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Toll free numbers for cholera alert are ( Econet only) 08089001 or 08089002 or 08089000 Office of the WHO Representative in Mobile number for cholera alerts and SMS is 0912 104 257 Water and Sanitation alert numbers Ministry of Health and Child Welfare 04 703 941-2 (during working hours) 2 917 710 (after hours) Date of issue:26th March, 2009

DAILY CHOLERA UPDATE AND ALERTS 26th March , 2009

* Please note that daily information collection is a challenge due to communication and staff constraints. On-going data cleaning may result in an increase or decrease in the numbers. Any change will then be explained. ** Daily information on new deaths should not imply that these deaths occurred in cases reported that day. Therefore daily CFRs >100% may occasionally result A. Highlights of the day:

• 228 Cases and 8 deaths added today (in comparison with 235 cases and 5 deaths yesterday) • 65.0% of the districts affected have reported today 39 out of 60 affected districts) • 91.9 % of districts reported to be affected (57 districts out of 62) • Cumulative Institutional Case Fatality Rate 1.7% • Daily Institutional CFR = 2.2% • One case reported previously from district in Matabeleland South was a long distant truck driver who had travelled from to and then to , develop signs and symptoms of Cholera at Mbalabala.

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 1 High priority districts to be investigated today

Districts reported Districts with a Districts with high Districts with Districts which have not reported for more than 3 high number of daily CFR > 5% : number of deaths cases re- days: cases today (cases outside health occurring after added today> 30 facility/ CTC > 3 more than 14 days 1. BRIDH 1. Chikomba Nil Nil 1. Murehwa 2. 2. 2. Rural 3. Kadoma 3. Kariba Urban 4. Zaka

1. Follow up actions

Province District/Area Flagged as a priority Cause for flagging, Action taken to be Responsible for Follow up with Follow up Status on taken (when and who will be doing what) Following up

Mash Central Mt Darwin 17.03.2009 • 69 Cases reported NPO-EHA/MOH PMD Mash Central The deaths were a 24.03.2009 • 12 Community Deaths cumulative figure from the beginning and there was error in reporting Harare 07-14.03.09 ( High • 33 cases reported on 07.03.09 NPO-EHA/MOH Chitungwiza City On-going number of cases (Batch reporting) Health 16.03.09( High number • 35 cases reported on 14.03.09 of cases) • 38 cases reported on 16.03.09 Mash West Kadoma 17.03.2009 • 131 cases reported NPO-EHA/MOH PMD Mash West A team is on the ground 23.03.2009 • 106 cases and 4 deaths reported

MASH EAST Makumbe 26.03.09 (non reporting) • No report received for 10 days NPO-EHA PMD office Situation stable reported on (Goromonzi) 16.03.09

Mudzi 11.03.09 (non reporting) • No report received for 5 days NPO-EHA PMD office Has reported 8 cases more from previous cases

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 2 2. Epidemiological Data Today's update Cumulative Province District/area affected Cases Deaths CFR of Community Cumula Cumulati Cumulati Commu Proportion Date last Number of added added cases Deaths added tive ve Deaths ve CFR nity Community updated days since today today added today (included in Cases (%) Deaths Deaths (%) previous today (%) the total) (included in report the total) Harare City Chitungwiza 27 0 0.0 0 3125 168 5.4 120 71.4 26/03/2009 0 BRIDH 33 0 0.0 0 5989 274 4.6 89 32.5 26/03/2009 0 Budiriro 9 0 0.0 0 8825 202 2.3 109 54.0 26/03/2009 0 Bulawayo Bulawayo Urban 0 0 0.0 0 443 18 4.1 11 61.1 26/03/2009 0 Mashonaland 4 0 0.0 0 2096 41 2.0 28 68.3 26/03/2009 0 Central Centenary - - - - 255 23 9.0 15 65.2 25/03/2009 1 Guruve - - - - 1032 43 4.2 32 74.4 24/03/2009 2 Mazowe 1 0 0.0 0 523 16 3.1 8 50.0 26/03/2009 0 Mbire - - - - 686 27 3.9 22 0.0 25/03/2009 1 Mt Darwin 1 0.0 0 3525 80 2.3 47 58.8 26/03/2009 0 Rushinga - - - - 330 19 5.8 12 63.2 24/03/2009 2 Shamva 24 0 0.0 0 1485 35 2.4 30 85.7 26/03/2009 0 Mashonaland Chikomba 4 2 50.0 0 270 20 7.4 15 75.0 26/03/2009 0 East Hwedza 0 0 0.0 105 5 4.8 4 80.0 25/03/2009 1 Makumbe 24 - - - - 445 5.4 17 70.8 16/03/2009 10 (Goromonzi) - - - - 149 9 6.0 7 77.8 25/03/2009 1 Mudzi 8 0 0.0 2730 159 5.8 80 50.3 26/03/2009 0 Murehwa - - - - 186 29 15.6 20 69.0 20/03/2009 6 Mutoko 19 1 5.3 1 364 80 22.0 70 87.5 26/03/2009 0 (Goromonzi) 0 0 0.0 0 672 17 2.5 12 70.6 26/03/2009 0 Seke 1 0 0.0 0 837 36 4.3 23 63.9 26/03/2009 0 UMP 0 0 0.0 0 542 53 9.8 27 50.9 26/03/2009 0 Mashonaland 0 0 0.0 0 3079 156 5.1 33 21.2 26/03/2009 0 West Hurungwe 1 0 0.0 0 2984 131 4.4 85 64.9 26/03/2009 0 Kadoma 13 3 23.1 2 6275 212 3.4 112 52.8 26/03/2009 0 Kariba Rural - - - - 464 41 8.8 31 75.6 21/03/2009 5 Kariba Urban - - - - 339 21 6.2 2 9.5 21/03/2009 5 Makonde 17 0 0.0 0 5464 200 3.7 139 69.5 26/03/2009 0 Norton 5 0 0.0 0 1239 50 4.0 16 32.0 26/03/2009 0 Zvimba 0 0 0.0 0 1113 82 7.4 53 64.6 26/03/2009 0

