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Comoros

Comoros Cholera Outbreak - DREF Operational Update #2 (MDRKM011)

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What happened, where and when?

On 14 September 2024, when the cholera outbreak that had been raging in the country since February was considered controlled, with WHO preparing an after-action review (AAR), and the NS and Delegation the lessons learned workshop, the disease reappeared in a village called Ndzaouze in the north of Grande Comores. On that day, a 58-year-old man returning from a party in Fassi felt ill and was taken to the hospital in Mitsamiouli and then to the El Marouf hospital in Moroni, where he died. He showed signs of cholera, which tests conrmed. Eight other infected people from the same area were transferred to the cholera treatment centre at Samba hospital and to Mitsamiouli the next day. DHS and CATI teams from the Comorian Red Crescent (CRCo) were called in to help with burial, disinfection and awareness-raising. In just a few weeks, the epidemiological situation on the island of Grande Comores has reached worrying proportions, with more than 200 new cases and 3 deaths. Presently, the epicenter of the outbreak is the island of Anjouan, which accounts for 60% of the reported deaths. This area is particularly affected as the rivers supplying water to the population have been contaminated, becoming a significant source of transmission. Despite over two months of response efforts, local markets are beginning to experience shortages, with essential equipment and supplies such as HTH (chlorine) and cholera beds running out.

This new situation has caught all those involved o guard as they prepare to complete their capacity-building activities. In the space of a few weeks, the epidemiological situation on the island of Ngazidja has taken on worrying proportions. In less than a month, more than 200 cases were recorded in 6 of Ngazidja's 7 districts, with 3 deaths. After three months (September to November), despite the eorts of all the partners and a new vaccination campaign on the island, there were 338 cases whose homes had been disinfected, as well as those of neighbours (2,371). 41,709 awareness-raising sessions with distribution of Stop Cholera Kits. 4 cholera burials were carried out by CRCo volunteers. The government of the Comoros has therefore decided to step up its response eorts with the support of its partners.

To this end, the Comoros National Red Crescent Society, which has been actively involved since the start of the epidemic, would also like to extend the scope of its response and its operating schedule from 9 to 11 months to ensure that its contribution to the response to the epidemic is commensurate with its scale.

The epidemic started when a boat from Tanzania arrived in Moroni on 31 January 2024, with a person who had died from cholera on board. The ship was carrying 25 people and had dropped a passenger in Moheli. Following confirmed tests, the Comoros Ministry of Health declared a cholera epidemic on February 2, 2024. A Cholera Treatment Center (CTC) was activated in Samba to treat cholera cases (hospital on the outskirts of Moroni). This was confirmed by the Dar Es Alam Laboratory and rearmed by the Comoros Ministry of Health.

Eleven weeks after the first cholera case was confirmed, the number of cases continues to increase (with 132 cases by end of February, 655 cases by end of March and 2,319 by 21st April 2024), and the outbreak has now spread to the three islands. The Government of Comoros decided to intensify response efforts, therefore the Comoros Red Crescent Society which has been actively involved since the beginning of the outbreak, will also extend the scope of its response and operation timeframe to ensure a contribution to the epidemic response in proportion to its scale. As of April 21st, a total of 2,319 cases had been reported (437 in Grande Comores, 1608 in Anjouan and 274 in Moheli). A total of 55 deaths had been reported by then with case fatality rate of 2,4% (3 out of 4 deaths happening in the community). The Government of Comoros decided to intensify response eorts, therefore the Comoros Red Crescent Society which has been actively involved since the beginning of the outbreak, also extended the scope of its response and operation timeframe to 9 months to ensure a contribution to the epidemic response in proportion to its scale.

On 21 July 2024, the cholera epidemic that had been raging in the Comoros, with Anjouan at its epicentre, was considered controlled. After 6 months of intense fighting, no new active or suspected cases were reported in the country and there were 10,342 cumulative cases with 149 deaths.