Global & Disaster Medicine

Archive for the ‘Cholera’ Category

Yemen: Cholera outbreak now largest and fastest on record, 600,000 children infected by Christmas

Save The Children

“….About 4,000 suspected cases are still being reported every day, more than half of them children under the age of 18. Of those infected, 25% of cases are children under the age of five……”

 


WHO: The death toll of the cholera epidemic in war-ravaged Yemen has risen to 2,151 since it broke out in late April.

Xinhua

Port of Aden, Yemen

NASA:  Post of Aden

 


Ending Cholera—A Global Roadmap to 2030 operationalises the new global strategy for cholera control at the country level and provides a concrete path toward a world in which cholera is no longer a threat to public health.

Global Task Force on Cholera Control

The road map address six interventions to tackle cholera in its hot spots:

  • Water, sanitation, and hygiene
  • Leadership and coordination
  • Health system strengthening
  • Surveillance and reporting
  • Use of oral cholera vaccine
  • Community engagement

“….By implementing the strategy between now and 2030, the Global Task Force on Cholera Control (GTFCC) partners will support countries to reduce cholera deaths by 90 percent……”


The Global Task Force on Cholera Control (GTFCC) launches new anti-cholera campaign

 

WHO

October 2017 | Geneva – An ambitious new strategy to reduce deaths from cholera by 90% by 2030 will be launched tomorrow by the Global Task Force on Cholera Control (GTFCC), a diverse network of more than 50 UN and international agencies, academic institutions, and NGOs that supports countries affected by the disease.

Cholera kills an estimated 95 000 people and affects 2.9 million more every year. Urgent action is needed to protect communities, prevent transmission and control outbreaks.

The GTFCC’s new plan, Ending Cholera: A Global Roadmap to 2030, recognizes that cholera spreads in endemic “hotspots” where predictable outbreaks of the disease occur year after year.

The Global Roadmap aims to align resources, share best practice and strengthen partnerships between affected countries, donors and international agencies. It underscores the need for a coordinated approach to cholera control with country-level planning for early detection and response to outbreaks. By implementing the Roadmap, up to 20 affected countries could eliminate cholera by 2030.

“WHO is proud to be part of this new joint initiative to stop deaths from cholera. The disease takes its greatest toll on the poor and the vulnerable – this is quite unacceptable. This roadmap is the best way we have to bring this to an end,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.

“Every death from cholera is preventable with the tools available today, including use of the Oral Cholera Vaccine and improved access to basic safe water, sanitation and hygiene as set out in the Roadmap,” said Dr Tedros Adhanom Gebreyesus. “This is a disease of inequity that affects the poorest and most vulnerable. It is unacceptable that nearly two decades into the 21st century, cholera continues to destroy livelihoods and cripple economies. We must act together. And we must act now.”

Advances in the provision of water sanitation and hygiene (WASH) services have made Europe and North America cholera-free for several decades. Today, although access to WASH is recognized as a basic human right by the United Nations, over 2 billion people worldwide still lack access to safe water and are potentially at risk of cholera. Weak health systems and low early detection capacity further contribute to the rapid spread of outbreaks.

Cholera disproportionally impacts communities already burdened by conflict, lack of infrastructure, poor health systems, and malnutrition. Protecting these communities before cholera strikes is significantly more cost-effective than continually responding to outbreaks.

The introduction of the oral cholera vaccine has been a game-changer in the battle to control cholera, bridging the gap between emergency response and longer-term control. Two WHO-approved oral cholera vaccines are now available and individuals can be fully vaccinated for just US$6 per person, protecting them from the disease for up to three years.

The Global Roadmap provides an effective mechanism to synchronize the efforts of countries, donors, and technical partners. It underscores the need for a multi-sectoral approach to cholera control with country-level planning for early detection and response to outbreaks.

By strengthening WASH in endemic “hotspots”, cholera outbreaks can be prevented. By detecting cholera outbreaks early, and responding immediately, large-scale uncontrolled outbreaks like the one observed in Yemen can be avoided – even in crisis situations.

Note to editors

The Global Task Force on Cholera Control (GTFCC) is a network of more than 50 organizations bringing together partners involved in the fight against cholera across all sectors and providing a strong framework to support countries in intensifying efforts to control cholera.

The Launch of the Global Roadmap is supported by the Bill and Melinda Gates Foundation, the Fondation Mérieux and WaterAid.


Yemen’s cholera outbreak has infected 612,703 people and killed 2,048 since it began in April.

Reuters

“….The United Nations has said the epidemic is man-made, driven by a civil war that has left 15.7 million people without clean water or sanitation. ….”

