Outbreak update – Cholera in Somalia, 24 May 2018

24 May 2018 – The Ministry of Health of Somalia has announced 312 new cases of cholera, including four associated deaths for week 19 (7 to 13 May) of 2018. Among them, 169 cases were reported from the flood-affected areas in the Lower Shabelle and Lower Jubba regions. The number of newly reported cases has increased for three consecutive weeks. The cumulative total of cases is 3 280, including 21 associated deaths (case-fatality rate 0.6%) since the beginning of the current outbreak in December 2017. 

Since the beginning of the outbreak, 19 districts in five regions have been affected: 14 districts in Banadir; one (Jowhar) in Middle Shabelle; three in Hiran; one (Afgoye) in Lower Shabelle; and one (Kismayo) in Lower Jubba. In week 19, active transmissions were reported in three regions – Banadir, Lower Jubba, and Lower Shabelle – while Middle Shabelle and Hiraan reported zero cases for two consecutive weeks. 

Following heavy rains in Ethiopia and Somalia, flash floods have been reported in four states; Middle Shabelle, Hiran, Lower Shabelle, and Lower Jubba. This has affected 718 000 people and forced 220 000 to be displaced. The cholera outbreak is expected to expand due to the floods that have led to contamination of water sources in flood-affected regions. Floods have also led to blockage of access to health services, which has delayed health-seeking by the affected population over the past three weeks. 

WHO leads efforts to support the Ministry, along with Health and WASH partners and local authorities, in response to this outbreak through technical and logistic support. This includes strengthening disease surveillance; supporting the operation of cholera treatment units/centers; conducting on-the-job training of the health workforce in case management; engagement of community health workers; provision of medical supplies; health and hygiene education in affected communities; and distribution of hygiene kits. 

WHO also continues to support the enhancement of laboratory capacity at the National Public Health Laboratory. Stool samples are being collected from six cholera treatment units/centres currently operational in four regions (Banadir, Hiran, Lower Jubba and Middle Shabelle). Of the 172 stool samples so far collected since the beginning of the year, 56 tested positive for Vibrio cholera.