Cholera in South Sudan Situation Report # 63 As at 23:59 Hours, 18 July 2014 Situation Update

Republic of South Sudan Cholera in South Sudan Situation Report # 63 as at 23:59 Hours, 18 July 2014 Situation Update

A total of 4,479 cholera cases including 102 deaths (CFR 2.3%) had been reported in South Sudan as of 18 July 2014, as summarized in Tables 1 and 2.

Table 1. Summary of cholera cases reported in Juba County, 23 April - 18 July 2014 New New Total cases Total Total New deaths Total Total cases Reporting Sites admisions discharges currently facility community Total cases today deaths discharged today today admitted deaths deaths

JTH CTC 5 1 0 9 16 0 16 1372 1395

Gurei CTC 1 3 0 2 2 0 2 357 361

Tongping CTC 0 0 0 3 2 1 3 56 60

Jube 3/UN House CTC 0 0 0 4 0 0 0 46 50

Nyakuron West CTC Closed 15 July 0 0 0 18 18

Gumbo CTC Closed 5 July 0 0 0 48 48

Nyakuron ORP Closed 5 July 0 0 0 20 20

Munuki ORP Closed 5 July 0 0 0 8 8

Gumbo ORP Closed 15 July 0 3 3 67 70

Other sites 0 0 0 0 1 14 15 1 16

Total 6 4 0 18 21 18 39 1993 2046 N.B. To prevent double counting of patients, transferred cases from ORPs to CTCs are not counted in the ORPs.

Table 2. Summary of cholera cases reported outside Juba County, 23 April – 18 July 2014 New New New Total cases Total Total Total Total cases Total States Reporting Sites admisions discharges deaths currently facility community deaths discharged cases today today today admitted deaths deaths

Kajo-Keji civil hospital 0 0 0 3 1 2 3 48 54 CES Yei Hospital 0 0 0 0 0 2 2 45 47

WES Lanyi- Mundri East 0 0 0 0 0 0 0 3 3

Jonglei Kolmanyang, Bor 0 0 0 0 0 0 0 1 1

Nimule Hospital 1 0 0 1 0 0 0 22 23

OTC PHCC, Magwi 4 0 0 5 8 0 8 121 134

Magwi PHCC* 0 0 0 0 0 0 0 1 1

Pajok PHCC, Magwi 0 0 0 1 0 0 0 0 1

Torit Hospital 0 0 0 60 7 9 16 832 908

Idali PHCU, Lafon 0 0 0 4 4 0 4 84 92 Bur Mutram PHCU, 0 0 0 7 0 1 1 60 68 Bur Payam, Torit Ohiri PHCC, Bur 0 0 0 2 3 0 3 33 38 Payam, Torit Ohila PHCC, Bur 0 0 0 10 0 0 0 0 10 Payam, Torit Imurok PHCU, Imurok EES 0 0 0 1 2 0 2 2 5 Payam, Torit Hiyala PHCC, Torit 0 0 0 23 0 0 0 88 111 Olere PHCU, Imurok 0 0 0 0 0 0 0 4 4 Payam, Torit Osito PHCU, Bur 0 0 0 17 0 0 0 26 43 payam, Torit Ileu PHCU, Hiyala 0 0 0 32 6 0 6 19 57 payam, Torit Hileu PHCC, Himodonge Payam, 0 0 0 0 0 0 0 4 4 Torit Ofiri PHCU, Kudo 0 0 0 0 0 0 0 5 5 Payam, Torit Kudo PHCC, Kudo 0 0 0 8 0 0 0 6 14 Payam, Torit Other sites 0 0 0 0 0 1 1 15 16

Upper Kaka 0 0 0 0 0 0 0 0 1

1 New New New Total cases Total Total Total Total cases Total States Reporting Sites admisions discharges deaths currently facility community deaths discharged cases today today today admitted deaths deaths

Nile Wau Shilluk, Malakal 0 0 0 151 16 1 17 625 793

Total 5 0 0 325 47 16 63 2044 2433 *No reports were received from EES on 18th except for Owiny kibul (Magwi county)

Figure 1: Central Equatoria State Epidemic curve as at 18 July 2014 Alive 140 Died

