Cholera and AWD outbreak bulletin in Eastern and Southern Africa, as of 17th September 2018,12th Issue

Regional Update for 2018 - as of 17 September 2018

Highlights

More than 28,553 cholera / AWD cases and 388 deaths (Case Fatality Rate, 1.4%) have been

reported in 10 out of 21 countries of Eastern and Southern Africa Region (ESAR) since the

beginning of 2018. These countries include; Angola, Kenya, Malawi, Mozambique, Rwanda,

Somalia, Tanzania, Uganda, Zambia and Zimbabwe. Somalia accounts for 21 % of the total

case load reported this year.

Currently, 3 out of the 21 countries in ESAR are reporting active transmission of cholera / AWD

(Zimbabwe, Tanzania and Somalia). During the week under review, Zimbabwe reported the

highest number of new cases (1,719 cases including 11 deaths). Of the three countries with

active transmission, Tanzania and Zimbabwe have recorded CFR above 1% in 2018 (1.8%

and 1.1% respectively).

Zimbabwe: The latest cholera outbreak declared on 5th September 2018 hit Harare city after

burst sewers in the Budiriro and Glenview suburbs contaminated water in boreholes and open

wells, which are used by residents. The outbreak has spread outside Harare, affecting 5 other

provinces. As of 14 September 2018, a cumulative total of 3,350 suspected cases and 32 deaths

(CFR, 1%) have been reported since the onset of the new outbreak. These cases have emerged from

the following 6 provinces: Harare (Harare: 3,299 including 31 deaths, Chitungwiza: 11), Midlands

(Gokwe north: 6), Masvingo (Masvingo: 1 case including 1 death), Manicaland (Buhera: 4, Makoni: 1,

and Mutare city: 13), Mashonaland East (Marondera: 6, Murehwa: 2, Wedza: 1, and Seke: 2), and

Mashonaland Central (Shamva: 3). Of the total suspected cases, 71 were confirmed positive for V.

cholera, Ogawa. During the week under review, week 37 (week ending 16 September 2018), 1,719

cases including 11 deaths were reported

The main risk factors include; contaminated water sources including boreholes and wells, as a result

of blocked and damaged sewer pipes. There is a high possibility of cross border spread with Zambia,

given the road traffic between Harare and Lusaka, as well as with Mozambique, which borders

Manicaland.

Tanzania: A slight increase in the epidemic trend has been noted. During week 36 (week ending 9

September 2018), 69 new cases including 1 death (CFR, 1.4%) were reported compared to 54 cases

reported in week 35 (week ending 2 September 2018). These new cases emerged from Ngorongoro

district. Cumulatively a total of 32,365 cases including 535 deaths have been reported since the

beginning of the outbreak in August 2015. Of these, a total of 3,734 cases and 69 deaths have been

reported in 2018. Cholera cases in 2018 nearly doubled during the period of January – July when

compared to the same period in 2017.

Somalia: A decline in the epidemic trend has been noted. During week 35, 49 new cases were reported

compared to 76 cases including 1 death reported in week 34 (week ending 26 August 2018). These

new cases are concentrated in the following regions; Banadir (40) and Lower Jubba (9). Cumulatively a

total of 6,385 cases including 42 deaths have been reported since the beginning of the outbreak in

December 2017. Of these, a total of 5,980 cases and 41 deaths have been reported in 2018.