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Archive Number 20090913.3223
Published Date 13-SEP-2009
Subject PRO/EDR> Cholera, diarrhea & dysentery update 2009 (22)

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2009 (22)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
Africa
[1] Cholera - Afghanistan
[2], [3] Cholera - Ethiopia
[4] Cholera - Kenya
[5] Cholera - Zimbabwe (Manicaland)
[6] Cholera - Nigeria (Adamawa)
Asia
[7] Cholera, shigellosis - Papua New Guinea
[8] Cholera - Papua New Guinea
[9] Cholera - India (Mumbai)
[10] Cholera - India (Gujarat)
[11] Cholera - Sri Lanka
[12] Cholera - Kuwait

*****
[1] Cholera - Afghanistan
Date: Sun 13 Sep 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5jfXemSXl7hzhlIPSOUeW7mcHIxnw>


Afghanistan has reported outbreaks of potentially lethal cholera in 
10 provinces across the impoverished country, the health ministry 
said on Sunday [13 Sep 2009].

The ministry "has so far recorded 673 cases countrywide" of the 
disease in almost 1/3rd of the country's 34 provinces, including in 
the capital Kabul. No deaths have been reported. All outbreaks are 
under control, and no active one is reported as of today, 13 Sep 
2009," a ministry statement said.

It said staff had been deployed to outbreak areas and medication was 
being provided to try to prevent the spread of the disease, which 
thrives where sanitation is poor and can spread rapidly.

Afghanistan's health system has been battered by decades of civil 
war, and facilities remain poor across the 5th poorest country in the world.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[A map of Afghanistan can be found at:
<http://geology.com/world/afghanistan-map.gif>. - Mod.LL]

******
[2] Cholera - Ethiopia
Date: Mon 7 Sep 2009
Source: Reuters [edited]
<http://af.reuters.com/article/topNews/idAFJOE5860HJ20090907?sp=true>


Cholera and other diarrheal diseases have infected 18 000 people in 
Ethiopia over the last 3 weeks in many parts of the country, 
including the capital Addis Ababa, according to a document seen by Reuters.

The document, minutes of a meeting attended by international health 
charities and UN agencies last Tuesday [1 Sep 2009], said half of 
moderate-to-severe cases of the 18 000 infections were cholera. It 
did not say how many were moderate-to-severe. Most of the diarrheal 
illnesses that were not cholera were acute watery diarrhea (AWD), 
health workers said [often used as a euphemism for cholera - Mod.LL].

"To date, there are approximately 14 000 cases of AWD/Cholera (in the 
regions) and an additional 4000 from Addis Ababa," the minutes of the 
meeting said.

Addis Ababa usually suffers less from diarrhea epidemics than other 
parts of the country, but the city's health authorities are 
investigating the hygiene standards of hundreds of hotels and 
restaurants, according to local media.

Health workers, who declined to be named, told Reuters the fatality 
rate was 2 percent when the outbreak began but that it had been 
reduced as local and international agencies stepped up their 
response. "The case fatality rate is falling as the response 
matures," the minutes of the meeting said. "The epidemic is now in 
its 2nd phase, case load taking the form of a series of peaks over a 
protracted period."

Ethiopia's Health Ministry said last week that 34 people had died 
from AWD but it had not yet confirmed any cholera cases.

Aid agencies now fear a religious festival scheduled for this month 
[September 2009] will worsen the outbreak of AWD and cholera. "The 
Meskel religious festival (is a) major cause for concern," the 
document said. "Up to 500 000 people are expected to gather for 10 
days from 15-30 Sep 2009 with poor access to safe drinking water and 
sanitation facilities."

Some governments in Africa are often reluctant to admit to the 
presence of cholera for fear it could hamper agricultural exports and tourism.

[Byline: Barry Malone]

--
Communicated by:
ProMED-mail Rapporteur Brent Barrett

[Addis Ababa and other regions of Ethiopia can be seen on a map at: 
<http://en.wikipedia.org/wiki/Regions_of_Ethiopia>. - Mod.LL]

******
[3] Cholera - Ethiopia
Date: Mon 7 Sep 2009
Source: UN Office for Coordination of Humanitarian Affairs (OCHA) [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db900SID/NSPR-7VNJZV?OpenDocument>


Acute Watery Diarrhea (AWD) cases have been reported from all 10 
sub-cities in Addis Ababa, with the highest caseload recorded from 
Akaki/Kaliti, Addis Ketema, Arada and Kolfe, according to official 
reports from the Federal Ministry of Health (FMoH). The outbreak also 
continues to spread in other regions of the country, and new woredas 
[administrative divisions] are reportedly affected in Amhara, 
Oromiya, Dire Dawa and SNNPR. Between 17 and 23 Aug 2009 (34th 
epidemiological week), a total of 2330 new cases of AWD and 22 deaths 
with 0.9 per cent case fatality rate have been reported from 61 
woredas and 10 sub-cities in Addis Ababa, Afar, Amhara, Somali, 
Oromiya and SNNPR. The ongoing kiremt rains and the continuous 
movement of pilgrims and migrant laborers to and from holy water 
sites and private farms are contributing to the spread of the 
disease. The re-opening of schools in mid-September 2009 also 
requires special attention.

--
Communicated by:
ProMED-mail Rapporteur Susan Baekeland

******
[4] Cholera - Kenya
Date: Mon 7 Sep 2009
Source: Daily Nation [edited]
<http://www.nation.co.ke/News/-/1056/654600/-/umsm3k/-/>


Eight people have died of cholera in Laisamis, Marsabit, while 6 
members of a Nairobi family are being treated for the disease at the 
Kenyatta National Hospital. The 6 Nairobi family members contracted 
the disease in Dandora Estate, Embakasi after drinking contaminated 
water from a nearby well, the Public Health director, Dr Shanaaz 
Shariff, said on Monday [7 Sep 2009].
Following the outbreak, a team of Public Health officials visited the 
area and treated the contaminated water with chlorine tablets.

"As the water rationing continues to bite, I would like to appeal to 
residents to observe basic hygiene standards and ensure they boil 
drinking water at all times," Dr Shariff said. The rationing program 
in the city is forcing some residents to use water from unknown or 
contaminated sources.

At the same time, the drought being experienced in most parts of the 
country has also led to a severe shortage of water, resulting in a 
rise in cases of cholera and other water-borne diseases. According to 
experts, more than 50 people have died from the killer disease in 
various parts of the country in the past 6 months.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The areas mentioned can be found on a map of Kenya at: 
<http://www.un.org/Depts/Cartographic/map/profile/kenya.pdf>. - Mod.LL]

******
[5] Cholera - Zimbabwe (Manicaland)
Date: Tue 25 Aug 2009
Source: Voice of America [edited]
<http://www.voanews.com/english/Africa/2009-08-25-voa46.cfm>


Health experts in Zimbabwe are considering the implications of 12 
cases of cholera confirmed this week in Chipinge district of eastern 
Manicaland province some weeks after the Ministry of Health declared 
that the deadly 2008-2009 cholera epidemic had run its course.

Health Minister Henry Madzorera has advised against alarm saying 
Zimbabwe is much better prepared to deal with such outbreaks now than 
it was at this time in 2008, when an epidemic began which eventually 
took 4228 lives from more than 98 000 cases over 10 months.

Executive Director Itayi Rusike of the Community Working Group on 
Health said the new cases show that while the epidemic has ended, 
cholera is now endemic and a continuous threat, warning that the 
onset of the rainy season could bring even more cases. Zimbabwe's 
rainy season typically begins in October.

