Cholera in South Sudan Situation Report # 67 As at 23:59 Hours, 22 July 2014 Situation Update

Republic of South Sudan Cholera in South Sudan Situation Report # 67 as at 23:59 Hours, 22 July 2014 Situation Update

As of 22 July 2014, a total of 4,765 cholera cases including 109 deaths (CFR 2.3%) had been reported in South Sudan as summarized in Tables 1 and 2. Laboratory results have confirmed cholera cases in Kapoeta North and Budi counties in Eastern Equatoria state.

Table 1. Summary of cholera cases reported in Juba County, 23 April - 22 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 3 9 0 2 16 0 16 1393 1411

Gurei CTC (changed to ORP) 3 3 0 0 2 0 2 363 365

Tongping CTC 0 0 0 3 2 1 3 58 64

Jube 3/UN House CTC 5 5 0 9 0 0 0 57 66

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 11 17 0 14 21 18 39 2033 2086 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 – 22 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 X X X 2 1 2 3 53 59 CES Yei Hospital X X X 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 X X X 1 0 0 0 22 23

OTC PHCC, Magwi 1 0 0 2 9 0 9 126 137

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

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

Torit Hospital X X X 41 7 9 16 851 908

Idali PHCU, Lafon X X X 0 4 0 4 89 93 Lwala PHCU, Pachidi X X X 0 0 1 1 1 2 payam, Lafon Bur Mutram PHCU, X X X 7 0 1 1 63 71 Bur Payam, Torit Ohiri PHCC, Bur X X X 10 3 0 3 43 56 Payam, Torit Ohila PHCC, Bur X X X 10 0 0 0 0 10 EES Payam, Torit Imurok PHCU, Imurok X X X 4 2 0 2 2 8 Payam, Torit Hiyala PHCC, Torit X X X 23 0 0 0 91 114 Olere PHCU, Imurok X X X 0 0 0 0 4 4 Payam, Torit Osito PHCU, Bur X X X 17 0 0 0 26 43 payam, Torit Ileu PHCU, Hiyala X X X 54 7 0 7 24 85 payam, Torit Hileu PHCC, Himodonge Payam, X X X 0 0 0 0 4 4 Torit Ofiri PHCU, Kudo X X X 0 0 0 0 5 5 Payam, Torit Kudo PHCC, Kudo X X X 29 1 0 1 19 49 Payam, Torit

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

Riwoto PHCC, Kapoeta X X X 3 1 0 1 48 52 North Other sites X X X 0 0 1 1 18 19

Kaka X X X 0 0 0 0 0 1 Upper Nile Wau Shilluk, Malakal X X X 134 16 1 17 678 829

Malakal PoC X X X 0 2 0 2 52 54

Total 1 X X 338 53 17 70 2269 2679 x: Facilities that have not reported

Figure 1: Central Equatoria State Epidemic curve as at 22 July 2014 140 Alive Died 120

100

40 Number of of cases Number 20

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

12/7/2014 10/7/2014 14/7/2014 16/7/2014 18/7/2014 20/7/2014 22/7/2014

23/04/2014 19/05/2014 21/04/2014 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 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 30 Date of onset

Figure 2: Eastern Equatoria State Epidemic curve as at 22 July 2014

90 Alive Dead 80 70 60 50 40 30

20 Numberof cases 10

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

18/7/2014 10/7/2014 11/7/2014 12/7/2014 13/7/2014 14/7/2014 15/7/2014 16/7/2014 17/7/2014 19/7/2014 20/7/2014 21/7/2014 22/7/2014

09/06/2014 10/06/2014 11/06/2014 12/06/2014 13/06/2014 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 28/06/2014 29/06/2014 30/06/2014 24 25 26 27 28 29 30 Date of onset

2 Figure 3: Upper Nile State Epidemic curve as at 22 July 2014 140 Died Alive 120

100

20 Numberof cases

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

17/7/2014 10/7/2014 11/7/2014 12/7/2014 13/7/2014 14/7/2014 15/7/2014 16/7/2014 18/7/2014 19/7/2014 20/7/2014

23/06/2014 24/06/2014 25/06/2014 26/06/2014 27/06/2014 28/06/2014 29/06/2014 30/06/2014 26 27 28 29 Date of onset

Data not available since 19 July 2014

Table 3: Areas that continue to report suspected cholera alerts as at 22 July 2014 Date of Details of the alert Area Action notification 23/07/2014 At least eight suspected cholera cases Malakal Case verification is underway; more detailed have been reported in the military County, Upper information will be availed after the investigations. base in Malakal County Nile State 22/07/2014 Five probable cases reported by HPF Ikotos county Case verification is under way, more information to at Isohe hospital, Ikotos county be availed after the investigations.

20/07/2014 A suspected cholera case was Lobonok, Juba Case verification was conducted by Juba county reported to Pager PHCU, close to County, Central surveillance team. Since the health facility lacked Lobonok PHCC. Equatoria State ringer’s lactate; the health facility in-charge secured them from nearby Lobonok PHCC as arrangements are made to secure fluids for the facility. The patient has since recovered. 05/07/2014 The number of AWD (suspected Bol, Lul Payam, Set up of MSF and ICRC CTCs in Bol and Kodok cholera cases) in Bol PHCU/CTC has Fashoda have been completed. Health partners including risen to 20 cases with six deaths. county, Upper MSF, CORDAID, & ICRC together with Fashoda Nile State 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.

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