Disease outbreak news: Cholera – Republic of the Sudan (9 October 2019)
On 8 September, Sudan’s Federal Ministry of Health (FMoH) notified WHO about a cholera outbreak in four localities in the Blue Nile State (BNS), south-eastern Sudan, bordering Ethiopia and South Sudan. The first case was detected on 28 of August 2019.
From 28 August through 8 October 2019, a total of 247 suspected cholera cases, including 8 deaths (case fatality ratio: 3.5 %), have been reported from four localities in Blue Nile State including Al Roseries (99), Ad Damazin (52), Wad Almahi (3) and Baw (2), and five localities in Sennar State including Abu Hugar (71), Singa (4), Alsoky (13), Aldaly wa Almzmom (2) and Sennar (1) . One hundred fifty cases were female (61%), and 238 (94.4%) were over 5 years of age.
As of 2 October, 28 out of 42 (67%) samples tested from affected States were confirmed by culture as _Vibrio cholerae _O1 Ogawa in the National Public Health Laboratory.
Public health response
The following public health response measures have been implemented:
With the support of WHO, the Federal Ministry of Health (FMoH) activated the national Cholera Task Force on 10 September;
WHO has deployed a technical team to assist FMoH with coordination of response and development of response strategy on the ground;
Surveillance and reporting system have been strengthened by the distribution of case definitions and case investigation forms, active case finding and maintaining the line list;
Activation of 14 Cholera Treatment Centres by MoH, 4 in Blue Nile State and 10 in Sennar State, and standardization of case management protocols;
FMoH, WHO, and UNICEF have provided cholera kits (enough to treat 200 people) with three additional kits (enough to treat 300 people) in the pipeline;
WHO is supporting the water quality surveillance system, water sampling, and testing, integrated vector management, and infection prevention & control activities;
State Ministry of Health in Blue Nile State and UNICEF are supporting the water chlorination activities and health promotion in the affected areas;
WHO is supporting national authorities to conduct an oral cholera vaccine (OCV) campaign in Blue Nile and Sennar States.
WHO risk assessment
Sudan is facing a continuous surge of acute watery diarrhea (AWD) /suspected cholera cases since 2016. The current outbreak was reported following recent severe rainstorms and flooding in 15 out of 18 States. As a result of the flooding, the country reported widespread damage to infrastructure, thus more cholera cases can be expected in the future. Although Blue Nile State shares borders with Ethiopia and South Sudan, there is currently no evidence of cross-border spread of the outbreak. The Government swiftly responded to the detection of cases and necessary control measures are being implemented by national authorities, with support from partners, to contain the outbreak.
WHO recommends proper and timely case management. Improving access to safe drinking water and sanitation infrastructure, as well as improving hygiene practices and food safety in affected communities are the most effective means of controlling cholera.
Key public health communication messages should be provided to the population. Vaccination should be considered to complement the core prevention and control activities and help prevent the spread of the outbreak. Currently an OCV campaign is being planned.
WHO does not recommend any travel or trade restrictions on Sudan based on the currently available information.
For further information, see: