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Archive Number 20091018.203150
Published Date 18-OCT-2009
Subject PRO/EAFR> Cholera, diarrhea & dysentery update 2009 (03): Africa

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2009 (03): AFRICA
********************************************************
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:
[1] Cholera - Cameroon (Far North)
[2] Cholera - Nigeria (Borno)
[3] Cholera - West Africa (Guinea Bisau)

******
[1] Cholera - Cameroon (Far North)
Date: Wed 14 Oct 2009
Source: Yahoo News [edited]
<http://ca.news.yahoo.com/s/afp/091014/health/cameroon_health_cholera?printer=1>

A cholera outbreak in northern Cameroon last month [September 2009] 
killed 51 people, a public health ministry source and national radio 
said Wednesday [14 Oct 2009]. "The latest report in our possession 
shows 23 deaths in the far north region where 144 cases of cholera 
were registered in the hospital," a ministry official told Agence 
France Presse (AFP) on condition of anonymity.

According to national public radio, Cameroon Radio Television (CRTV), 
the illness also killed 28 people in the neighbouring northern region 
where 152 cases were recorded. The radio station quoted another 
ministry official.

In 2004, at least 100 people died in an outbreak in southern Douala, 
the country's economic capital. Cholera is a water-borne disease that 
can also be transmitted by food that has been in contact with sewage. 
It causes serious diarrhoea and vomiting leading to dehydration. With 
a short incubation period, it can be fatal if not treated in time.

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

[The Far North Region of Cameroon can be located on the ProMED/Health 
map of Cameroon at
<http://healthmap.org/r/00Eh>. - Mod.JFW]

*****
[2] Cholera - Nigeria (Borno)
Date: 16 Oct 2009
Source: Times Live (South Africa) [edited]
<http://www.timeslive.co.za/news/africa/article154363.ece>


Nigeria cholera death climbs to 149
-----------------------------------
The toll in a cholera outbreak in northern Nigeria rose to 149 today 
[16 Oct 2009] with 52 more deaths, a provincial health official said. 
"We have recorded 52 deaths from cholera outbreak in 4 local 
government areas of the state while 1335 have been hospitalised," the 
director of disease control in Borno State, Abdallah Sadiq, told AFP.

"The disease was 1st reported on 10 Sep 2009 in Gwoza local 
government on the border with Cameroon from where it spread to 6 
other districts," he said. He said Biu local government on the border 
with Chad was the worst affected area where 650 were infected, 
forcing health officials to open a camp for the victims.

Cholera has claimed 77 lives in recent weeks in Adamawa State, 
leaving nearly 1000 people hospitalized. In late September, officials 
in Jigawa State announced the deaths of 11 people in a cholera 
outbreak which affected 400 others at a village outside the state 
capital. In Taraba state, neighboring Adamawa, another cholera 
outbreak killed 9 people and infected 120 others.

Cholera is a water-borne disease and can also be transmitted by food 
that has been in contact with sewage. It causes serious diarrhoea and 
vomiting leading to dehydration. With a short incubation period, it 
can be fatal if not treated in time.

[Byline: Sapa - AFP]

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

[Borno State is found in Northern Nigeria and can be located on the 
ProMED/Health map of Nigeria at
<http://healthmap.org/r/00TS>. - Mod JFW]

*****
[3] Cholera - West Africa (Guinea Bisau)
Date: 15 Oct 2009
Source: IRIN News [edited]
<http://www.irinnews.org/PrintReport.aspx?ReportId=86596>


Stopping cholera emergencies
----------------------------
Cholera outbreaks in West Africa generally trigger extra 
hand-washings in households and panic-buying of bleach for treating 
water. But beating the deadly -- but easily preventable -- illness 
requires that such hygiene practices become routine, health experts say.

Researchers with the London School of Hygiene and Tropical Medicine 
(LSHTM) say knowing the drivers behind behaviour, and tying hygiene 
messages to those impulses, is crucial for preventing cholera, which 
has become a recurring health emergency in West Africa.

"If we want sustainable change we need to make sure people practice 
things so they become habits," Jeroen Ensink of LSHTM's environmental 
health group told IRIN. One way for aid agencies to do so, he said, 
is to dissociate hygiene messages from cholera -- which is seasonal 
-- and link them instead to general diarrhoeal disease.

Ensink also said it might be time to 're-brand' hygiene and health 
messages, as knowledge of cholera's causes does not always translate 
into new habits. "Hand-washing messages need not be just about 
health; they can be about: if you want to be modern, to smell nice, 
to be attractive to the opposite sex, use soap." The use of proper 
latrines can be linked to privacy instead of just proper hygiene, he added.

