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Cholera in South Sudan Situation Report # 93 As at 23:59 Hours, 15-21 September 2014

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Cholera in South Sudan Situation Report # 93 As at 23:59 Hours, 15-21 September 2014 Republic of South Sudan Cholera in South Sudan Situation Report # 93 as at 23:59 Hours, 15-21 September 2014 Situation Update As of 21 September 2014, a total of 6,128 cholera cases including 139 deaths (CFR 2.27%) had beenTable reported1. Summary in of South cholera Sudan cases asreported summarized in Juba in County Tables, 23 1 April and –2.21 September 2014 New New New deaths Total cases Total Total admisions discharges Total Total cases Reporting Sites 15-21 Sept currently facility community Total cases 15-21 Sept 15-21 Sept deaths discharged 2014 admitted deaths deaths 2014 2014 JTH CTC 3 3 0 0 16 0 16 1455 1479 Gurei CTC (changed to ORP) Closed 28 July 2 0 2 365 367 Tongping CTC 0 2 1 3 69 72 Closed August Jube 3/UN House CTC Closed August 0 0 0 0 97 97 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 Pager PHCU 1 1 0 0 1 5 6 42 48 Other sites 0 0 0 1 15 16 1 17 Total 4 4 0 0 22 24 46 2190 2244 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 –21 September 2014 New New New Total cases Total Total admisions discharges deaths Total Total cases Total States Reporting Sites currently facility community 15-21 Sept 15-21 Sept 15-21 deaths discharged cases admitted deaths deaths 2014 2014 Sept 2014 Kajo-Keji civil hospital 0 0 0 0 3 4 7 86 93 CES Yei Hospital -- 0 0 0 0 2 2 45 47 WES Lanyi- Mundri East -- 0 0 0 0 0 0 3 3 Jonglei Kolmanyang, Bor -- 0 0 0 0 0 0 1 1 Nimule Hospital 2 2 0 0 0 0 0 106 106 OTC PHCC, Magwi -- 0 0 0 10 0 10 141 151 Magwi PHCC 0 0 0 5 1 0 1 12 18 Pajok PHCC, Magwi -- 0 0 0 0 0 0 1 1 Nyolo CTC, Magwi 0 0 0 0 0 0 0 25 25 Idali PHCU, Lafon -- 0 0 0 5 1 6 90 96 Lwala PHCU, Pachidi -- 0 0 0 0 1 1 1 2 payam, Lafon Longiro PHCU,Lafon -- 0 0 0 1 0 1 15 16 Lalanga PHCU, Lafon 0 0 0 0 0 2 2 63 65 EES Torit Hospital 4 4 0 0 8 9 17 1407 1424 Bur Mutram PHCU, -- 0 0 0 0 1 1 59 60 Bur Payam, Torit Ohiri PHCC, Bur -- 0 0 0 3 0 3 53 56 Payam, Torit Ohila PHCC, Bur -- 0 0 0 0 0 0 24 24 Payam, Torit Imurok PHCU, Imurok -- 0 0 0 2 1 3 10 13 Payam, Torit Hiyala PHCC, Torit -- 0 0 0 0 0 0 86 86 Olere PHCU, Imurok -- 0 0 0 0 0 0 4 4 Payam, Torit Osito PHCU, Bur -- 0 0 0 0 0 0 42 42 payam, Torit 1 New New New Total cases Total Total admisions discharges deaths Total Total cases Total States Reporting Sites currently facility community 15-21 Sept 15-21 Sept 15-21 deaths discharged cases admitted deaths deaths 2014 2014 Sept 2014 Ileu PHCU, Hiyala -- 0 0 0 3 7 10 147 157 payam, Torit Hileu PHCC, Himodonge Payam, -- 0 0 0 0 0 0 6 6 Torit Ofiri PHCU, Kudo -- 0 0 0 0 0 0 5 5 Payam, Torit Kudo PHCC, Kudo -- 0 0 0 1 0 1 54 55 Payam, Torit Moti PHCU, Ifwotu, -- 0 0 2 0 1 1 4 7 Torit Riwoto PHCC, Kapoeta 3 3 0 0 1 0 1 74 75 North SSRCORPs, Nyong -- 0 0 0 0 0 0 70 70 Payam, Torit St. Theresa, Isohe, 0 7 1 2 2 2 4 93 102 Ikotos Ibahure PHCC, ibahure 0 0 2 1 0 1 23 25 Payam, Lopa/Lafon Other sites -- 0 0 0 0 0 0 23 24 Kaka -- 0 0 0 0 0 0 0 1 Wau Shilluk, Malakal -- 0 0 4 15 2 17 885 906 Upper Nile Malakal PoC -- 0 0 0 2 0 2 59 61 Other sites -- 0 0 0 2 0 2 55 57 Total 9 16 1 15 60 33 93 3772 3884 x: Facilities not reporting; -- no cases reported for at least two weeks Figure 1: South Sudan Cholera Epidemic Curve, week 17-38, 2014 1200 1000 800 No No Cases 600 400 200 0 Epidemiological week 2014 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 WES UNS EES CES Figure 2: Cholera Case Distribution by Age, Sex and State – week 38 6 5 1 4 1 3 2 No. No. cases 2 4 3 1 2 0 0 CES EES CES EES <5yrs ≥5YRS Female Male 2 Figure 3: New Cholera Cases in Juba County during week 38, 2014 3 2 No. No. cases 1 1 1 1 1 0 0 0 0 0 Lologo Kelang Gumbo Munuki Karpeto Gwadiang JebelDinka Jibi/Karpeto Kator Northern Lobonok Rejaf Munuki Bari Figure 4: New Cholera Cases in Magwi County during week 38, 2014 2 1 No. No. cases 1 1 0 0 Malakia East Motoyo East Malakia West Nimule Figure 5: New