[Byline: Patience Rusere and Sandra Nyaira]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The location of the eastern province of Manicaland can be found on a 
map at: 
<http://www.un.org/Depts/Cartographic/map/profile/zimbabwe.pdf>. - Mod.LL]

******
[6] Cholera - Nigeria (Adamawa)
Date: Sat 22 Aug 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5ju91MrepySKR59Kq5brdVUXc6_fw>


A cholera outbreak in northern Nigeria has killed 13 more people, 
taking the death toll to 52, the health commissioner said on Saturday 
[22 Aug 2009]. "We recorded more cases of [the] cholera outbreak in 
the state in the last 5 days," Zainab Baba Kwanci told AFP of the 
outbreak in Adamawa state. "In Demsa, we have recorded 9 deaths, 
while 120 people are hospitalized. In Fufure, we recorded 4 deaths 
and 18 hospitalized."

39 people were reported killed by the disease in Maiha, according to 
local government official Yahaya Hamman-Julde. He said "scores of 
people" had been hospitalized as a result of the disease, stressing 
that an ongoing strike by medical workers in the state was hampering 
efforts to assist the sick.

Last September 2008, a spate of cholera outbreaks in northern Nigeria 
claimed almost 100 lives in Katsina, Zamfara and Bauchi states.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The northeastern state of Adamawa can be seen on a map of Nigeria 
at: <http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf>. - Mod.LL]

******
[7] Cholera, shigellosis - Papua New Guinea
Date: Mon 7 Sep 2009
Source: IRIN [edited]
<http://www.irinnews.org/report.aspx?ReportID=86035>


12 people have died from the 1st outbreak of cholera in 50 years in 
Papua New Guinea (PNG), and the disease must be urgently contained 
before it spreads further, the World Health Organization (WHO) says.

Eigil Sorensen, WHO's representative in Papua New Guinea, said 
cholera appeared in 2 coastal villages in northern Morobe Province at 
the end of July 2009 and gradually spread to 4 districts in the 
province, but was not identified until a month later.

"Cholera hasn't been reported in Papua New Guinea for the last 50 
years," Sorenson told IRIN, adding that the world health body was 
investigating the cause of the outbreaks. It's a major concern, 
mainly because the healthcare system in PNG remains weak. Rural 
health services are quite weak. and if cholera becomes endemic, it 
will become a major challenge," he said.

Of the 130 reported cases so far, there had been 12 deaths, Sorensen 
said, and the disease appeared to be spreading through low level 
transmission. "Since there is low level transmission and the number 
of cases remains relatively low, we think there is no contamination 
of any major water sources," he said. However, the disease has 
appeared in Lae, the provincial capital, which Sorenson attributed to 
people traveling from rural areas into the city.

Medical NGO Medecins Sans Frontieres (MSF) said on 7 Sep 2009 that 
Angau Hospital in Lae was on high alert over the cholera outbreak and 
that it had helped the Ministry of Health establish a cholera 
treatment center there. MSF's emergency team has sent 7 additional 
staff, including 3 nurses and a water and sanitation specialist, to 
assist in the urgent response.

Morobe Province has also been hit by unrelated outbreaks of 
shigellosis, a bacterium that causes bloody diarrhea. Sorenson said 
about 40 people might have died from shigella in the last month in 
remote districts in Morobe.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[A map of Papua New Guinea can be seen at: 
<http://wpcontent.answers.com/wikipedia/commons/4/42/Papua_New_Guinea_map.png>. 
- Mod.LL]

******
[8] Cholera - Papua New Guinea
Date: Mon 31 Aug 2009
Source: BBC News [edited]
<http://news.bbc.co.uk/2/hi/asia-pacific/8230018.stm>


An outbreak of cholera has reportedly killed more than 40 people in a 
remote area of Papua New Guinea. Government officials said that 
hundreds of other villagers in Morobe Province have fallen ill. A 
World Health Organization medical team has confirmed the outbreak, 
and PNG's health minister has ordered measures to contain its spread.

This is the 1st time the disease has officially been confirmed in the country.

The deaths are reported to have occurred in the remote Finsch-hafen 
district of Morobe province on the northern coast of Papua New 
Guinea. Officials said that up to 800 people have been taken ill.

