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Republic of South Sudan CHOLERA RESPONSE UPDATES AS of 19-August-2017

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Republic of South Sudan CHOLERA RESPONSE UPDATES AS of 19-August-2017 Republic of South Sudan CHOLERA RESPONSE UPDATES AS OF 19-August-2017 . Coordination of cholera response Overall coordination of the cholera response at the national level is coordinated by the National Cholera Taskforce that meets weekly on Wednesdays from 2pm in the WHO conference hall in Juba. In addition, the cholera coordination meeting in Juba Teaching Hospital is always on Monday starting 11am and Friday starting 9am in the Postgraduate School. At the sub-national level, Cholera Taskforce Committees are coordinating the cholera response in all the affected states and counties. Other non-affected states have also initiated cholera preparedness meetings in Aweil, Torit, Wau, Yambio, and Rumbek. Surveillance and case management updates. Cholera Alerts Overall, only one cholera alert was received during the week Ayod County: One suspect cholera case was reported on 20th Aug 2017 in Kandak payam. CMD, the health cluster partner operating in the area is to conduct an investigation and general assessment of the situation and share findings. General Cholera trends. There is a significant decline in cholera cases in the country over the past three weeks. The average number of cases reported in the last three epidemiological week is 80. The number of counties with active transmission reduced to nine from 11 in the past 4 weeks. These include Kapoeta South, Kapoeta East, Kapoeta North, Tonj East, Yirol East, Nyirol, Ayod, Duk and Juba. Low transmission continues to be reported in Lankien, Duk, Pieri, Uror, Akobo West and Yirol West. Also, cholera has been confirmed in Budi County in Kapoeta state with over 11 cases reported between the 15th and 16th August, 2017. In Juba, transmission in Don Bosco IDP camp is controlled following the first round of oral cholera vaccination from 3rd to 6th July 2017 although there are few sporadic cases being reported. There is sporadic transmission also from Jebel Suk, Mahad, Newsite, Munuki Bk C, and Thongpiny areas. Cholera response updates and field missions At least 50 cholera treatment facilities including cholera treatment centers and units; and oral rehydration points are currently operational in the areas with active cholera transmission. In Juba, HLSS has been supported by Unicef to establish 9 ORP sites in AlSabbah hospital; Gurei; Kator; Lologo; Gumbo; Don Bosco, KorWoliang, Nesitu, and Nyakuron. In Tonj East, there are currently seven (7) cholera treatment facilities (4-CTUs and 3-ORPs) The four CTUs are located in Makuac, Mapara, Paweng and Paliang payams while the ORPs are in Ager bac, Aliet and Apernum. Four more ORPs are proposed to be sited at Marial Lou where cholera has been confirmed, Wunbol, Golguk and Pagour. One more CTU has been established in response to the case upsurge in Marial Lou. A total of 15 cholera treatment facilities have been set up in Kapoeta state, with Kapoeta South having 1CTC, 1CTU, and 1 ORP; Kapoeta East having 3CTUs and 3 ORPs; and Kapoeta North having 1 CTC and 5 ORPs.and One ORP is being put up in Budi County Oral cholera vaccination A total of 640,893 (71%) doses have been deployed during the first round and 161,321 doses in the second round. Cholera cases have significantly reduced in areas where the OCV campaigns have been conducted so far in 2017. Since the beginning of 2017, cholera vaccines have been deployed in Leer, BorPoC, Malakal Town, BentiuPoC, Mingkaman IDP settlement, Aburoc IDPs, Bentiu/Rubkona Town, Ayod (Pagil, Tar, Jiech, Karmun, Padek, and Kandak), Juba (Don Bosco IDPs), Kapoeta North, Kapoeta South, Kapoeta East and Tonj East and surrounding payams.( Ref. Tab.2) The next phase of the campaign will target the remaining four prioritized counties including Juba, Akobo/Uror, Lankien and Panyijiar with a target population of 395,940. An additional 2 million doses of oral cholera vaccines are required to mitigate the risk of cholera in high risk areas and to interrupt transmission in the areas with ongoing transmission. WHO is in the final stages of securing these additional doses to complement the ongoing cholera response. Table 2: Doses of Oral Cholera Vaccines deployed in 2017 by site Target First round Second round No Site pop. # vacc. %cov. # vacc. %cov. Drop Vacc. Dates Partner out 1 Leer 44,731 30,772 69 - - - 22-Feb-17 MedAir, WHO,UNICEF 2 Malakal Town 16,500 10,499 64 - - - 