 

 


A slow death in Yemen: War, malnutrition, cholera and no end in sight

NY Times

 


Somalia in crisis: Measles, Cholera, Drought, Famine

WHO

WHO and Federal Ministry of Health of Somalia call for urgent support to address measles outbreak in Somalia

16 August 2017 – As millions of people in Somalia remain trapped in a devastating cycle of hunger and disease, WHO and health partners are working with national health authorities to save lives and reach the most vulnerable with essential health services.

More than 2 years of insufficient rainfall and poor harvests have led to drought, food insecurity and a real risk of famine. Malnutrition, mass displacement as a result of the drought, and lack of access to clean water and sanitation have created ideal conditions for infectious disease outbreaks.

“Somalia is facing one of the worst humanitarian crises in the world. Millions of people, already on the brink of famine, are now at risk of rapidly spreading infectious diseases like cholera and measles. Normally, these diseases are easy to treat and prevent, but they can turn deadly when people are living in overcrowded spaces and are too weak to fight off infection,” said Dr Ghulam Popal, WHO Representative in Somalia.

Drought has led to a lack of clean water and the largest cholera outbreak in the last 5 years, with more than 57 000 cases and 809 cumulative deaths reported as of 31 July 2017. Health partners, together with national health authorities, scaled up its efforts to respond to this event by setting up cholera treatment centers in affected districts and providing support in water and sanitation to prevent the spread of the disease. In March, WHO and partners conducted Somalia’s first national oral cholera vaccination campaign, and successfully reached over 450 000 vulnerable people. Due to ongoing efforts, the number of cholera cases in Somalia has declined, from 13 656 cases of acute watery diarrhoea/cholera in May 2017 to 11 228 cases in June 2017.

Somalia is also facing its worst measles outbreak in 4 years, with over 14 823 suspected cases reported in 2017 (as of 31 July), compared to 5000–10 000 cases per year since 2014. The situation is especially critical for millions of under-vaccinated, weak and hungry children who are more susceptible to contracting infectious diseases. More than 80% of those affected by the current outbreak are children under 10 year of age.

In early 2017, WHO and partners, in collaboration with national health authorities, vaccinated almost 600 000 children aged 6 months to 5 years for measles in hard-to-reach and hotspot areas across the country. Despite these efforts, the transmission of measles continues, compounded by the ongoing pre-famine situation, continued mass displacement, and undernourished children living in unhygienic conditions.

In order to contain the outbreak, a nationwide campaign is planned for November 2017 to stop transmission of the disease, targeting 4.2 million children. The campaign will also intensify efforts to strengthen routine immunization and reach unvaccinated children to boost their immunity. As shown by the response to the cholera outbreak, with the right interventions, health authorities are confident that similar success may be seen in controlling the measles outbreak.

US$ 14.4 million (a cost of US$ 3.36 per child) is required by WHO and health partners to conduct the measles vaccination campaign in November 2017, of which WHO required US$ 6.8 million. To date, no funding has been received.


The total number of suspected cholera cases in Yemen this year hits 500 000!

WHO

Cholera count reaches 500 000 in Yemen

News release

The total number of suspected cholera cases in Yemen this year hit the half a million mark on Sunday, and nearly 2000 people have died since the outbreak began to spread rapidly at the end of April.

The overall caseload nationwide has declined since early July, particularly in the worst affected areas. But suspected cases of the deadly waterborne disease continue to rage across the country, infecting an estimated 5000 people per day.

The spread of cholera has slowed significantly in some areas compared to peak levels but the disease is still spreading fast in more recently affected districts, which are recording large numbers of cases.

Yemen’s cholera epidemic, currently the largest in the world, has spread rapidly due to deteriorating hygiene and sanitation conditions and disruptions to the water supply across the country. Millions of people are cut off from clean water, and waste collection has ceased in major cities.

A collapsing health system is struggling to cope, with more than half of all health facilities closed due to damage, destruction or lack of funds. Shortages in medicines and supplies are persistent and widespread and 30 000 critical health workers have not been paid salaries in nearly a year.

“Yemen’s health workers are operating in impossible conditions. Thousands of people are sick, but there are not enough hospitals, not enough medicines, not enough clean water. These doctors and nurses are the backbone of the health response – without them we can do nothing in Yemen. They must be paid their wages so that they can continue to save lives,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.

WHO and partners are working around the clock to set up cholera treatment clinics, rehabilitate health facilities, deliver medical supplies, and support the national health response effort.

More than 99% of people sick with suspected cholera who can access health services are surviving. Furthermore, nearly 15 million people are unable to get basic healthcare.

“To save lives in Yemen today we must support the health system, especially the health workers. And we urge the Yemeni authorities – and all those in the region and elsewhere who can play a role – to find a political solution to this conflict that has already caused so much suffering. The people of Yemen cannot bear it much longer – they need peace to rebuild their lives and their country,” said Dr. Tedros.


