Situation Report Adamawa State Ministry of Health TTITLE 2021 Cholera Outbreak Situation Report SERIAL NUMBER 09 EPID-WEEK 35 DATE 5th September, 2021 Highlights o 45 new suspected cases with 2 deaths have been reported within the reporting week (Yola North=14 with 1 death, Yola South=25 cases with 1 death and Girei=6 cases with 0 death) o Total suspected case count now stands at 169 with 7 deaths (CFR=4.1 %) o WHO with support from SMOH, ADPHCDA & NCDC trained 41 Active Case Search members on Cholera & other priority diseases to carry out ACS.They have been deployed to the 6 affected LGAs. o WHO with support from SMOH, ADPHCDA & NCDC trained 40 CTC staff on Cholera case management, IPC, PSS & RCCE. They were from Fufore, Shelleng, Gombi and the CTC in SSHY o 17 Community Champions have been trained and deployed to 6 affected LGAs to carry out risk communications and to support ACS. This was carried out by WHO with support from SMOH & ADPHCDA Epidemiological Summary The total number of cases reported as at 5th September, 2021stands at 169 suspected cases with 7 deaths (CFR=4.1%), Girei reported 44 cases with 2 deaths (CFR= 4.5%); Yola North reported 39 suspected case with 1 death (CFR= 2.6%), Yola South reported 33 suspected cases with 1 death (CFR= 3.0%), Shelleng reported 17 cases with 0 death (CFR=0%), Fufore reported 2 cases with 0 deaths (CFR=0%) and Gombi reported 34 cases with 3 death (CFR=8.8%). Of the 169 suspected cases, 15 revealed 01 serotype. 1 | P a g e 60 50 40 30 20 Suspected Suspected cases 10 0 22 23 26 27 28 29 30 31 32 33 34 35 Week of onset Cases Deaths Figure 1: Epi curve of suspected cases of cholera and deaths in Adamawa state as at 5th September, 2021 Yola Girei Yola Shelleng Gombi Fofore Total North South Cases New suspected 14 6 25 0 0 0 45 Cumulative 39 44 33 17 34 2 169 Deaths New deaths 1 0 1 0 0 0 2 Cumulative deaths 1 2 1 0 3 0 7 Laboratory* Specimens collected 19 19 1 0 4 2 45 Specimen (Culture +ve) 11 14 1 0 4 1 31 Specimen (01 serotype) 1 10 1 0 3 1 16 Table 1: Number of cases, deaths and samples tested for Cholera in Adamawa as at 5th September, 2021 . (* samples collected will be updated) 2 | P a g e Figure 2: Map of Adamawa State showing Cholera affected LGAs as at 5th September, 2021 Activity Girei Yola North Yola South total Partners No of water points mapped 69 97 48 214 IRC No of water points tested 69 97 48 214 IRC Number and % of contaminated water points 65 (30) 84 (39%) 46 (22%) 195 (91%) - Number and % of water points being SI, IOM, 15 (8%) 17 (9%) 0 (0%) 32 (16%) chlorinated NRC Number and % of water points not being 54 (28%) 60 (31%) 48 (25%) 162 (84%) - chlorinated Table 2: Distribution of Water point chlorination in the affected LGAs in Adamawa State, as at August 25th 2021. Coordination o The coordination meeting between State response teams and Development partners holds Mondays and Thursdays o Pillar meetings of partners & government is ongoing o Generated reports and action points are shared with Government Agencies and Development partners Surveillance and Laboratory o 45 new suspected cases with 2 deaths have been reported. 3 | P a g e o DSNOs are line listing suspected Cases and collecting sample o 15,115 households so far have been visited by the 3 ACS teams in Yola North, Yola South & Girei LGAs. 14 suspected cases were detected and reported. o WHO supported by SMOH, NCDC & ADPHCDA has trained and deployed 41 additional ACS individuals to Gombi, Shelleng, Fufore, Yola North & Yola South o WHO provided 50 biohazard bags to the laboratory in SSH o Regular hot spot analysis has been shared to stakeholders to guide the response Case management o 9 cases currently on admission in the CTC o 48 cases were admitted and 37 discharges in the CTC Specialist Hospital Yola o 2 deaths recorded at the CTC o WHO with support from SMOH, ADPHCDA & NCDC trained 40 CTC staff on Cholera case management, IPC, PSS & RCCE. They were from Fufore, Shelleng, Gombi and the CTC in SSHY o SI is currently supporting water trucking in the CTC following the breakdown of the borehole. o No stipends for the contracted staff who work in the SSH CTC after 4 weeks of work Wash o Chlorination of twenty (20) water points is ongoing in Girei LGA, Adamawa state. 754,928 liters (754m3) of water was chlorinated during the reporting week period. o Door to door HP on cholera prevention is ongoing in Girei LGA, Adamawa state. 2,710 individuals (360HHs) were reached with HP awareness sessions in Njabbore community of Girei LGA, o 244 pieces of soaps were distributed the hygiene promotion sessions. o 38 cholera cases were reported from the CTC in Adamawa for the week. As a result, 38 cholera kits were distributed to the patients. o 151 HHs (23 case+ 128 neighboring) and 23 latrines were disinfected by the disinfection team o 720 pieces of soaps was distributed to the neighboring HHs that were sprayed/Disinfected. Risk Communication o WHO supported Community Champions Risk Communication reached 12,800 individuals from 1,920 households in 7 settlements of Yola South, Yola North, Girie, Shelleng, Gombi and Fufore were reached. 10 suspected cholera cases were detected and linked with the reporting channels. o Sensitization letter containing key cholera messages on prevention and control have been written and distributed to state Chairman CAN and Muslim council to sensitize their members Logistics o ICRC donated 50 cartoons of Ringers Lactate o WHO provided 50 Biohazard bags to the laboratory in SSHY Challenges o Inadequate water point mapping, profiling, testing, chlorination and supervision across the affected LGAs o More partners required to support risk communication 4 | P a g e o Funds to support outbreak response is yet to be released by the state Government o LGA level coordination needs to be strengthened o Lack of stipends to support Case Managers in the CTC in SSH & GH Garkida o Ambulance services still a challenge especially for distant locations o Some of the health facilities in affected LGAs have inadequate manpower o Most referred cases from PHCs are coming in critical state o Poor sanitation in affected areas o Shortage of Aquatabs for household distribution to treat household drinking water. o Shortage of IEC materials. o Open defecation still ongoing in some of the affected areas o Inadequate supply of Iv fluids and other WASH commodities o Shortage of soap for distribution at HH during Hygiene Promotion for personal hygiene. o Shortage of Aquatabs for household distribution to treat household drinking water. Way forward o DPH to mobilize colleagues from other ministries and security agencies so as to have a multidisciplinary approach to outbreak response (One health) o Advocate to partners willing to build public latrines o Set up CTU in affected LGAs o Solicit for funds to train healthcare workers in the affected and at risk LGAs o Continue to engage partners for more support across thematic areas o Share reports timely with NCDC and solicit for support of response material to be supplied to the state. o Solicit for the collaborative support of other ministries in the state to curb the outbreak o Solicit for financial support from the state Government to address the response 5 | P a g e .