120

100

60 Number of cases of Number

2/7/2014 4/7/2014 6/7/2014 8/7/2014

10/7/2014 12/7/2014 14/7/2014 16/7/2014 18/7/2014

21/04/2014 23/04/2014 25/04/2014 27/04/2014 29/04/2014 01/05/2014 03/05/2014 05/05/2014 07/05/2014 09/05/2014 11/05/2014 13/05/2014 15/05/2014 17/05/2014 19/05/2014 21/05/2014 23/05/2014 25/05/2014 27/05/2014 29/05/2014 31/05/2014 02/06/2014 04/06/2014 06/06/2014 08/06/2014 10/06/2014 12/06/2014 14/06/2014 16/06/2014 18/06/2014 20/06/2014 22/06/2014 24/06/2014 26/06/2014 28/06/2014 30/06/2014 17 18 19 20 21 22 23 24 25 26 27 28 29 Date of onset

Figure 2: Eastern Equatoria State Epidemic curve as at 18 July 2014 Alive 90 Dead 80

40 82 72 71 70 71 74 67 63 66 30 57 60 58 56 59 53 51 46 44 46 20 39 39 37 Number Number of cases 34 26 10 18 19 10 13 5 7

0 1 1 4 3 2 4 3 0 0

1/7/2014 2/7/2014 3/7/2014 4/7/2014 5/7/2014 6/7/2014 7/7/2014 8/7/2014 9/7/2014

10/7/2014 11/7/2014 12/7/2014 13/7/2014 14/7/2014 15/7/2014 16/7/2014 17/7/2014 18/7/2014

13/06/2014 28/06/2014 09/06/2014 10/06/2014 11/06/2014 12/06/2014 14/06/2014 15/06/2014 16/06/2014 17/06/2014 18/06/2014 19/06/2014 20/06/2014 21/06/2014 22/06/2014 23/06/2014 24/06/2014 25/06/2014 26/06/2014 27/06/2014 29/06/2014 30/06/2014 24 25 26 27 28 29 Date of onset

Figure 3: Upper Nile State Epidemic curve as at 15 July 2014 140 Dead Alive 120

100

Cholera cases Cholera 40

Date of visit

Table 3: Areas that continue to report suspected cholera alerts as at 17 July 2014 Date of Details of the alert Area Action notification

05/07/2014 The number of suspected cholera Malakal PoC Cholera cases are being managed in the MSF cases in Malakal PoC has risen to 53 CTC in the PoC. Health Cluster meetings are with two deaths. No new cases have ongoing to coordinate the response. Active been admitted in the CTC for the last surveillance and contact tracing remain a two days. priority in PoC 2&4. Laboratory test results for the four samples sent to the National Reference Laboratory are pending. Two epidemiologists from the WHO are on the ground to support response efforts. 05/07/2014 The number of AWD (suspected Bol, Lul Payam, The set up of MSF and ICRC CTC in Bol has cholera cases) in Bol PHCU/CTC has Fashoda been completed and another in Kodok. Health risen to 20 cases with 6 deaths. county, Upper partners including MSF, CORDAID, & ICRC Nile State together with Fashoda county health department team are coordinating preparedness & response efforts through regular health cluster meetings. WHO supported the response with one DDK kit, cholera RDTs, and Cary Blair media. 01/07/2014 A total of 50 suspected cases Kapoeta North, Case management is ongoing in Irwoto including two deaths have been Eastern PHCC/CTC where three patients are currently reported from at least five payams in Equatoria State admitted. Laboratory test results for the three Kapoeta North County. There are samples submitted to the National Public three patients admitted in Irwoto Health Reference Laboratory are still pending. PHCC CTC

Many thanks to the staff at CTCs, MoH at national level and state levels, especially the Department of IDSR, who have helped to gather the information presented here. Situation Reports are posted on the WHO website: http://www.who.int/hac/crises/ssd/en/ as well as on the Humanitarian Info webpage: http://southsudan.humanitarianresponse.info/clusters/health.

The MoH/WHO surveillance team welcomes feedback and data provided by individual agencies. Given the fast evolving nature of this epidemic, errors and omissions are inevitable: we will be grateful for any information that helps to rectify these. Send any comments and feedback to: E-mail: [email protected], The Toll free numbers for the ambulance are: Gemtel: 9999, Vivacell: 0952000098 and the toll free for alerts is Zain: 0912000098.

Contacts: For more information please contact,

Dr. Pinyi Nyimol Mawien Dr Othwonh Thabo Director General - Preventive Health Services Ag. Director - IDSR MoH, Republic of South Sudan MoH, Republic of South Sudan Tel: +211955604020 Tel: +211 0954082015