Somalia

Outbreak update – Cholera in Somalia, 1 August 2021

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31 August 2021 – The Ministry of Health of Somalia has announced 129 new suspected cases of cholera, with 1 reported death, for epidemiological week 30 (26 July to 1 August 2021). All cases were reported from Banadir, Bay and lower Shabelle regions. The most affected 23 districts were in Hirshabelle, South West states and Puntland, and 17 districts of Banadir region. Of the total cases reported from Somalia since the week 1, 3858 (63%) were children under 5 years of age with 51% of cases being female.

The total number of suspected cholera cases in 2021 is 3858, including 27 associated deaths with a case fatality ratio (CFR) of 0.7%. The highest CFR was reported in Abdul Aziz district (11.11%). The overall attack rate of 103 cases per 100 000 persons were reported from 23 district and the most affected districts included Daynile, Adale and Madina.

The current cholera outbreak started in December 2017 following floods that affected districts in the basins of Jubba and Shabelle rivers. It was contained in five of the six regions while active transmission has continued to be reported from Banadir. Flash floods caused by heavy Gu rains in April 2020 led to the contamination of water sources that led to an increase in the number of cholera cases. The total number of suspected cholera cases in 2021 is 3858, including 27 associated deaths with a case fatality ratio (CFR) of 0.7%. The highest CFR was reported in Abdul Aziz district (11.11%). The overall attack rate of 103 cases per 100 000 persons were reported from 23 district and the most affected districts included Daynile (643 per 100 000 population), Adale (554 per 100 000 population) and Madina (298 per 100 000 population).

Since January 2021, a total of 623 stool samples were collected out of which 178 tested positive for Vibrio Cholerae Ogawa.

The overall reduction in the number of new cholera cases as compared to the numbers at the beginning of the outbreak is attributed to improved implementation of preventive interventions including oral cholera vaccination (OCV) campaigns and the strengthening of water, sanitation and hygiene (WaSH) activities in hot spots. However, the current floods and cholera outbreak occurred at a time when COVID-19 cases are increasing in all regions of Somalia, stretching the already limited capacity to respond to the cholera alerts.

WHO continues to provide leadership and support to health authorities and partners in implementing activities that can mitigate the outbreak. Disease surveillance is being managed with the support of WHO through an electronic system known as the Early Warning Alert and Response Network (EWARN) and is currently being expanded to all health facilities across the country. WHO and the Ministry of Health continue to monitor outbreak trends through EWARN and promptly investigate and respond to all alerts.