Situation Report for Acute Watery Diarrhea/Cholera, Epidemiological Week 4 (23 - 29 January 2017)

Highlights

• As of epidemiological week 4, the reported number of AWD/Cholera cases has slightly decreased as compared to the previous week but the outbreak has spread to new districts in Puntland (refer table 1 below)

• A total of 877 new suspected AWD/cholera cases and 15 deaths (CFR: 1.7%) were reported from 37 districts during epidemiological week 4 (23rd -29th January).

• Almost 51% of all new cases were recorded in Baidao district, and 12% were reported from 4 districts in Puntland.

• New districts and villages in Lower Shebelle and two regions in Puntland have reported new cholera cases, and the surveillance officers are planning to conduct field investigation and collect specimens

Situation update

• A total of 877 suspected AWD/cholera cases and 15 deaths (CFR: 1.7%) were recorded from 37 districts across six regions during this reporting period. However, the trend of cholera cases recorded this week has slightly decreased as compared to the cases reported in previous week (Refer to below table 1). Of these cases, 107 of were reported from 4 districts in Puntland for the first time in five years.

• Total cumulative cases of 3 113 with 47 deaths (CFR; 1.5%) were recorded across the country in the first four weeks of 2017. However, the trend of cholera cases and deaths recorded in the first four weeks is significantly higher as compared to the cases recorded the same period in 2016 (refer to below epicurve graph). The current cholera outbreak is spill-over from last year’s major cholera outbreak, which recorded 15,619 cases and 548 deaths. The current outbreak affected six regions in south central and Puntland:

• Bay Region: A total of 392 cholera cases and 11 deaths were recorded in Baidao, Bayhow and Aliyow Munim districts as of week 4 and the trend has been increasing in the last four weeks.

• Banadir Region: a total of 130 cholera cases 4 deaths were recorded across 17 districts across the region and the number of reported cases and deaths have decreases slightly in week 4.

• Hiiran Region: a total of 28 AWD/cholera cases and 0 deaths were recorded in Beletweyn, Jalalaqsi and Buuloburte, and the trend of cases and deaths declined in the last two weeks.

• Lower Shebelle Region: a total of 125 cholera cases and 0 deaths were recorded in Marka, Shalanbod, Waagaade, Janaale and Qoryoley districts, and the trend has decreased on week 4.

• Middle Shebelle: a total of 95 cholera cases and 0 death were recorded in Jowhar, Mahaday, Balad and other villages, and the outbreak has spread to new communities during this reporting period.

• Bari: A total of 31 cases and no death were reported in in Bosasso district, and this is the first cholera is reported in the last five years.

• Mudug: A total of 76 cases and 0 deaths were recorded in Galdogob, Galkayo and Jariiban, and the most likely reason is the water shortage due to the draught.

• Considering the available surveillance data, even with the reduction in the number of cases reported this week there is strong evidence that the cholera outbreak is spreading to new villages and districts, and the ongoing draught and subsequent water shortage and malnutrition are exacerbating the spread of the outbreak.

• Most of the districts reporting the cholera cases are along the Shebelle River and there is a severe water shortage due to dryness of the river.

• Active transmission of cholera is still going in all districts in Banadir region, but Hodan, Daynile, Dharkeynlay and Wadajir recorded the highest number of cholera cases.