--
Communicated by:
Scott E. Miller, Ph.D.
Deputy Under Secretary for Science
Smithsonian Institution
Washington, DC
<millers@si.edu>

[ProMED-mail thanks Dr. Miller for this posting. - Mod.LL]

*****
[9] Cholera - India (Mumbai)
Date: Fri 11 Sep 2009
Source: Express News Service [edited]
<http://www.indianexpress.com/news/kalbadevi-sees-spurt-in-cholera-cases-bmc-screens-residents/515597/>


The congested Kalbadevi area has witnessed a sudden increase in 
cholera cases, with 9 persons from the locality already admitted to 
hospitals in the last 2 days. The area houses an enormous amount of 
contaminated water, one of the major causes of the disease. The 
Brihanmumbai Municipal Corporation (BMC) has started screening 
residents in the area.

Until late Thursday evening [10 Sep 2009], 9 people were admitted to 
Kasturba Hospital, while 2 were admitted to GT Hospital with cholera 
symptoms, including vomiting, diarrhea and fever. The patients are 
from Ramnath Sadan, a makeshift godown [a waterside warehouse - 
Mod.LL] where a floating population of about 15 to 20 resides. All of 
them tested positive for cholera in the hanging drop test to 
ascertain the organism.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

A map of the southern city island of Mumbai (Bombay) can be seen at 
<http://www.mapsofindia.com/maps/maharashtra/mumbai-map.htm>. The 
city's location on the western coast of India can be seen at 
<http://www.lonelyplanet.com/mapshells/indian_subcontinent/india/india.htm>, 
and the HealthMap/ProMED-mail interactive map at 
<http://healthmap.org/r/00BT>. - Mod.LL]

******
[10] Cholera - India (Gujarat)
Date: Fri 11 Sep 2009
Source: Express News Service [edited]
<http://www.indianexpress.com/news/one-cholera-case-reported-in-narmada-village-24-admitted/515635/>


A cholera case was reported from Lachras village of Narmada district 
on Thursday [10 Sep 2009]. An 18-year-old youth treated at Rajpipla 
Civil Hospital has been confirmed as a positive case of cholera. 
Incidentally, 3 adults have died in the area in the last 3 days after 
they complained of diarrhea.

Sources said 24 people from the area have been admitted to Civil 
Hospital and Mehta Clinic in Rajpipla. While Dr Suman, Rajpipla Block 
Health Officer, accepted that one cholera case has been reported at 
Lachras, he refused to accept that the 3 died after drinking 
contaminated water. While a post-mortem report of Tadvi revealed that 
she suffered from heart disease, post-mortem of the other 2 could not be done.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[Vadodara District is a district in the eastern part of the state of 
Gujarat in western India. The city of Vadodara (Baroda) is in the 
western part of the district. Gujarat can be seen on a map at: 
<http://en.wikipedia.org/wiki/Gujarat>. - Mod.LL]

*****
[11] Cholera, - Sri Lanka
Date: Tue 1 Sep 2009
Source: Niadhasa News [edited]
<http://news.nidahasa.com/news.php?go=fullnews&newsid=881>


Peoples Liberation front (JVP) parliamentarian Bimal Rathnayake today 
[1 Sep 2009]) said that the spread of cholera in the IDP camps in 
Vavuniya has increased. Quoting a report released by the Disaster 
Preparedness and Response Unit of the Health Ministry, he said most 
of the IDP deaths were caused by pneumonia and cholera.

Meanwhile, aid groups say that Sphere standards [Humanitarian Charter 
Minimum Standards in Disaster Response; see 
<http://www.sphereproject.org>. - CopyEd.MSP] at IDP camps are being 
undermined due to overcrowding. "We are missing Sphere standards by a 
long way, particularly in the WASH [water, sanitation and hygiene] 
cluster," David White, Oxfam's country director in Colombo, told 
IRIN, citing instances where some people were going without water for 
washing for up to 3 days.

"We're not even close," said another international aid worker. "With 
the monsoon rains, it's going to get worse," he warned.