Cholera Cases in Kapoeta North County during week 38, 2014 3 2 No. No. cases 1 2 1 0 Natil Malibakanyit Najie (Natil) Karakamoge 3 Table 3. Cholera alerts reported between 15 – 21, August 2014 Date of Details of the alert Area Action notification 24/08/2014 Pager PHCU reported a cluster of nine Lobonok Verification conducted by the county (9) acute watery diarrhoea cases Payam, Juba, surveillance team including five (5) community deaths. CES - The WHO has supplied case management The cases have been reported from supplies and a tent to accommodate the two (2) villages (Karpeto & Pager) in - suspect cases Lobonok Payam, Juba County. By 21 WASH interventions at the community September 2014; the cases had risen level are still pending to 48 including six (6) deaths [five - A joint mission of MoH and partners community deaths & one death in the visited Lobonok during week 37 assess health facility]. - the outbreak and support the response Surveillance and laboratory A total of 13 new cholera cases were reported in Juba County in week 38 with the majority being reported in Juba 4 (31%), while the rest were reported from Torit (4 cases), Kapoeta North (3 cases), and Magwi (2 cases) as illustrated in Figures 3 to 5. There were no new cholera cases reported from the rest of the counties in week 38. As seen from Figure 1, the cholera trend is on the decline in all the five states where cholera has been confirmed. Overall, 187 (43.4%) of the samples tested have been positive for cholera by culture. Due to the declining cholera trend, it is recommended that all new suspect cholera cases have samples obtained for laboratory confirmation. Case management Management of new cholera cases is ongoing in Juba, Nimule, Torit, and Kapoeta North where new cases were reported during week 38. Adequate supplies have been availed to support case management activities in the cholera treatment centres where the cases are being treated. Social mobilization Social Mobilization efforts and responses are ongoing in Central Equatorial states, Eastern Equatorial State, Jonglei and Upper Nile where some AWD/Cholera cases are still being reported in some areas. In Central Equatoria State, Mumuki and Gudele in Juba town, Lobonok payam and Kajo-Keji continue to be affected by cholera. SMOH, CRS and ACF social mobilizers and hygiene promoters are distributing aquatabs and cholera information, education and communication (IEC) materials in the villages. In Eastern Equatoria State, Save the Children continues with social mobilization on the prevention of cholera and other diarrheal disease in Torit and Lopa-Lafon. Altogether 245 households comprising 1,681 people were reached with 245 bars of soap; 490 sachets of oral rehydration salts (ORS); and 2,450 tablets of pur. In Jonglei State social mobilization volunteers reached 1,284 people with non-food items (NFI) and cholera prevention messages. Three community meetings took place and were attended by 80 community leaders including religious, local chiefs, youth and women group leaders. - A video play was screened at Royal Junior School and reached 300 pupils and four teachers. IEC materials comprising 10 banners and 100 stickers were produced and four solar radios given to the teachers. - Radio Jonglei MF95 continues to play cholera awareness campaign messages in English, Arabic, Dinka and Nuer. - A radio talk with the Bor municipality health officer took place last Friday, during which teachers were educated on cholera control and prevention. The children also practiced and demonstrated hand washing with water and soap. - Radio Jonglei FM 95.9 continues with Radio spot messages on cholera prevention and control broadcast six times daily after every program. The messages reach listeners within Bor county. - To date 169, 502 households and 210 schools have been reached countrywide with cholera prevention and control messages. Community skills are being strengthened on safe drinking water and rehydration through ORS and sugar salt solution (SSS) with the help 1,119 social mobilizers.
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