resources for health promotion and community engagement
- Insecurity in various parts of the country including; Garissa
Somalia Country Priorities
In September, fighting and insecurity continued to force civilians out of their homes, particularly in Unity and Upper Nile. Many of those had been displaced several times in recent months. In Unity, fighting and insecurity in Koch, Mayendit, and Rubkona counties forced the relocation of aid workers, suspension of food distribution and medical evacuation of civilians. In Upper Nile, fighting in and around Aburoc, on the western bank of the River Nile, on 11 September, reportedly led to civilian deaths, displacement and forced the temporary relocation of aid workers.
Situation and Needs of Children in South Sudan
UNICEF works in South Sudan with over 137 partners (including both CSO and Govt) to provide nutrition, health, WASH, education and child protection services, with priority to live saving interventions for the population most affected by the humanitarian crisis.
This weekly bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 46 events in the region. This week’s edition covers key ongoing events, including:
- Plague in Madagascar
- Cholera in the Democratic Republic of the Congo
- Cholera in Uganda
- Cholera in north--east Nigeria
- Hepatitis E in Niger
Humanitarian crisis in Ethiopia
6 of the 21 countries in Eastern and Southern Africa have over 20% of their population using an unimproved water source and they include; Ethiopia, Somalia, Tanzania, Zambia, Mozambique and Madagascar. Of these countries, Somalia has recorded the highest number of cholera cases and deaths. Countries which have 11 to 20% of their population using unimproved water sources include; South Sudan, Uganda, Rwanda, Burundi, Eritrea, Angola, Zimbabwe and Lesotho. 5 of these countries (South Sudan, Rwanda, Burundi, Angola and Zimbabwe) have reported outbreaks in 2017.
3 of the 21 countries in Eastern and Southern Africa have over 50% of their population using unimproved sanitation facilities and they include; Tanzania, Ethiopia and Uganda. Cumulatively, Tanzania has reported 2697 cases since the beginning of 2017. Countries which have 25 to 50% of their population using unimproved sanitation facilities include: Somalia, Kenya, Burundi, Malawi, Mozambique, Zambia and Madagascar. Cumulatively, these countries have reported 83, 346 cases in 2017, and majority of these cases emerging from Somalia.