Close to 300 000 people languish in 30 government camps in Vavuniya, 
Mannar, Jaffna and Trincomalee districts.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

A map of the island nation of Sri Lanka can be found at: 
<http://www.mapsofworld.com/sri-lanka/maps/sri-lanka-political-map.jpg>. 
- Mod.LL]

******
[12] Cholera - Kuwait
Date: Wed 2 Sep 2009
Source: Kuwaiti Times [edited]
<http://www.kuwaittimes.net/read_news.php?newsid=MzYwMzQ3Mjk5>


Preliminary tests conducted on seawater samples collected from 
inshore areas along Kuwait's coasts have shown traces of the cholera 
bacterium, according to medical experts. The Ministry of Health (MoH) 
reportedly sent a doctor from its environmental health department to 
take the samples for testing at its general health department, with 
the tests finding traces of the deadly disease bacteria in them.

The presence of the cholera bacterium is believed to be due to the 
recent dumping of raw, untreated sewage into the sea due to the 
breakdown of the Mishref sewage plant.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[see also:
Cholera, diarrhea & dysentery update 2009 (21) 20090819.2939
Cholera, diarrhea & dysentery update 2009 (20) 20090724.2616
Cholera, diarrhea & dysentery update 2009 (19) 20090720.2575
Cholera, diarrhea & dysentery update 2009 (18) 20090709.2469
Cholera, diarrhea & dysentery update 2009 (17) 20090429.1620
Cholera, diarrhea & dysentery update 2009 (16) 20090310.0991
Cholera, diarrhea & dysentery update 2009 (15) 20090212.0632
Cholera, diarrhea & dysentery update 2009 (14) 20090210.0604
Cholera, diarrhea & dysentery update 2009 (13) 20090204.0491
Cholera, diarrhea & dysentery update 2009 (12) 20090203.0474
Cholera, diarrhea & dysentery update 2009 (11) 20090128.0393
Cholera, diarrhea & dysentery update 2009 (10) 20090126.0355
Cholera, diarrhea & dysentery update 2009 (09) 20090122.0275
Cholera, diarrhea & dysentery update 2009 (08) 20090120.0245
Cholera, diarrhea & dysentery update 2009 (07) 20090116.0182
Cholera, diarrhea & dysentery update 2009 (06) 20090113.0140
Cholera, diarrhea & dysentery update 2009 (05) 20090112.0124
Cholera, diarrhea & dysentery update 2009 (04) 20090110.0107
Cholera, diarrhea & dysentery update 2009 (03) 20090107.0061
Cholera, diarrhea & dysentery update 2009 (02) 20090105.0038
Cholera, diarrhea & dysentery update 2009 (01) 20090102.0015
2008
----
Cholera, diarrhea & dysentery update 2008 (57) 20081231.4125
Cholera, diarrhea & dysentery update 2008 (50) 20081208.3854
Cholera, diarrhea & dysentery update 2008 (30) 20080702.2019
Cholera, diarrhea & dysentery update 2008 (10) 20080212.0563
Cholera, diarrhea & dysentery update 2008 (01) 20080104.0047
2007
----
Cholera, diarrhea & dysentery update 2007 (67) 20071231.4200
Cholera, diarrhea & dysentery update 2007 (60) 20071126.3824
Cholera, diarrhea & dysentery update 2007 (40) 20070924.3164
Cholera, diarrhea & dysentery update 2007 (20) 20070511.1509
Cholera, diarrhea & dysentery update 2007 (01) 20070105.0047
2006
----
Cholera, diarrhea & dysentery update 2006 (52) 20061229.3646
Cholera, diarrhea & dysentery update 2006 (50) 20061215.3528
Cholera, diarrhea & dysentery update 2006 (30) 20060724.2037
Cholera, diarrhea & dysentery update 2006 (10) 20060303.0675
Cholera, diarrhea & dysentery update 2006 (01) 20060106.0040]
........................................................ll/msp/dk

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