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Cholera outbreak in the horn of Africa
World Report
Cholera outbreak in the horn of Africa Cholera is spreading at an alarming rate in the horn of Africa, worsening dire situations in countries facing humanitarian crises. Andrew Green reports.
www.thelancet.com Vol 389 June 3, 2017
government and rebel forces, that has ravaged much of the country’s infrastructure. Officials estimate that only about 45% of the country’s health facilities are currently functioning, and public sector employees, including doctors and nurses, have gone unpaid for more than half a year. About 60% of the population is facing food insecurity, including 6·8 million people who are one step short of famine on the Integrated Food Security Phase Classification.
“In Somalia...’the severity and extent of the current outbreak is unprecedented’. It has now reached 75% of the country...” “People are working 24/7 on all the different issues”, said Kjetil Østnor, Oxfam’s regional programme manager for the Middle East. “Everyone is extremely busy...delivering water, food. And then the cholera outbreak comes on top of that.” Emergency teams have been focusing on care as people have fallen ill with the disease, but also have improved access to clean water and education on how to limit transmission. The surge in cases over the past month—which more than doubled the number of confirmed or suspected cases since the start of the outbreak and has now reached 19 of the country’s 22 governorates—has forced aid workers to expand those efforts and sometimes pull resources from other responses. “Without additional support with regard to the system and to the impact of the conflict, it’s not going to be contained properly”, said Liny Suharlim, Agency for Technical Cooperation and Development’s country director in Yemen. The humanitarian relief agency is providing safe drinking water and running hygiene promotion efforts. “There are still massive gaps that need to be patched up.”
In Somalia, officials have linked the latest outbreak of cholera to a drought that began in October, 2016, creating widespread shortages of food and clean drinking water. Cholera is endemic in Somalia, but Abdinasir Abubakar, an epidemiologist with WHO, said “the severity and extent of the current outbreak is unprecedented”. It has now reached 75% of the country, he said. In Somalia, as in Yemen, aid workers are also dealing with competing priorities, including the drought and food shortages that currently affect 3·3 million people. The disease’s spread appears to have slowed in the past 4 weeks, Abubakar said, the result of a widespread cholera vaccination effort. More than 1 million people living in high-risk areas have so far received the two-dose oral vaccine. “However, it’s too early to celebrate any success, since we are entering another cholera season as the rainy season has begun and floods are expected to flow”, he said. The cholera epidemic in Somalia also appears to be linked to the AWD outbreak in Ethiopia that began at the start of the year, though the Ethiopian Government has not confirmed the cholera bacteria as the cause. More than 90% of the suspected AWD cases are in the Somali region of the country, which borders Somalia. WHO officials said the situation in that region has also improved after the response to the outbreak increased in recent weeks, with weekly reported cases down to less than 700 from a high of more than 4000. In all three settings, officials have warned that funding is well off target and without more financial commitments, the outbreaks could easily spiral out of control.
REUTERS/Khaled Abdullah
Outbreaks of infectious diarrhoeal diseases in Yemen, Somalia, and Ethiopia are devastating communities already suffering from conflict, drought, and potential famine, global health officials have warned. Yemen has been contending with an outbreak of cholera since October of last year. However, the country has seen a spike in cases over the past month, with more than 35 000 suspected or confirmed patients since late April and more than 360 deaths, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). Across the Gulf of Aden, drought-hit Somalia has seen more than 40 000 suspected or confirmed cases of cholera since the beginning of the year, according to WHO, and 693 deaths. In neighbouring Ethiopia, there have been more than 33 000 cases of acute watery diarrhoea (AWD) and 776 deaths in the same period. Epidemiologists are investigating the cause of the new wave of cases in Yemen. “This is the second wave of cholera we have seen here recently, and it is spreading at an alarming rate”, Nevio Zagaria, head of mission in Yemen for WHO, told The Guardian. “We have started an investigation to determine whether a new and more virulent strain of the cholera, perhaps originating in Somalia or Ethiopia, has been generating a higher mortality rate during this second wave of infection.” Officials also suspect a link to the start of the rainy season in late April, which may have spread contaminated water. Public health experts are mounting different responses in each situation, reflecting the challenges in the countries that range from instability to drought. In Yemen, the cholera response is happening against a backdrop of more than 2 years of fighting between the
Andrew Green 2179
Cholera outbreak in the horn of Africa Cholera is spreading at an alarming rate in the horn of Africa, worsening dire situations in countries facing humanitarian crises. Andrew Green reports.
www.thelancet.com Vol 389 June 3, 2017
government and rebel forces, that has ravaged much of the country’s infrastructure. Officials estimate that only about 45% of the country’s health facilities are currently functioning, and public sector employees, including doctors and nurses, have gone unpaid for more than half a year. About 60% of the population is facing food insecurity, including 6·8 million people who are one step short of famine on the Integrated Food Security Phase Classification.
