On 25 August 2015, WHO was notified by the Ministry of Health and Social Welfare (MOHSW) of Tanzania of new foci of cholera outbreaks in the country. Dar es Salaam, Pwani (Coast), Iringa and Morogoro are the new affected areas. These new cholera foci are reported, while the Kigoma area outbreak has just ended.
The cholera outbreak in Dar es Salaam region started on 15 August 2015 whilst the Morogoro region outbreak started on 18 August 2015. As of 4 September 2015, the cumulative number of cholera cases in the affected areas is 857 cases including 13 deaths. Laboratory tests processed and confirmed the presence of Vibrio cholerae, type O1 Ogawa strain.
On 31 August 2015, Morogoro reported only 1 case from Kilakala but the main affected area is Dar es Salaam. A team of health officers has started mobilizing the community by educating and providing disinfectants (Chlorine tablets) from house-to-house starting with Kilakala, the area that has been severely hit by the outbreak. This activity will continue in other areas too. Apart from the Kilakala case, there is no other case reported in Morogoro on 31 August 2015.
In Kigoma, there has been no cholera case reported in the last three weeks. This situation indicates the end of the cholera outbreak although vigilance is still required. From May 2015 to 26 August 2015, cumulative suspected / confirmed cases reported in Kigoma are 4833 including 40 deaths. This figure includes 4528 cases within Burundian asylum seekers and 305 cases from the host communities.
Public health response
The national task force has been activated to manage the outbreak. With the support of WHO and partners, five treatment centres have been opened in Dar es Salaam and Morogoro to manage cases. The Ministry of Health and Social Welfare has deployed experts in the field to provide technical support on surveillance including active case finding as well as case management, water and sanitation, laboratory and social mobilization interventions.
Rapid assessment has been conducted in order to identify gaps and urgent needs. The regional authorities, MOHSW, WHO and partners are holding twice weekly coordination meetings on the response effort. The WHO Representative undertook a field visit to assess the situation and advocated for quick control of the outbreaks.
Remaining challenges include the need to improve water, sanitation and hygiene (WASH) conditions as well as improve stocks of medicines, disinfectants and supplies for case management, contact tracing and social mobilization. Concerning WASH challenges, City municipal water Engineers and Ministry of Water Engineers are working hand-in-hand with the Dar es Salaam Water and Sewerage Cooperation (DAWASCO) to ensure safe water to the affected population.
The WHO Tanzania Country Office provided the MOHSW water treatment supplies and disinfectants to strengthen the cholera outbreak response in the country. Items handed over included: 1000 cartons of disinfectants (2 400 000 tablets) and 100 litres of Cresol Saponated Liquid (LYSOL), all worth a total of US$ 21 130 equivalents to Tanzania Shillings TShs 42 260 000. In addition to these items, WHO has committed to provide funds nearly TShs 174 000 000 to support case management, laboratory services, surveillance and social mobilization activities. The overall cost of WHO support is worth a total of US$ 102 347 equivalent to Tanzania Shillings TShs 216 260 000.
Cholera is a diarrhoeal disease caused by Vibrio cholerae. Cholera outbreaks are recurrent in many African countries and are linked to poor hygiene and sanitation and insufficient preparedness and capacities. Tanzania has experienced cholera outbreaks in the past with Kigoma region being the most affected. The country has developed this year a long term plan for cholera prevention and control.
WHO does not recommend any travel or trade restriction to Tanzania based on the current information available.