Email: [email protected] http://ochaonline.un.org/Default.aspx?alias=ochaonline.un.org/zimbabwe

Toll free number for alert is Office of the WHO Representative in 08089001 or 08089002 or 08089000

Mobile number for alerts is 0912 104 257 Date of issue:14th January, 2008

DAILY CHOLERA UPDATE AND ALERTS 14th January, 2009

A. Highlights of the day: • 1550 cases and 104 deaths added today (in comparison 642 cases and 81 deaths yesterday) • 42.1 % of the areas affected have reported today (24 out of 57 affected districts) • 87.1 % of districts reported to be affected (54 districts/62) • All 10 of the country's provinces are affected • CTC set up in Gokwe North to cater for cases in Denda area • Newly affected areas : Ndipe( ), Chigwikwi (Chivi) • Number of deaths in and Mwenezi reduced after data cleaning.

Districts reported an high Districts with a daily CFR > 5% : Districts with high number of Districts which have not reported for more than 3 number of cases today (cases deaths outside health days: added today> 30) 1. Kadoma facility/ CTC > 3 1. Guruve 10. Lupane 1. Kadoma 2. Gokwe North 2. Mazowe 2. Hurungwe 1. Bikita 3. 3. Beitbridge 4. Rushinga 4. Bikita 5. Mudzi 5. Gokwe North 6. Murehwa 6. Gokwe South 7. 8. Hwedza 9. UMP

B. Conclusion of the day: High priority districts to investigated today Priority districts to call back on the phone (as delay of more than 3 days to report) and in red High priority districts which needs field visit (no report for more than 7 days) • Kadoma • Gokwe North • Guruve • Mudzi • Hurungwe • Gokwe South • Mazowe • Murehwa • Beitbridge • Bindura • Marondera • Bikita • Rushinga • Hwedza • UMP • Lupane • Hwedza

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 1

C- Follow up actions Province District Flagged as a priority Action taken and next step (when and who will be doing what) Responsible for Follow up on Following up Status Harare 13/01/09 (High number • Follow up with City Health Directorate Data Managers On-going of cases) • Follow up on the issue of disaggregating data MASH WEST Makonde 12/01/09 (Borehole not • To contact partners to help with the repair of the borehole and NPO-EHA to follow up On-going functioning) water tank which is not functioning at Kamhonde CTC with WASH and Health Cluster Zvimba 13/01/09 • Rumours reported from Mutorashanga (1 case), Rafingora (7 NPO-EHA On-going cases), Darwendale (4 cases and 2 community deaths) and Mt NPO-EHA to Hampden (19 cases). followup with IOM • To make a follow up with IOM making a follow up and WASH • Zvimba DHT confirmed the Mutorashanga outbreak. District has problems with water supply at Dzivarasekwa Extension clinic CTC and Banket District Hospital CTC. No partners in the district – 14/01/2009 Hurungwe 12/01/09 (High CFR) • Follow up with PMD NPO-EHA On-going Norton 13/01/09 (Not reporting • Follow up with PMD NPO-EHA On-going for > 3days) Kadoma 13/01/09 (High CFR) • Follow up with PMD NPO-EHA On-going MASH EAST UMP 08/01/09 (High number • Follow up with PMD NPO-EHA to followup On-going of cases) • Supplies have been delivered to the province. Find partners to with ZNFP, OXFAM, 10/01/09 (High number help in the distribution of supplies. IOM, CRS of cases) • World vision has adopted a vehicle to be used for cholera issues 13/01/09 (Non reporting only for >3 days) Hwedza 10/01/09 (More than 3 • Follow up with PMD NPO-EHA On-going days without cases) • Telephone exchange not working • Health information officer gone out to collect data Mutoko 13/01/09 (non reporting) • Follow up with PMD for non reporting NPO-EHA On-going Hwedza 13/01/09 (non reporting) • Follow up with PMD for non reporting NPO-EHA On-going Goromonzi 12/01/09 (High CFR) • Follow up with PMD NPO-EHA On-going MASH Shamva 13/01/09 (High CFR) • Follow up with PMD NPO-EHA On-going CENTRAL Mbire 13/01/09 (High CFR) • Follow up with PMD NPO-EHA On-going Mazowe 13/01/09 (non reporting) • Follow up with PMD for non reporting Data Managers On-going • DMO’s number has been provided for follow up Rushinga 13/01/09 (non reporting) • Follow up with PMD for non reporting Data Managers On-going MANICALAND 08/01/09 (High number • Follow up with PMD NPO-EHA to follow up On-going of cases) • PHE team not available to respond to the issue with MDM 11/01/09 (High number of cases) 11/01/09 (High number of cases) 12/01/09 (High number