“In Somalia...’the severity and extent of the current outbreak is unprecedented’. It has now reached 75% of the country...” “People are working 24/7 on all the different issues”, said Kjetil Østnor, Oxfam’s regional programme manager for the Middle East. “Everyone is extremely busy...delivering water, food. And then the cholera outbreak comes on top of that.” Emergency teams have been focusing on care as people have fallen ill with the disease, but also have improved access to clean water and education on how to limit transmission. The surge in cases over the past month—which more than doubled the number of confirmed or suspected cases since the start of the outbreak and has now reached 19 of the country’s 22 governorates—has forced aid workers to expand those efforts and sometimes pull resources from other responses. “Without additional support with regard to the system and to the impact of the conflict, it’s not going to be contained properly”, said Liny Suharlim, Agency for Technical Cooperation and Development’s country director in Yemen. The humanitarian relief agency is providing safe drinking water and running hygiene promotion efforts. “There are still massive gaps that need to be patched up.”
In Somalia, officials have linked the latest outbreak of cholera to a drought that began in October, 2016, creating widespread shortages of food and clean drinking water. Cholera is endemic in Somalia, but Abdinasir Abubakar, an epidemiologist with WHO, said “the severity and extent of the current outbreak is unprecedented”. It has now reached 75% of the country, he said. In Somalia, as in Yemen, aid workers are also dealing with competing priorities, including the drought and food shortages that currently affect 3·3 million people. The disease’s spread appears to have slowed in the past 4 weeks, Abubakar said, the result of a widespread cholera vaccination effort. More than 1 million people living in high-risk areas have so far received the two-dose oral vaccine. “However, it’s too early to celebrate any success, since we are entering another cholera season as the rainy season has begun and floods are expected to flow”, he said. The cholera epidemic in Somalia also appears to be linked to the AWD outbreak in Ethiopia that began at the start of the year, though the Ethiopian Government has not confirmed the cholera bacteria as the cause. More than 90% of the suspected AWD cases are in the Somali region of the country, which borders Somalia. WHO officials said the situation in that region has also improved after the response to the outbreak increased in recent weeks, with weekly reported cases down to less than 700 from a high of more than 4000. In all three settings, officials have warned that funding is well off target and without more financial commitments, the outbreaks could easily spiral out of control.
REUTERS/Khaled Abdullah
Outbreaks of infectious diarrhoeal diseases in Yemen, Somalia, and Ethiopia are devastating communities already suffering from conflict, drought, and potential famine, global health officials have warned. Yemen has been contending with an outbreak of cholera since October of last year. However, the country has seen a spike in cases over the past month, with more than 35 000 suspected or confirmed patients since late April and more than 360 deaths, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). Across the Gulf of Aden, drought-hit Somalia has seen more than 40 000 suspected or confirmed cases of cholera since the beginning of the year, according to WHO, and 693 deaths. In neighbouring Ethiopia, there have been more than 33 000 cases of acute watery diarrhoea (AWD) and 776 deaths in the same period. Epidemiologists are investigating the cause of the new wave of cases in Yemen. “This is the second wave of cholera we have seen here recently, and it is spreading at an alarming rate”, Nevio Zagaria, head of mission in Yemen for WHO, told The Guardian. “We have started an investigation to determine whether a new and more virulent strain of the cholera, perhaps originating in Somalia or Ethiopia, has been generating a higher mortality rate during this second wave of infection.” Officials also suspect a link to the start of the rainy season in late April, which may have spread contaminated water. Public health experts are mounting different responses in each situation, reflecting the challenges in the countries that range from instability to drought. In Yemen, the cholera response is happening against a backdrop of more than 2 years of fighting between the
Andrew Green 2179