LSHTM has studied the impact of government and aid agency prevention 
and preparedness measures in Guinea and Guinea-Bissau as part of a 
project funded by the European Commission humanitarian aid department (ECHO).

The ECHO project aims to build a more coherent approach to cholera 
control with sound preparedness and early response. And ECHO says 
'quick impact' actions in vulnerable communities should be 
accompanied by longer-term prevention measures.

To date, emergency and development strategies fail to address the 
disease properly, lacking common objectives and complementary 
actions, ECHO says.

ECHO is focusing on Guinea and Guinea-Bissau, where cholera has 
become endemic; during 2007 and 2008 more than 23 000 people were 
infected and 560 died in the 2 countries.

But all of West Africa is highly vulnerable to cholera and a regional 
approach is needed; ECHO and its partners will study lessons from 
Guinea and Guinea-Bissau to see what might be applied more widely.

As part of the ECHO-funded project UN Children's Fund and NGOs are 
training local health workers in responding to cholera, boosting 
communications strategies and developing emergency kits, which 
include sanitation and water purification materials, to keep 
outbreaks in check.

"We know that the solution to cholera is an overall improvement in 
water, sanitation and environmental conditions," said ECHO water and 
sanitation expert Francisco Gonzalez. But he said before such 
significant and permanent changes can be made, proper preparedness 
and response can save a lot of lives.

But to be effective anti-cholera actions must not be merely reactive, 
health experts say. LSTHM researchers observed in Guinea-Bissau that 
while most people could recite verbatim hand-washing and other 
hygiene messages, they apply them consistently only when cholera 
strikes. Changing such behaviour takes years, not months, said LSHTM's Ensink.

The World Health Organization calls cholera a principal indicator of 
social development. Overcrowding in poor-sanitation urban areas is a 
main driver of cholera. And the disease hits the poorest of the poor 
most heavily. With factors like poverty, rapid and unregulated 
urbanization and poor infrastructure all favouring cholera outbreaks, 
substantial socio-economic fixes are necessary to eliminate cholera 
as a cyclical health disaster.

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


[The ProMED/ Health map of Guinea Bissau in West African can be seen at
<http://healthmap.org/r/00Wq>. - Mod.JFW]

The cholera outbreaks in Northern Nigeria continue to escalate as 
authorities work to contain them. The outbreaks started in Adamawa 
state in early August 2009 before spreading to the neighboring states 
of Borno, Jigawa, and Taraba in Nigeria and to the Far North region 
in Cameroon. In this update the deaths have increased to 149 and 51 
in Northern Nigeria and the Far North region of Cameroon 
respectively. This rapid spread of the outbreaks reaffirms the fact 
that most of West Africa is highly vulnerable to cholera outbreaks 
and hence the need for a regional approach for building a more 
coherent approach to cholera control with sound preparedness and 
early response. The ECHO project in Guinea Bissau therefore will have 
big lessons that can be applied to the rest of the countries in West 
Africa so as to reverse the current cholera trends in the region. - Mod.JFW]


[see also:
Cholera, diarrhea & dysentery update 2009 (02): Africa  20091011.203025
Cholera, diarrhea & dysentery update 2009 (01): Africa  20091009.202994
Cholera, diarrhea & dysentery: Worldwide  20090914.202068
Cholera - Nigeria (02): (Borno)  20091003.202860
Cholera - Uganda (02): (Kasese)  20091002.202854
Cholera - Nigeria: (Jigawa)  20091002.202850
Cholera - Rwanda: (Western Province)  20091002.202849
Cholera - Tanzania: (Zanzibar West)  20090927.202711
Undiagnosed fatalities - Nigeria: (Adamawa) RFI  20090925.202673
Cholera - Ethiopia (03): Addis Ababa, susp  20090918.202407
Undiagnosed diarrheal illness - DR Congo: (North Kivu), fatal  20090918.202370
Cholera, diarrhea & dysentery: Worldwide  20090914.202068
Cholera - Kenya: Turkana  20090914.202053]

[Additional background information on cholera is available from the 
general ProMED-mail list. The postings below can be found at
<http://www.promedmail.org>. - Mod.JFW]

[Cholera, diarrhea & dysentery update 2009 (25)  20091009.3500
Cholera, diarrhea & dysentery update 2009 (24)  20090930.3411
Cholera, diarrhea & dysentery update 2009 (23)  20090921.3319
Cholera, diarrhea & dysentery update 2009 (22)  20090913.3223
Cholera, diarrhea & dysentery update 2009 (21)  20090819.2939
Cholera, diarrhea & dysentery update 2009 (20)  20090724.266
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]
...................................jfw/ejp/be

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