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Situation Report #41 on Cholera in South Sudan As at 23:59 Hours, 1 August 2015

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Situation Report #41 on Cholera in South Sudan As at 23:59 Hours, 1 August 2015 Republic of South Sudan Situation Report #41 on Cholera in South Sudan As at 23:59 Hours, 1 August 2015 Situation Update As of 1 August 2015, a total of 1,411 cholera cases including 42 deaths (CFR 2.98%) have been reported in Juba and Bor Counties in Central Equatoria and Jonglei States respectively. In Juba County, 1,293 cases including 41 deaths (CFR 3.17%) have been reported from seven Payams (Table 1). In Bor, 118 cases including one death (CFR 0.85%) have been reported from Malou in Makuach Payam and other areas within the County. The initial cases in Juba were traced back to 18 May 2015 in UN House PoC where the first cholera case was confirmed on 1 June 2015. The most affected Payams in Juba County are Kator, Rejaf, Northern Bari, and Munuki that have registered attack rates (cases per 10,000) of 221, 199, 140, and 24 respectively (Annex 1). In Bor, the initial cases were reported from Malou in Makuach Payam. Makuach Payam is the most affected in Bor and has registered an attack rate (cases per 10,000) of 31 (Annex 1 and 2). Table 1. Summary of cholera cases reported in Juba and Bor Counties, 18 May – 1 August 2015 Reporting Sites New New New Total cases LAMA* Total Total Total Total cases Total cases admisions discharges deaths currently facility community deaths discharged admitted deaths deaths CES – Juba County 13 9 0 28 208 25 16 41 1016 1293 IMC UN House PoC clinic 0 0 0 2 0 0 1 1 71 74 Juba Teaching Hospital 6 6 0 21 204 21 7 28 716 969 MedAir Gumbo CTU 6 1 0 5 0 1 0 1 76 82 MedAir Gudele ORP 0 0 0 0 0 0 0 0 8 8 HLSS Nyakuron ORP 0 0 0 0 0 0 0 0 23 23 HLSS Kator ORP 0 0 0 0 0 0 0 0 7 7 HLSS Gurei ORP 1 1 0 0 0 0 0 0 35 35 HLSS Munuki ORP 0 0 0 0 0 0 0 0 3 3 HLSS Al Sabah ORP 0 0 0 0 0 1 0 1 10 11 HLSS Lologo ORP 0 0 0 0 0 0 0 0 8 8 MSF Munuki CTC 0 1 0 0 4 0 0 0 41 45 Other sites in Juba 0 0 0 0 0 2 8 10 18 28 Jonglei State – Bor 2 1 0 2 3 1 0 1 112 118 Bor State Hospital 2 1 0 2 3 1 0 1 112 118 Total 15 10 0 30 211 26 16 42 1128 §1411 *LAMA: LEAVE AGAINST MEDICAL ADVICE; CES- Central Equatoria State; § Following data cleaning, 56 duplicate records were deleted from the database. A total of 15 new cholera cases were reported in Juba and Bor on 1 August 2015 (Table 1 and Figure 1). o 13 new cases were reported from Juba County, with the majority originating from Gumbo Shirkat. o The two new admissions in Bor state hospital originated from Hai Salam and Naknyang (Figure 1), Figure 1: New cholera cases in Juba and Bor by residence on 1 August 2015 6 5 4 3 5 2 1 1 1 1 1 1 1 1 1 1 1 0 Number casesofNumber Nyakuron Kor Romula Shirkat Kadoro Check point Airport Gondokoro Bojur Kofuri Hai Salam Naknyang west Munuki Rejaf Juba Gondokoro Blank Northern Bari Makuach Baidit Juba Bor 1 During week 31 of 2015 (week of 1 August 2015), most of the cholera cases in Juba originated from Kor William and Lologo in Kator; Jebel Dinka, Lokuilili, and Hai Baraka in Northern