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 2 Province District Flagged as a priority Action taken and next step (when and who will be doing what) Responsible for Follow up on Following up Status of cases) District 06/01/09 (High CFR) • Follow up with PMD Social Mobilization to On-going 08/01/09 (High number • High CFR was as a result of cases and deaths identified from the follow up with PMD and of cases) community through active community based surveillance groups. DMO 12/01/09 (High CFR & • Health promotion to follow up number of cases) • Community based surveillance teams discovering retrospective deaths from the community. • Governor meeting with the members of the apostolic sect today – 12/01/09 • PHE team not available to respond to the issue Mutasa 10/01/09 (Not reporting • Follow up with PMD NPO-EHA On-going for more than 3 days) • PHE team not available to respond to the issue Chimanimani 12/01/09 (High number • Follow up with PMD NPO-EHA On-going of cases) • PHE team not available to respond to the issue 12/01/09 (High number • Follow up with PMD NPO-EHA of cases) • PHE team not available to respond to the issue Mutare 12/01/09 (High number • PHE team not available to respond to the issue NPO-EHA of cases) • Governors visit to the District will be there tomorrow (15/01/09) Zaka 11/01/09 (Not reporting • Follow up with PMD NPO-EHA On-going for more than 3 days) Bikita 12/01/09 (High CFR & • Follow up with PMD MOH to follow up On-going number of cases) • 26 cases and 17 deaths were reported 13/01/09 (High CFR ) • CTC was set up in the area MIDLANDS Gokwe North 11/01/09 (Not reporting • Follow up with PMD NPO-EHA follow up Done for more than 3 days) • Denda reported 94 cases. Provincial team has gone to with CONCERN 13/01/09 (New cases) investigate. • Dende clinic in Chireya ward 3 reported 129 cases and 6 deaths. There are currently no medical NGOs. • MOH are aware and are doing their best. • A CTC has been opened in the area Gokwe South 05/01/09 • New cases and deaths reported in Gokwe in Mutenga area. NPO-EHA to follow up On-going 07/01/09 (High CFR) • Follow up with PMD with MSF Spain, IFRC 08/01/09 (High number • Health cluster coordinator making a follow up and Zimbwe Red Cross, of cases) • Follow up with PMD CONCERN 13/01/09 (New cases) • Cases reported from 4 households in Mateta area – 08/01/2009 • No medical facilities in the ward. Nearest facility is 30km away • Follow up email send out. Waiting for response • Sesame reported 2 new cases. 03/01/09 • 4 cases reported in new area (). PNO relayed NPO-EHA follow up On going 08/01/09 (Rumour) information. PMD office following up with CONCERN • Communication problem 04/01/09 • Rumour of cholera cases from area • PMD has been contacted. DEHO has gone to investigate

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 3 Province District Flagged as a priority Action taken and next step (when and who will be doing what) Responsible for Follow up on Following up Status • No fuel available to go and do investigations – 12/01/09 • Fuel to be available as from Friday this week Mberengwa 12/01/09 • A new area in Mberengwa named Ngungumane reported 5 NPO-EHA follow up On-going cases and zero deaths. Cases in Mberengwa are scattered with CONCERN NPO-EHA to follow throughout the district. Red cross pulled out of the district. up with World is requesting for fuel Vision MAT NORTH Lupane 11/01/09 (Not reporting • Follow up with PMD NPO-EHA On-going for more than 3 days) Binga 13/01/09 • Binga reported 200 cases and 26 deaths from Pashu, Shaba, On-going Chunga and Siyabuwa areas • SAVE the children to provide supplies • UNICEF has been sending supplies • 600 litres available to send supplies • 4 teams have been send out to make investigations in the affected areas. Meeting to be held on Satarday by the team • The reported 200 cases were over a period of time • To find out if there is a CTC in Binga MAT SOUTH Beitbridge 14/01/09 • A new area called Binde reported 2 cases On-going 09/01/09 • Rumour confirmed in West Nicholson. 4 cases and 1 death NPO-EHA Done

