Outbreak Update – Cholera in Somalia, 8 November 2018

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8 November 2018 – The Ministry of Health of Somalia has announced 22 new suspected cases of cholera with no deaths for epidemiological week 43 (22 to 28 October) of 2018. Of these new cases, 68% (15 cases) were females. 40% (9 cases) were children below five years of age.

The cumulative total of cases is 6520, including 43 associated deaths (case-fatality rate 0.6%), since the beginning of the current outbreak in December 2017 along the Shabelle River. The outbreak has spread in the south and central regions and affected districts include Jowhar, Kismayo, Bulobarde, Afgoye, Merka and Banadir. Since week 28, the trend of cases has been declining, only Banadir region has been reporting cases and deaths in the last four weeks. Lower Jubba has reported zero cases for the last five weeks. In week 43, active transmission of AWD/cholera was reported in eight districts in the Banadir region; Darkenley, Daynile, Hawlwadag, Hodan, Karran, Madina, Waberi, and HamarWeine. Darkenley, Daynile, Hodan, and Medina have reported more than 450 cases cumulatively.

Stool samples have been collected from six cholera treatment units in four regions (Banadir, Hiraan, Lower Jubba and Middle Shabelle) and tested in the National Public Health Laboratory (NPHL) in Mogadishu. This reporting period, 15 stool samples were collected from Banadir hospital and seven samples tested positive for Vibrio cholerae, serotype O1 Ogawa. In total, of 296 stool samples that have been tested since the beginning of this year, 87 samples tested positive. Routine collection and analysis of stool samples has continued at NPHL.

WHO and the Ministry of Health continue to monitor outbreak trends through the early warning alert and response network (EWARN) system and promptly investigate and respond to all alerts. WHO also provides leadership and support to the health authorities and partners in activities to mitigate the outbreak, including on case management, surveillance and laboratory investigations, water, sanitation and hygiene (WASH) and risk communication. This week, refresher trainings on case management for health care workers in Banadir hospital were conducted, as well as trainings on sample collection and analysis of stool samples at the National Public Health Laboratory in Mogadishu.