Bari; Hai Jebel, Nyakuron west, and Mia sava in Munuki; and Gumbo and Shirkat in Rejaf (Figure 1.1). During week 31 of 2015, the most affected Payams in Juba County were Kator, Rejaf, Northern Bari, and Munuki that registered attack rates (cases per 10,000) of 15, 14, 9.2, and 1.3 respectively (Annex 1). Figure 1.1: New cholera cases by residence during week 31 of 2015 7 6 5 s e s a c 4 f o r e b 3 6 6 m u N 5 2 4 3 3 3 1 2 2 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 i l l l i i i i i t t f t r r r t r S l i g a a a a e a e 5 1 a n a n o o o o C o o a a C a B t t r r r k i g a s e e e e m m m a a a e t a o t u r r n r l v l k y y d k g i n R n b d a u a n o b j d o i t r i i u u j i i t u t k n w e w b b b k o a a a b r r o o a f o l k s i k g u n a a a n i l l o L S o a R n e S u P b d u o r c u a o u a a i l g e e e l o i r l m i g k a S r u d y o p u o g l o p u n a a a o r a a P J J J R W u k K o p i i K i G k m o o J d a r 3 D p h n k u o l G o g T S S K o n w k l M Z B n i a i a e l k o m N L n h l k u l o i i S B a a n i i M d k B b e n K a G o a r o u L c h L W e A c k a S w u e A e u L i e y R a a a o i a n L o y o a T e b N H b r r M i u b e S A r b a J b M e r b N o T n i H H N m h u D e a u o o r u e u e N J H o J u a o e J J G C J S K k u J H G i K L K H a e G y r u N G Juba Kator Munuki Northern Bari Rejaf Gondokoro Bor Juba Bor Cumulatively, 1,411 cholera cases including 42 deaths (26 facility and 16 community) have been reported in Juba and Bor Counties since the initial case was reported on 26 May 2015 in Juba (Tables 1 and 2). Of the 42 deaths, nine (21%) occurred in children under five years while 27 (64%) occurred in males. In Juba County, Juba Payam has registered the highest CFR followed by Northern Bari, Munuki, Rejaf, and Kator (Annex1). Table 2: New cholera cases by facility and week in Juba and Bor Counties, 18 May – 1 August 2015 New cases by epidemiological week of 2015 Reporting Facility 21 22 23 24 25 26 27 28 29 30 31 Grand Total CES – Juba County 4 2 7 56 130 229 235 161 237 150 82 1293 JTH 0 2 2 32 119 208 207 116 146 93 44 969 Juba 3 IMC clinic 4 0 4 9 6 13 10 10 11 5 2 74 HLSS Nyakuron ORP 0 0 0 0 0 0 2 3 11 2 5 23 HLSS Kator ORP 0 0 0 0 0 0 0 3 1 2 1 7 MedAir Gudele ORP 0 0 0 0 0 0 0 4 3 1 8 MedAir Gumbo CTU 0 0 0 0 0 5 15 20 25 10 7 82 HLSS Gurei ORP 0 0 0 0 0 0 0 1 11 10 13 35 HLSS Munuki ORP 0 0 0 0 0 0 0 1 0 2 3 HLSS Al Shabah ORP 0 0 0 0 0 0 0 0 4 3 4 11 HLSS Lologo ORP 0 0 0 0 0 0 0 0 2 4 2 8 MSF Munuki CTC 0 0 0 0 0 0 0 0 23 18 4 45 Other sites in Juba 0 0 1 15 5 3 1 3 0 0 28 Jonglei State – Bor County 0 0 0 0 0 5 46 33 21 8 5 118 Bor State Hospital 0 0 0 0 0 5 46 33 21 8 5 118 Grand Total 4 2 7 56 130 234 281 194 258 158 87 1411 As seen from Figure 2, the initial and isolated cases were reported from UN House PoC in Juba starting on 26 May 2015. However, following epidemiological investigations on 27 May 2015, cases could be traced back to 18 May 2015. Cholera was eventually confirmed on 1 June 2015 in Juba after Vibrio cholerae inaba was isolated from the one of five samples tested in the National Public Health Laboratory.
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