Zimbabwe health cluster weekly bulletin No. 2 - 12 Dec 2008

Situation Report
Originally published

- WHO HQ/AFRO Task Force deploys to Harare, meets MoHCW, humanitarian partners

- Cholera Command Control Team roll out

- Biggest Health Cluster meeting held

- Supply plan organized

- Coordinated response to Chegutu outbreak

- Cholera cases, deaths increase

- Excessive IV use could cause supply gap


As of 12 December, 17 908 suspected cases of cholera had been reported in 9 of Zimbabwe's 10 provinces (48 out of 62 districts), with 877 deaths (case fatality rate (CFR) 4.9%). Most cases were in Harare/Budiriro (8454 cases and 208 deaths - CFR 2.5%), followed by Beitbridge (3456 cases and 91 deaths - CFR 2.6%), Mudzi (1237 cases and 78 deaths - CFR 6.3%) and Chitungwiza (551 cases and 99 deaths - CFR 18%.) Higher CFRs have been reported in a number of other areas.

For more information, see http://ochaonline.un.org/Default.aspx?alias=ochaonline.un.org/zimbabwe

Major causes for the current outbreak are: lack of clean drinking water and sanitation, weak health services, and health staff strike, mainly by nurses. Health staff unable to obtain salaries from banks due to the acute shortage of banknotes, making it too burdensome and expensive to travel to work.

75% of the cases in Harare come from the last 2 weeks, with upwards of about 3000 in that time. WHO is looking at a minimum clinical attack rate of 5-10% in Budiriro, western Harare. Urgency is to act fast to prevent another Budiriro-like outbreak. Cholera transmission continues to be intense within Harare city, though, as of 9 December, the main focus had not shifted beyond high-density suburbs in the southwest of the city. An outbreak has been recorded in Chegutu, northern Zimbabwe, with more than 600 cumulative cases.

In South Africa as of 12 December, 859 cumulative cases and 11 deaths (CFR of 1.2%) had been recorded, with the bulk of the cases (731) in the Limpopo area. Cases have also been reported in Botswana and Mozambique, but in smaller numbers.

According to WHO figures, there have been 200 human cases of anthrax reported since November, with 8 deaths. Consumption of contaminated meat is a possible cause.

Map - Zimbabwe: Areas Affected by Cholera Outbreaks (August-November 2008) showing locations of Cholera Treatment Centres/Units (as of 08 Dec 2008)