Outbreak update – Cholera in Somalia, 18 October 2018

18 October 2018 – The Ministry of Health of Somalia has announced 23 new cases of cholera including one death for week 40 (1 to 7 October) of 2018. Since week 28, there has been a significant downward trend in the number of new cholera cases reported weekly. The cumulative total is 6464 cases and 43 associated deaths (case-fatality rate 0.7%) since the beginning of the current outbreak in December 2017. Of 278 stool samples collected since the beginning of this year and tested in the National Public Heatlh Laboratory in Mogadishu, 85 tested positive for Vibrio cholerae, serotype O1 Ogawa.

The cholera outbreak started in December 2017 in Beletweyne along the river Shabelle and has spread to Jowhar, Kismayo, Afgoye Merka and Banadir. For the past two weeks, cholera cases have been localized only in Banadir region. In week 40, active transmission of AWD/cholera was reported in nine district in Banadir region (Daynile, HamarJabja, Darkenly, Hawlwadag, Hodan, Madina, Waberi, Heliwaa and Wardigley districts). Banadir region has the highest concentration of IDPs who reside in camps or poor living conditions with limited safe water and sanitation. 30% of the reported cases in week 40 are under five years of age, and 78% of cases were women.

The oral cholera vaccination campaigns implemented in 11 high risk districts of the central region in 2017 has greatly contributed to the reduction in the number of new AWD/cholera cases compared to the same time in 2017. All cases reported during week 40 had not received a vaccination before.

WHO continues to provide leadership and support for activities with the Ministry of Health (MoH) to respond to this cholera outbreak, including case management, surveillance and laboratory investigations and water sanitation, hygine (WASH) and risk communication.

This week, on-the-job training for health care workers was conducted in cholera treatment centers in Kismayo, Farjano, Banadir and Marka. WHO supports the disease surveillance system which has collected data from 415 health facilities across the country through the Early Warning Alert and Response Network (EWARN). This surveillance system contributes to early detection of epidemic-prone diseases including cholera and prompt response to outbreaks by using an electronic platform.  A total of 1500 hygiene kits have been distributed in villages in Kismayo and hygiene promotion for cholera prevention and community awareness campaigns were conducted in Farjano, Allanley, Gulwade and Shaqalaha in Kismayo district.