Cholera Daily SitRep as of 4th November 2017 Ministry of Health

Highlights  6 additional suspected cholera cases were reported  No death reported.  No case reported from for OVER 3 weeks.  No Alert. Epidemiological summary  Total number of suspected cases of cholera reported stands at 5305, with 61 deaths (CFR = 1.2%). 2660 cases in the Muna corridor (Jere LGA), 736 cases in Dikwa, 1756 cases in , cases in MMC and stands at 58 and 20 respectively. 1 new cases reported from Guzamala (Guworam) today, and the cumulative for Guzamala stand at 75 cases.  Out of the 274 samples tested using RDTs, 220 (80%) were positive while 120 (64%) of 187 samples were culture positive. Table 1: Number of suspected cholera cases reported as of 4th November 2017 Jere MMC Mafa Dikwa Monguno Guzamala* Total Cases New cholera suspected cases 4 0 0 0 1 1 6 Cumulative cholera suspected cases 2660 58 20 736 1756 75 5305 Deaths New deaths 0 0 0 0 0 0 0 Cumulative deaths 43 2 0 13 3 0 61 Laboratory Number of specimen tested (RDT) 171 10 5 29 49 10 274 Specimen Positive RDT 145 8 4 19 38 6 220 Number of specimen tested (culture) 96 10 6 29 36 10 187 Specimen Positive Culture 64 7 2 18 25 4 120 * Gwaram in Guzamala LGA, a community very close to Munguno and patients referred and admitted in Munguno CTC.

Fig1. Map of Borno state showing affected LGAs.

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Six (6) suspected cholera cases reported on 4th November 2017 in Borno, showing a consistent trend (Fig 2). 4 suspected cases from Jere (fig 3), 1 case reported from Monguno, 1 case from Gworam in Guzamala LGA referred and treated in Munguno CTC (Fig. 5). Dikwa has remained silent for over 3 weeks now (Fig. 4).

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Fig 2a: Daily Epi-curve of cholera cases and line-curve showing number of deaths in Borno state

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Fig.2b: Weekly Epi-curve of cholera cases in Borno state by weeks

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0 0 16 - 20 21 - 27 28 Aug 4 - 10 11 - 17 18 - 2425 Sep- 2 Oct - 9 Oct - 16 Oct 23 Oct 30 Oct Aug Aug - 3 Sep Sep Sep Sep 1 Oct 8 Oct 15 Oct - 22 - 29 - 5 Nov Oct Oct

Fig.3a: Daily Epi-curve of suspected cholera cases in Jere and MMC Fig.3b: Weekly Epi-curve of suspected cholera cases in Jere and MMC

120 500 450 100 400 80 350 300 60 250 200 40 150 20 100 50 0 0 28 Aug - 4 - 10 11 - 17 18 - 24 25 Sep- 2 Oct - 8 9 Oct - 16 Oct - 23 Oct - 30 Oct - 3 Sep Sep Sep Sep 1 Oct Oct 15 Oct 22 Oct 29 Oct 5 Nov Fig 4a: Daily Epi-curve of suspected cholera cases in Dikwa LGA Fig 4b: Weekly Epi-curve of suspected cholera cases in Dikwa LGA 160 800 140 700 120 600 100 500 80 400 60 300 40 200 20 100 0 0

28 Aug - 4 - 10 11 - 17 18 - 24 25 Sep- 2 Oct - 8 9 Oct - 16 Oct - 23 Oct - 30 Oct -

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9/11/2017 9/13/2017 9/15/2017 9/17/2017 9/19/2017 9/21/2017 9/23/2017 9/25/2017 9/27/2017 9/29/2017 10/1/2017 10/3/2017 10/5/2017 10/7/2017 10/9/2017 11/2/2017 11/4/2017

10/13/2017 10/15/2017 10/17/2017 10/19/2017 10/21/2017 10/23/2017 10/25/2017 10/27/2017 10/29/2017 10/31/2017 10/11/2017 3 Sep Sep Sep Sep 1 Oct Oct 15 Oct 22 Oct 29 Oct 5 Nov Fig.5a: Daily Epi-curve of suspected cholera cases in Monguno Fig.5b: Weekly Epi-curve of suspected cholera cases in Monguno *NB: The last bar on the weekly epidemiological curves above are not complete data for week 44* Response 1. Surveillance

 Active case search continues in hot spots and high-risk areas  NO ALERT  DIKWA LGA still Silent, No case reported  No new case found during Community case search in Jere LGA  Gwaram, Guzamala LGA:

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- Active case search and health promotion by the LGA RRT and WHO Hard-To-Reach team still ongoing.  Priority locations identified and communicated to WASH and risk communication teams for priority intervention in Jere LGA: Response activities to continue in Kaleri, Fariya, Shuwari and old .

Laboratory Results – No sample collected & no test conducted today 2. Case management Table 2: In-patient admissions to CTCs Jere MMC Dikwa Monguno Mafa Total Admissions New admissions 4 0 0 2 0 6 Number on Admission 1 0 0 3 0 4 New Discharges 8 0 0 2 0 10

 3 CTCs and 4 ORPs are fully functional across the state.  Alima Madinatu ORP to be closed on 6th November, 2017  MSF Muna CTC relocating and to operate in Bolori II from 6th November 2017 due to insecurity, ambulance to standby for patients in Muna area

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4. Vaccination  Request for OCV for the second round of the campaign in Jere, MMC Dikwa, Mongono, Konoduga, and Mafa, vaccine to arrive by 29/11/2017.  OCV campaign date to be determined, tentative for December 2017

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