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Public Health Service Centers for Disease Control and Prevention (CDC) Memorandum Date: November 6, 2017 From: WHO Collaborati

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Public Health Service Centers for Disease Control and Prevention (CDC) Memorandum Date: November 6, 2017 From: WHO Collaborati Public Health Service DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Disease Control And Prevention (CDC) Memorandum Date: November 6, 2017 From: WHO Collaborating Center for Dracunculiasis Eradication, CDC Subject: GUINEA WORM WRAP-UP #251 To: Addressees Every uncontained Guinea worm from any source can spread infection! GUINEA WORM OUTBREAK IN ETHIOPIA After eleven consecutive months with no reported cases of Guinea worm disease, the Ethiopian Dracunculiasis Eradication Program (EDEP) has detected a total of 14 apparent cases between September 25 and October 16, 2017. At least one of the case patients allegedly had a worm emerge as early as mid-August. All of the patients are males between 16 and 40 years old, 11 are ethnic Oromo, and 1 is Agnuak; only one was contained. Nine patients were detected in Oromia Region, where they reside, while 3 were detected in Gambella Region (Figure 1, Tables 1 and 2). This outbreak was only discovered when the index case appeared at the regional hospital in Gambella town for treatment on September 25. Subsequently it was learned that two patients with broken worms had been treated at health centers in Yeti kebele (sub-district) in Anfilloo woreda (district) of Oromia Region before September 25 and sent home. The two patients were not reported to health authorities, they were not queried as to the potential sources of their infection, and no containment measures were taken. Figure 1 REPORTED CASES OF DRACUNCULIASIS BY COUNTRY 2015 - 2017* 2015 2016 2017* Number of cases Number of cases Number of cases 0 5 10 15 20 0 5 10 15 20 0 5 10 15 20 Chad 9 Chad 16 Chad 14 Mali 5 Mali 0 Mali 0 8 (36%) of 22 14 (56%) of 25 10 (38%) of 26 cases contained. cases contained. cases contained. * Provisional: as of S. Sudan 5 S. Sudan 6 S. Sudan 0 31 October 2017 Ethiopia 3 Ethiopia 3 Ethiopia 12 Table 1 ETHIOPIA DRACUNCULIASIS ERADICATION PROGRAM LINE LISTING OF CASE OF GUINEA WORM DISEASE Patient Case Contained Presumed source of infection identified Presumed source of infection is known NVA? Kebele (subdistict), Village or Locality 1=imported 2= Home Village or Case # Woreda (District) and Date Detected of Detection indigenous Locality Region Date GW emerged Date worm fully (Yes, No or If no, date of Ethnicity Age Sex Yes/No Name Yes/No Actions/Comments (D/M/Y) extracted Pending) Abate Rx 1.1 25‐Sep‐17 Goyi farm tanker Patient drank tank water at Goyi Mohammed Adwong Kebele, Itang water/stagnant water farm, but did not know the source of Crasher (NVA) rock Special Woreda Oromo 32 M 25‐Sep‐17 No 28‐Oct‐17 2Gomi Yes Yes 1.2 15‐Oct‐17 source in canal near Goyi water. He also took a shower in the quarry Gambella farm canal near Goyi farm. 1.3 25‐Oct‐17 Itang Special Woreda, Patient drank tank water at Goyi 2 Gambella Town Oromo 19 M 26‐Sep‐17 28‐Sep‐17 No No 2 Gambella Town Yes Goyi farm tanker water Yes Gambella farm. Patient drank tank water at Goyi late Aug or early Sept Goyi farm tanker farm. The tractor driver of Goyi farm (need follow up Yeti Kebele, Anfilo water/stagnant water had taken him once to fetch water 3 Gomi Village Oromo 20 M investigation to be 30‐Sep‐17 No No 2 Gomi Yes Yes Woreda, Oromia source in canal near Goyi from Joro pond. He went to bathe in a conducted in Gomi to be farm stagnant source of water in the canal sure) near Goyi farm. 4.1 Yeti Kebele, Anfilo 15‐Sep‐17 30‐Sep‐17 No No Patient drank tank water at Goyi Gomi Village Oromo 23 M 2 Gomi Yes Goyi farm tanker water Yes Woreda, Oromia farm. 4.2 16‐Oct‐17 5.1 8‐Sep‐17 16‐Oct‐17 30‐Sep‐17 No No Patient drank tank water at Goyi Yeti Kebele, Anfilo Goyi farm tanker farm, but did not know the source of 5.2 Gomi Village Oromo 24 M 14‐Oct‐17 Yes Woreda, Oromia water/Joro pond water. He went to bathe in Joro pond once. 5.3 14‐Oct‐17 Yeti Kebele, Anfilo 6.1 Gomi Village Oromo 20 M 13‐Sep‐17 30‐Sep‐17 No No Woreda, Oromia Goyi farm tanker Patient drank tank water. He bathed 2 Gomi Yes Yes water/Joro pond in Joro pond once. 6.2 1‐Oct‐17 