Nigeria – North-East Flash Update No. 4 – Cholera Outbreak, 14 September 2018

The cholera outbreak, that was declared in Borno State, northeast Nigeria, on 5 September 2018 by the State Ministry of Health, continues. A total of 1,102 cases of suspected cholera have been recorded in eight local government areas (LGAs), including 21 deaths, as of 13 September 2018. This represents a fatality rate of 1.9 per cent. Since the previous OCHA flash update of 11 September, the number of cases has increased by 24 per cent. Jere, Magumeri and Maiduguri Metropolitan Council (MMC) remain the worst affected LGAs, largely due to the poor water, sanitation and hygiene conditions in these areas that are also congested. The first suspected cases were recorded on 19 August 2018. The following cases have been recorded (see map): Jere (414 including 5 deaths) - Magumeri (243 including 4 deaths) - MMC (238 including 5 deaths) - Chibok (96 including 3 deaths) - Konduga (63 including 3 deaths) - Kaga (29 including 1 death) - Damboa (8) - Shani (11).

The Response & the Needs

• Health partners and community mobilisers have visited 4,796 households in recent days as part of active case search, to encourage individuals with cholera-like symptoms to be screened.

• A 100-bed Cholera Treatment Centre (CTC) is operational in Dala (a locality in MMC), and in Magumeri LGA a Cholera Treatment Unit (CTU) is operating from an existing health facility. Another CTC, with a 20-bed capacity, in Dalaram locality (in MMC) will be set up in coming days. CTC capacity will remain over-stretched however as the number of cases continues to rise.

• Oral Rehydration Points (ORPs) are operating in El-Miskin, Muna Garage and Customs House camps for internally displaced people, and partners are identifying additional locations for ORPs in the three most affected LGAs. Additional ambulances are still required in all affected LGAs to transport those seeking treatment.

• Hygiene promotion activities, including mosque announcements and radio broadcasts in Marghi, Hausa, Kanuri and Shuwa, are underway in the affected LGAs to sensitize people to the risk of cholera, teach them how to prevent and manage diarrhea at home, and educate them on the use of chloride tablets for household water treatment and safe water storage. There is also messaging on the dangers of open defecation.

• In terms of sanitation, humanitarian organisations are working to dislodge and repair latrines in the affected camps for internally displaced people where the risk of transmission is high due to congested living conditions.

• The State Ministry of Health, with the support of humanitarian partners, is coordinating the response through the Emergency Operation Centre (EOC). Coordination meetings are currently held twice a week at the EOC, and daily at LGA level. The State Ministry of Health is also issuing daily situation reports.

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