Somalia has 3 new cholera deaths & more than 1,000 new cases

WHO

Cholera in Somalia, 27 July 2017

27 July 2017 – The Ministry of Health of Somalia has reported 1068 AWD/cholera cases and 3 deaths for week 28 (10 – 16 July 2017) with a case-fatality rate of 0.3%. Of these, the highest number of cases (286/27%) was reported in Middle Shebelle region, followed by Mudug, Sool and Banadir.

The cumulative number of cases stands at 58 524, including 812 deaths, in 15 regions across the country. The overall case-fatality rate of 1.4% remains above the emergency threshold of 1%. However, the cholera outbreak which started in January 2017 is slowing down, thanks to timely interventions by WHO, national health authorities and health partners.

WHO and health partners have been working in partnership with the Ministry of Health and local authorities to bring much needed relief to the populations.

Cholera response and prevention efforts are being continued throughout the country. With improvements to the surveillance systems in the country, a total of 265 sentinel health facilities are now able to report on health alerts, in addition to existing reporting mechanisms.

Chlorination of water sources was conducted in selected villages and IDP camps in Lower Jubba among returnees. Community sensitisation was conducted in IDP camps in Kismayo. Nearly 60 tonnes of essential medical supplies have been distributed to all regions since the start of the outbreak.

Somalia has been experiencing a severe drought due to lack of rains for consecutive seasons and poor rainfall. With livestock and crops destroyed and hundreds of thousands of Somalis displaced, around 6.7 out of 12.3 million people are in urgent need of humanitarian assistance. Nearly 5.5 million people are at risk of contracting water-borne diseases like cholera.

Related Links

Weekly cholera updates

Somalia situation updates


Cholera: Life and Death in yemen

WHO

The life and death struggle against cholera in Yemen

July 2017

Cholera continues to spread in Yemen, causing more than 390 000 suspected cases of the disease and more than 1800 deaths since 27 April.

WHO and its partners are responding to the cholera outbreak in Yemen, working closely with UNICEF, local health authorities and others to treat the sick and stop the spread of the disease.

Each of these cholera cases is a person with a family, a story, hopes and dreams. In the centres, where patients are treated, local health workers work long hours, often without pay, to fight off death and help their patients make a full recovery.

WHO/S. Hasan

Fatima Shooie sits between her 85-year-old mother and 22-year-old daughter who are both receiving treatment for cholera at the crowded 22 May Hospital in Sana’a.

“We have no money even for transportation to the hospital. My husband works as a street cleaner but he hasn’t received a salary for 8 months and he is our only breadwinner,” Fatima said. “I’m afraid that the disease will transmit to other family members.


WHO/S.Hasan

Dr Adel Al-Almani is the head of the diarrhoea treatment centre in Al-Sabeen Hospital in Sana’a. He and his team often work 18 hours a day to deal with the influx of patients.

More than 30 000 Yemeni health workers have not been paid in more than 10 months. Yet many, like Dr Al-Almani, continue to treat patients and save lives.


WHO/S. Hasan

Eight-year-old Mohannad has overcome cholera following 3 days of treatment in the diarrhoea treatment centre at Al-Sabeen Hospital in Sana’a. Mohannad lost his mother and sister when a bomb went off near their home in Hajjah. He and his father have since fled to Sana’a.

“Mohannad is all I have in this life after my wife and daughter died. When he was infected with cholera I was very anxious that he would have the same fate of his mother and sister,” said Mohannad’s father


WHO/S. Hasan

A health worker tends to Khadeeja Abdul-Kareem, 20. Khadeeja was forced to flee the conflict in Al-Waziya District, Taiz. Displaced from her home, she struggles to make ends meet – a situation compounded by her illness.


WHO/S. Hasan

It was a long and painful journey in search of treatment for Abdu Al-Nehmi, 53. The road from his village in Bani Matar District to Sana’a City was bumpy and the car broke down along the way. The whole time he was suffering from kidney pain in addition to severe diarrhoea and vomiting.

“There is no health centre in our area. We have to spend 2-3 hours to arrive at a proper health facility in Sana’a,” he said.

To date, WHO, UNICEF, and partners have supported the establishment of 3000 beds in 187 diarrhoea treatment centres and 834 fully operational oral rehydration therapy corners.


WHO/S. Hasan

Nabila, Fatima, Amal, Hayat and Hend are working as nurses in Azal Health Centre in Sana’a and have dedicated themselves to treating patients arriving with severe dehydration.

“Every day, we receive severe cases that come with complicated conditions, but we manage to save the lives of most of them. Sometimes, a new severe case arrives while we’re so busy treating another case,” said Nabila Al-Olofi, one of nurses working in the centre.

“Yes, we have no regular salaries as nurses, but saving lives is our biggest gain.”

WHO, together with UNICEF, is also delivering medical supplies and paying incentives, travel costs and overtime payments for health workers to enable them to continue to treat patients.


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