9‐Oct‐17 Patient drank tank water at Goyi Goyi farm tanker 7.1 12‐Oct‐17 30‐Sep‐17 Yes farm, but did not know the source of Yeti Kebele, Anfilo water/stagnant water Gomi Village Oromo 20 M 2 Gomi Yes Yes water. He went to bathe in a stagnant Woreda, Oromia source in canal near Goyi source of water in the canal near Goyi farm 7.2 19‐Oct‐17 farm. Patient drank tank water at Goyi Goyi farm tanker farm, but did not know the source of Yeti Kebele, Anfilo water/stagnant water 8 Gomi Village Oromo 28 M 8‐Oct‐17 30‐Sep‐17 No No 2 Gomi Yes Yes water. He showered in a stagnant Woreda, Oromia source in canal near Goyi source of water inside the canal near farm Goyi farm. Goyi farm tanker Patient drank tank water at Goyi 9.1 14‐Oct‐17 14‐Oct‐17 No No 2 Duri Yes Yeti Kebele, Anfilo water/stagnant water farm, but did not know the source of Duri Village Oromo 25 M Woreda, Oromia source in canal near Goyi water. He showered in a stagnant 9.2 16‐Oct‐17 farm source of water inside the canal near Yeti Kebele, Anfilo pending further Patient worked with all the current 10 Duri Village Oromo 40 M Sep‐17 16‐Oct‐17 No No 2 Duri No Woreda, Oromia investigation Goyi farm cases. Patient drank tank water at Goyi Yeti Kebele, Anfilo 11 Duri Village Oromo 25 M 8‐Oct‐17 16‐Oct‐17 No No 2 Duri Yes Goyi farm tanker water farm, but did not know the source of Woreda, Oromia water. Goyi farm tanker 12.1 Terkudi Kebele, Abobo 22‐Sep‐17 25‐Oct‐17 14‐Oct‐17 No 20‐Oct‐17 Patient drank tank water at Goyi farm water/Joro pond/stagnant Gutok Woreda, Gambella Agnua 16 M 2 Gutok Yes and saw the tractor fetch water from water source in canal near Region Joro pond. 12.2 28‐Oct‐17 Goyi farm Table 2 Number of Laboratory-Confirmed Cases of Guinea Worm Disease, and Number Reported Contained by Month during 2017* (Countries arranged in descending order of cases in 2016) COUNTRIES WITH NUMBER OF CASES CONTAINED / NUMBER OF CASES REPORTED ENDEMIC % CONT. TRANSMISSION JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL* CHAD 0 / 0 1/1 1/1 1/2 2/2 1/2 2/2 0/1 0/2 1/1 / / 9/ 14 64% SOUTH SUDAN 0 / 0 0 / 0 0 / 0 0 / 0 0 / 0 0 / 00/00/00/00/0 / /0/ 00% ETHIOPIA^ 0 / 0 0 / 0 0 / 0 0 / 0 0 / 0 0 / 00/00/00/7 1/5 / / 1/ 12 0% MALI § 0/0 0 / 0 0 / 0 0 / 0 0 / 0 0 / 00/00/00/00/0 //0/ 00% TOTAL* 0 / 0 1 / 1 1 / 1 1 / 2 2 / 2 1 / 22/20/10/92/6/ / 10/ 26 75% % CONTAINED 0% 100% 100% 50% 100% 50% 100% 0% 0% 33% 38% #DIV/0! *Provisional ^ Only one of the 12 cases confirmed to date. Laboratory confirmation of worms emerging from other patients pending. Cells shaded in black denote months when zero indigenous cases were reported. Numbers indicate how many cases were contained and reported that month. Cells shaded in yellow denote months when one or more cases of GWD did not meet all case containment standards. §Reports include Kayes, Koulikoro, Segou, Sikasso, and Mopti, Tinbuktu and Gao Regions; contingent on security conditions during 2017 the GWEP continued to deploy one technical advisor to Kidal Region to oversee the program. Number of Laboratory-Confirmed Cases of Guinea Worm Disease, and Number Reported Contained by Month during 2016* (Countries arranged in descending order of cases in 2015) COUNTRIES WITH NUMBER OF CASES CONTAINED / NUMBER OF CASES REPORTED ENDEMIC % CONT. TRANSMISSION JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL* CHAD 0 / 0 1 / 1 0 / 0 1 / 1 1 / 10/ 1 1 / 2 1 / 31/ 23/40/0 0/1 9 / 16 56% MALI § 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0/0 0 / 00% SOUTH SUDAN 0 / 0 0 / 0 0 / 00/00/03 / 4 0/0 0/0 0 / 1 0/0 0 / 1 0/0 3 / 6 50% ETHIOPIA 0 / 0 0 / 0 0 / 00/01 / 1 1 / 1 0/0 0/0 0 / 1 0/0 0/0 0/0 2 / 3 67% TOTAL* 0 / 0 1 / 1 0 / 0 1 / 1 2 / 2 4 / 6 1 / 2 1 / 31/ 43/40/10/114 / 25 56% % CONTAINED 0% 100% 0% 100% 100% 67% 50% 33% 25%75% 0% 0% 56% #DIV/0! *Provisional Cells shaded in black denote months when zero indigenous cases were reported. Numbers indicate how many imported cases were contained and reported that month. Cells shaded in yellow denote months when one or more cases of GWD did not meet all case containment standards. §Reports include Kayes, Koulikoro, Segou, Sikasso, and Mopti, Tinbuktu and Gao Regions; contingent on security conditions during 2016, the GWEP continued to deploy one technical advisor to Kidal Region to oversee the program.
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