Cholera and AWD Outbreaks in Eastern and Southern Africa Region, as of 15 June 2019, 11th Issue

Highlights

Almost half of the countries in Eastern and Southern Africa region (ESAR) have been affected by cholera outbreaks since the beginning of 2019. More than 12,102 cholera / AWD cases including 51 deaths have been reported in 10 countries in the region, with an average Case Fatality Rate of 0.4%, since the beginning of 2019. These countries include; Angola, Burundi, Kenya, Malawi, Mozambique, Tanzania, Somalia, Uganda, Zambia and Zimbabwe. Mozambique accounts for 58.1% (7,034) of the total case load reported this year, followed by Kenya at 23% (2,789).


Currently 5 out of the 10 countries with reported cholera / AWD outbreaks in ESAR since week 1 of 2019, have active transmission and they include; Kenya, Somalia, Tanzania, Mozambique and Zambia and . During the week under review, Kenya reported the highest number of new cases (188 cases including 2 deaths), followed by Somalia (133 cases) and Tanzania (115 cases including 1 death). Of the countries with active transmission, overall Zambia has recorded the highest Case Fatality Rates (CFR) in 2019 at 2.4%.


Kenya: An increase in the epidemic trend has been noted over the last 9 weeks (from epidemiological week 15 to 23), with an average weekly incidence of 174 cases. For instance, during week 23 (week ending 9 June 2019), 188 new cases including 2 deaths (CFR, 1.1%) were reported compared to 284 cases including 3 deaths (CFR, 1.1%) reported in week 22 (week ending 2 June 2019). New cases emerged from the following three Counties: Garissa (103), Nairobi (76) and Kajiado (9). Cumulatively, since January 2019, a total of 2,789 cases including 19 deaths (CFR, 0.7%) have been reported from nine Counties (Narok, Kajiado, Nairobi, Garissa, Mandera, Machakos, Embu, Wajir and Mombasa). High risk areas are characterized by unavailability of potable water, poor sanitation and hygiene practices and the situation is likely to be exacerbated in view of the current long rains.


Somalia: The outbreak has been on an increasing trend in the month of May 2019, from 47 cases in epidemiological week 18 (week ending 5 May 2019) to 133 cases in epidemiological week 22. All new cases reported in week 22 (133 cases) emerged from Banadir region. Cumulatively a total of 1,203 cases with no deaths have been reported since the beginning of 2019. Children under five years bear the brunt of the cholera outbreak, representing 77% of the total case load reported in week 22. Overall (from week 1 to 22, 2019), the most affected districts in Banadir include; Hodan (137; AR 0.1), Madina (135; AR 0.2) and Daynile (125; AR 0.21).


Tanzania: A new outbreak started in Dar es Salaam city during epidemiological week 21 (week ending 26 May 2019). Since then a total of 165 cases including 2 deaths (CFR, 1%) have been reported in this city, as of 13 June 2019. Cumulatively, a total of 33,702 cases including 556 deaths were reported in the United Republic of Tanzania since August 2015.


Mozambique: The cholera outbreak is on a downward trend following the effective cholera vaccination campaign. During week 22, 19 new cases were reported compared to 39 cases reported in week 21. This raises the total number of cholera cases reported since the declaration of the cholera outbreak on 27 March 2019 to 7,034 including 8 deaths (CFR, 0.1%). These cumulative number includes; 6,768 cases and eight deaths reported from the Cyclone Idai affected districts (Beira, Buzi, Dondo and Nhamatanda) in Sofala Province; and 266 cases reported from Cyclone Kenneth affected districts (Metuge, Mecufi and Pemba city) in Cabo Delgado province. A decrease in the number of sites reporting cholera outbreaks has been noted. Out of 3 sites (Pemba, Mecufi and Metuge districts) with reported cholera outbreaks in Cabo Delgado, Mecufi did not report new cases in week 22. In Sofala, out of 4 sites (Beira, Dondo, Buzi and Nhamatanda districts) with reported cholera outbreaks, only Nhamatanda district reported new cases in week 22.


Zambia: A decline in the epidemic trend has been noted in the last two weeks. During week 22, 19 new cases were reported compared to 56 cases reported in week 21. All new cases emerged from Northern province. Cumulatively a total of 417 cases including 10 deaths have been reported since the beginning of 2019.

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