Outbreak update – Cholera in Somalia, 20 October 2019

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14 November 2019 – The Ministry of Health (MoH) of Somalia has announced 41 new suspected cases of cholera, with no deaths, for epidemiological week 42 (14 – 20 October) in 2019. No suspected cholera cases were reported between epidemiological weeks 1 and 7 due to the closure of the main cholera treatment center from which the data was collected. The cumulative total number of suspected cholera cases since the beginning of this outbreak in December 2017 is 8912, including 46 associated deaths. During this reporting period, all of the cases were reported from a total of 27 districts in Banadir and lower Jubba regions. Of the 41 cases reported during this week, 63% of the cases (26) are children below 5 years of age.

The cholera outbreak has been contained in the districts of Jubaland, Hirshabelle and South West States following the implementation of oral cholera vaccination (OCV) campaigns and other health interventions in these areas. Active transmission is still reported in Banadir. These areas have experienced heavy rains in the recent past that may have contributed to the contamination of water sources leading to repeated cholera outbreaks. Over the past two weeks there has been an increase in the number of cholera cases reported from 39 to 41 cases. Only eight out of the 17 districts of Banadir reported new cholera cases during the week with the most affected districts being Darkenley, Madina, Hodan and Jubba.

Reports from the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA) show that over 80 000 people have been displaced from 16 districts located in the basins of rivers Shabelle and Jubba. These communities have limited access to safe water and proper sanitation. This implies that the chances of cholera outbreak in these districts is very high.

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 OCV and strengthening water, sanitation and hygiene (WaSH) activities in hot spots.

Of the 820 stool samples tested since December 2017, a total of 162 samples tested positive for Vibrio cholerae. In week 42, 34 stool samples were tested with Rapid Diagnostic Test (RDT) out of which seven came out positive.

In June 2019, WHO and MoH implemented an OCV campaign in six cholera high risk districts of Kahda, Hamajajab and Heliwa in Banadir region as well as Kismayo, Balad and Afgoi. A total of 621 875 (96.7%) of people aged one year and above received the first dose of cholera vaccine.

WHO continues to provide leadership and supports the health authorities and partners in activities to mitigate the outbreak. The disease surveillance system is managed by the Electronic Early Warning Alert and Response Network (EWARN) system with the support of WHO and is currently being expanded to all health facilities across the country. WHO and the MoH continue to monitor outbreak trends through the EWARN system and promptly investigate and respond to all alerts.