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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:30 th March, 2009

DAILY CHOLERA UPDATE AND ALERTS 29th 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:

• 242 Cases and 15 deaths added today (in comparison with 121 cases a nd 0 deaths yesterday) • 60% of the districts affected have reported today 36 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 = 6.1%. • Batch reporting from Nyanga district stretching over 13 days resulting in 99 cases and 11 deaths, an average of 8 cases per day. • Batch reporting from Rushinga (28 cases) •

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. Nyanga 1. Nyanga Nil Nil 1. Makumbe 6. Urban 2. (Goromonzi) 7. Gokwe North 3. 2. Guruve 4. Budiriro 3. Mbire 5. Kadoma 4. 5. Kariba Rural

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 Bindura 29.3.2009 • Continuosu high number of cases in NPO-EHA PMD’s Office On going Bindura Urban

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 NPO-EHA/MOH PMD Mash West 27.03.2009 High • 41 cases reported number of case 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

Manicaland 27.3.2009 • High number of cases (51) NPO-EHA ?? Batch reporting

Nyanga 29.3.2009 • High number of cases and deaths (99 NPO-EHA PMD;s Office Batching reporting cases and 11 deaths) after 13 days gap

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 2 2. Epidemiological Data Today's update Cumulative Province District/area Cases Deaths CFR of Community Cumulative Cumulative Cumulative Community Proportion affected added added cases Deaths Cases Deaths CFR (%) Deaths Community today today added added today (included in the Deaths (%) total) today (included in the total) (%) City Chitungwiza 20 1 5.0 0 3201 169 5.3 120 71.0 BRIDH 17 0 0.0 0 6054 274 4.5 89 32.5 Budiriro 10 1 10.0 1 8857 203 2.3 110 54.2 Bulawayo 18 0 0 0.0 0 443 4.1 11 61.1 Urban Mashonaland Bindura 12 1 8.3 0 2148 42 2.0 28 66.7 Central Centenary 255 23 9.0 15 65.2 Guruve 1032 43 4.2 32 74.4 Mazowe 0 0 0.0 0 524 16 3.1 8 50.0 Mbire 686 27 3.9 22 0.0 Mt Darwin 1 0 0.0 0 3526 80 2.3 47 58.8 Rushinga 28 0 0.0 0 358 19 5.3 12 63.2 Shamva 4 0 0.0 0 1492 35 2.3 30 85.7 Mashonaland Chikomba 270 20 7.4 15 75.0 East Hwedza 105 5 4.8 4 80.0 Makumbe 24 (Goromonzi) 445 5.4 17 70.8

Marondera 149 9 6.0 7 77.8 Mudzi 0 0 0.0 2730 159 5.8 80 50.3 Murehwa 186 29 15.6 20 69.0 364 80 22.0 70 87.5 17 (Goromonzi) 672 2.5 12 70.6 Seke 840 36 4.3 23 63.9 UMP 0 0 0.0 0 543 53 9.8 27 50.9 Mashonaland Chegutu 0 0 0.0 0 3084 156 5.1 33 21.2

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 3 Today's update Cumulative Province District/area Cases Deaths CFR of Community Cumulative Cumulative Cumulative Community Proportion affected added added cases Deaths Cases Deaths CFR (%) Deaths Community today today added added today (included in the Deaths (%) total) today (included in the total) (%) West Hurungwe 2984 131 4.4 85 64.9 Kadoma 17 1 5.9 0 6347 218 3.4 112 51.4 Kariba Rural 464 41 8.8 31 75.6 Kariba Urban 339 21 6.2 2 9.5 Makonde 15 0 0.0 0 5496 200 3.6 139 69.5 Norton 17 0 0.0 0 1262 50 4.0 16 32.0 Zvimba 0 0 0.0 1113 82 7.4 53 64.6 Manicaland Buhera 3579 88 2.5 65 73.9 Chimanimani 1358 74 5.4 31 41.9 3120 77 2.5 32 41.6 Makoni 618 65 10.5 54 83.1 3335 229 6.9 221 96.5 Mutasa 32 8 25.0 8 100.0 Nyanga 99 11 11.1 0 783 72 9.2 46 63.9 Mutare City 163 6 3.7 5 83.3 Matabeleland Binga 0 0 0.0 0 1100 56 5.1 48 85.7 North Lupane 0 0 0.0 0 2 0 0.0 0 0.0 Nkayi 0 0 0.0 0 34 9 26.5 7 77.8 Matabeleland 0 0 0.0 0 5139 149 2.9 48 32.2 South 0 0 0.0 0 74 9 12.2 6 66.7 0 0 0.0 0 1 0 0.0 0 - Plumtree 0 0 0.0 0 32 1 3.1 1 0.0 Bikita 0 0 0.0 0 2633 178 6.8 138 77.5 Chiredzi 0 0 0.0 0 4362 152 3.5 85 55.9 Chivi 1580 138 8.7 106 76.8 Gutu 0 0 0.0 0 326 14 4.3 6 42.9 Masvingo 0 0 0.0 0 936 64 6.8 31 48.4

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 4 Today's update Cumulative Province District/area Cases Deaths CFR of Community Cumulative Cumulative Cumulative Community Proportion affected added added cases Deaths Cases Deaths CFR (%) Deaths Community today today added added today (included in the Deaths (%) total) today (included in the total) (%) Mwenezi 0 0 0.0 0 799 68 8.5 52 76.5 Zaka 0 0 0.0 0 853 62 7.3 53 85.5 Midlands Chirumhanzu 0 0 0.0 0 57 2 3.5 2 100.0 Gokwe North 0.0 2627 124 4.7 96 77.4 Gokwe 65 2 0 0.0 0 1758 3.7 40 61.5 South City 0.0 5 (Mkoba) 0 0 0 245 2.0 2 40.0 0 0 0.0 0 932 46 4.9 19 41.3 Mberengwa 0.0 423 33 7.8 29 87.9 0 0 0.0 0 34 8 23.5 7 87.5 0 0 0.0 0 941 28 3.0 15 53.6 Total 242 15 6.2 1 93845 4110 4.4 2523 61.4 “-“ : No report, - Flagged for follow up -Report received after more than 1 day

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 5