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 3 Today's update Cumulative Province District/area affected Cases Deaths CFR of Community Cumula Cumulati Cumulati Commu Proportion Date last Number of added added cases Deaths added tive ve Deaths ve CFR nity Community updated days since today today added today (included in Cases (%) Deaths Deaths (%) previous today (%) the total) (included in report the total) Manicaland - - - - 3528 88 2.5 65 73.9 24/03/2009 2 Chimanimani - - - - 1358 74 5.4 31 41.9 25/03/2009 1 Chipinge 61 2 3.3 0 3120 77 2.5 32 41.6 26/03/2009 0 Makoni - - - - 618 65 10.5 54 83.1 24/03/2009 2 0 0 0.0 0 3335 229 6.9 221 96.5 26/03/2009 0 Mutasa - - - - 32 8 25.0 8 100.0 24/03/2009 2 Nyanga - - - - 684 61 8.9 46 75.4 25/03/2009 1 Mutare City 0 0 0.0 0 163 6 3.7 5 83.3 26/03/2009 0 Matabeleland Binga 0 0 0.0 0 1100 56 5.1 48 85.7 26/03/2009 0 North Lupane 0 0 0.0 0 2 0 0.0 0 0.0 26/03/2009 0 Nkayi 0 0 0.0 0 34 9 26.5 7 77.8 26/03/2009 0 Matabeleland Beitbridge 0 0 0.0 0 5139 149 2.9 48 32.2 26/03/2009 0 South 0 0 0.0 0 74 9 12.2 6 66.7 26/03/2009 0 Umzingwane 0 0 0.0 0 1 0 0.0 0 - 26/03/2009 Plumtree 0 0 0.0 0 32 1 3.1 1 0.0 26/03/2009 0 Bikita 0 0 0.0 0 2629 178 6.8 138 77.5 26/03/2009 0 Chiredzi 0 0 0.0 0 4350 152 3.5 85 55.9 26/03/2009 0 Chivi 0 0 0.0 0 1577 138 8.8 106 76.8 26/03/2009 0 Gutu - - - - 326 14 4.3 6 42.9 24/03/2009 2 Masvingo 0 0 0.0 0 936 64 6.8 31 48.4 26/03/2009 0 Mwenezi 0 0 0.0 0 799 68 8.5 52 76.5 26/03/2009 0 Zaka - - - - 853 62 7.3 53 85.5 22/03/2009 4 Midlands Chirumhanzu 0 0 0.0 0 57 2 3.5 2 100.0 26/03/2009 0 Gokwe North - - - - 2627 124 4.7 96 77.4 25/03/2009 1 Gokwe South - - - - 1755 65 3.7 40 61.5 25/03/2009 1 City (Mkoba) 0 0 0.0 0 244 5 2.0 2 40.0 26/03/2009 0 0 0 0.0 0 932 46 4.9 19 41.3 26/03/2009 0 Mberengwa - - - - 423 33 7.8 29 87.9 25/03/2009 1 0 0 0.0 0 34 8 23.5 7 87.5 26/03/2009 0 0 0 0.0 0 941 28 3.0 15 53.6 26/03/2009 0 Total 228 8 3.5 3 93274 4090 4.4 2522 61.7 “-“ : No report, - Flagged for follow up -Report received after more than 1 day

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 4