18-22 May MSF-E, WHO,UNICEF 3 BorPoC 2,265 1,926 85 1,885 83 - 3-4 Apr/ HLSS, 26-29 Apr WHO,UNICEF 4 Mingkaman 111,278 68,512 62 42,296 38 - 12-26 May MedAir, 10-21 Jun WHO,UNICEF 5 Ayod Tar 19,400 15,649 81 - - - 9-22 May MedAir, WHO,UNICEF 6 AyodPagil 4,850 3,943 81 - - - 9-22 May MedAir, WHO,UNICEF 7 BentiuPoC 112,924 72,514 64 77,603 69 - 5-10 May IOM, WHO, UNICEF 8 Rabkona&Bentiu 35,204 31,908 91 38,387 109 - 20-23 Jun IOM, WHO, town UNICEF 9 Aburoj IDPs 11,640 10,723 92 - - 20-22 May MSF-E, WHO,UNICEF Ayod (Jiech, 10 Karmun,Padek&Kand 15,000 11,140 74 - - - 22-25 Jun IOM, CMD, ak) WHO, UNICEF MSF-H, 11 Juba Don Bosco IDPs 5,940 3,909 66 1150 19 - 3-6 Jul; 24- WHO,UNICEF 27 Jul WHO, 12 Tonj East 189,058 160,862 85 - - - 6-12Aug UNICEF, IOM,CCM, THESO 13 Kapoeta North 141,520 73,767 52.1 - - - 29 Jul-4-Aug WHO, UNICEF, SCI 14 Kapoeta South 97,000 78,469 81 29 Jul-4-Aug WHO,UNICEF, ARC 15 Kapoeta East 97,000 66,300 68 29 Jul-4-Aug WHO, UNICEF, SCI Total doses deployed 2017 904,310 640,893 71 161,321 42 Fig.1: Updated First Round OCV Vaccination, 2017 Target Coverage % Coverage 1,000,000 90.0 379,398 85.1 900,000 80.9 80.0 800,000 72.3 68.4 70.0 700,000 60.0 600,000 52.1 50.0 500,000 40.0 160,862 Target/Coverage 400,000 % Coverage 30.0 300,000 73,767 524,578 78,469 66,300 200,000 20.0 100,000 189,058 10.0 141,520 97,000 97,000 0 0.0 Kap-N Kap-S Kap-E Tonj-E Total Counties A total of 379,398 out of a target of 524,578 across the four counties were vaccinated, representing 72.3% of the target population. Kapoeta South and Tonj East recorded slightly above 80%, that is, 80.9% and 85.1% respectively. Following a low coverage in Kapoeta North during the first round, a mop-up campaign was conducted in the area which saw the 29,329 more people vaccinated. This brings the total of people vaccinated in the county to 73, 767 (52%). Kap= Kapoeta North, South, East and Tonj East Laboratory updates A total 664 samples of cholera have been tested of which 41% (272) have been confirmed positive for Vibrio cholerae. Tab.3: Laboratory statistics Culture results State (County) Cumulative New positives in week 32 Positive Cumulative Negative Total tested Central Upper Nile 0 0 5 5 Jonglei-Duk 0 7 5 12 Jonglei-Bor South 0 6 3 9 Jonglei-Lankien 0 4 3 7 Jubek-Juba 2 115 149 266 Terekeka 0 2 0 2 Eastern Lakes - Mingkaman 0 44 52 96 Eastern Lakes – Yirol West 0 3 0 3 Eastern Lakes – Yirol East 0 4 6 10 Imatong 0 7 1 8 Fangak – Fangak 0 18 42 60 Fangak – Ayod 0 1 2 3 Wau 0 0 6 6 Boma 0 0 3 3 Northern Liech – Rubkona 0 32 76 108 Northern Liech – Mayom 0 1 3 4 Southern Liech – Leer 0 2 0 2 Southern Liech - Panyijiar 0 1 0 1 Southern Liech – Mayendit 0 4 6 10 Fashoda – Kodok, Aburoc 0 3 5 8 Central Upper Nile (Pigi) 0 3 5 8 Central Upper Nile (Malakal) 0 1 11 12 Kapoeta (Kapoeta South) 0 4 2 6 Kapoeta (Kapoeta East) 0 4 0 4 Kapoeta (Budi county) 0 2 0 2 Tonj State (Tonj East) 0 3 3 6 Torit 0 0 2 2 Renk (Geiger) 0 1 0 1 Total tested 02 272 390 664 WASH CLUSTER RESPONSE UPDATES Note: WASH Cluster partners to send their Cholera response updates by Friday 4pm every week at [email protected] [email protected] WASH Cluster Key Cholera Response updates: 13th-19th August, 2017 Nine (9) WASH Cluster partners namely Help, RUWASSA, CCOSS, CAFOD, MEDAIR, ADA, CRS, NH reported in the prescribed WASH Cluster Cholera weekly reporting matrix Locations with WASH Partners Ongoing actions with number of population reached with Cholera Gaps and recommended action ongoing outbreak and present interventions hot spots (Payam level) IOM - A cumulative total of 110 boreholes have been worked on, (Kapoeta North – 46 repaired and 0 rehabilitated, Kapoeta South – 43 repaired and 21 rehabilitated), benefitting approximately 55,000 individuals. - Kapoeta case management, - House to house visits for hygiene promotion carried out in Kapoeta surveillance & OCV working North (Najie, Chumakori, Lokwamor, Lomeyen, Paringa and group meeting: Wednesday Nakwa) and Kapoeta South (Napetait, Nanaknak and Kapoeta 9th Augu12 2017 (10h – 11h town), reaching 10,369 individuals (2,480 men, 3,448 women, and AM); 4,441 children) during the week. Kapoeta South - Kapoeta WASH cluster - The hygiene promotion activities passed messages on safe disposal (Nakwasingira, Napetait, meeting: Friday 11th August of human waste, proper handwashing with soap and running Nanaknak, Kapoeta 2017 (1.30PM – 3h PM) water at all critical times, safe water chain and handling, good town) and IOM health seeking behavior for cholera and mobilization for OCV.
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