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 4

D. Epidemiological Data Today's update Cumulative Province District/area Cases Deaths CFR of Community Cumulative Cumulative Cumulative Community Proportion Date last Number affected added added cases Deaths Cases Deaths CFR (%) Deaths Community updated of days today today added added (included Deaths (%) since today today in the total) previous (%) (included in the report total) Harare - - - - 977 153 15.7 115 75.2 13/01/2009 1 Harare - - - - 10939 238 2.2 16 6.7 13/01/2009 1 Bulawayo urban - - - - 387 12 3.1 8 66.7 12/01/2009 2 Mashonaland Shamva - - - - 66 15 22.7 15 100.0 13/01/2009 1 Central Centenary - - - - 140 15 10.7 11 73.3 12/01/2009 2 Mazowe - - - - 155 4 2.6 3 75.0 09/01/2009 5 Guruve - - - - 62 9 14.5 7 77.8 10/01/2009 4 Mbire - - - - 28 7 25.0 0 0.0 13/01/2009 1 Mt Darwin - - - - 93 5 5.4 2 40.0 12/01/2009 2 Bindura - - - - 384 15 3.9 13 86.7 10/01/2009 4 Rushinga - - - - 96 4 4.2 4 100.0 09/01/2009 5

Mashonaland Mudzi - - - - 2051 125 6.1 62 49.6 10/01/2009 4 East Murehwa - - - - 113 19 16.8 13 68.4 09/01/2009 5 Makumbe - - - - 249 22 8.8 17 77.3 12/01/2009 2 (Goromonzi) 28 0 0 0 332 16 4.8 11 68.8 14/01/2009 0 (Goromonzi) Mutoko 0 0 0 0 154 20 13.0 14 70.0 14/01/2009 0 Marondera - - - - 71 7 9.9 5 71.4 10/01/2009 4 Chikomba 3 0 0.0 0 80 17 21.3 16 94.1 14/01/2009 0 Hwedza - - - - 27 1 3.7 1 100.0 06/01/2009 8 UMP - - - - 145 16 11.0 8 50.0 09/01/2009 5 Seke 17 0 0.0 0 533 18 3.4 11 61.1 14/01/2009 0 Mashonaland Makonde 262 14 5.3 12 3308 116 3.5 66 56.9 14/01/2009 0 West - - - - 282 14 5.0 2 14.3 13/01/2009 1 Mahombekombe Kariba Rural - - - - 354 34 9.6 24 70.6 13/01/2009 1 Zvimba - - - - 220 20 9.1 18 90.0 13/01/2009 1 Kadoma 142 22 15.5 22 1743 125 7.2 73 58.4 14/01/2009 0 Hurungwe 106 4 3.8 2 1111 64 5.8 41 64.1 14/01/2009 0 Norton 0 0 0 0 786 33 4.2 11 33.3 14/01/2009 0 24 0 0.0 0 2267 141 6.2 30 21.3 14/01/2009 0

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 5 Today's update Cumulative Province District/area Cases Deaths CFR of Community Cumulative Cumulative Cumulative Community Proportion Date last Number affected added added cases Deaths Cases Deaths CFR (%) Deaths Community updated of days today today added added (included Deaths (%) since today today in the total) previous (%) (included in the report total) Manicaland Mutasa - - - - 9 5 55.6 5 100.0 12/01/2009 2 Mutare City - - - - 18 1 5.6 0 0.0 12/01/2009 2 Buhera - - - - 1229 43 3.5 37 86.0 12/01/2009 2 Chipinge - - - - 1174 56 4.8 32 57.1 12/01/2009 2 Makoni - - - - 406 49 12.1 44 89.8 12/01/2009 2 Mutare - - - - 1585 156 9.8 154 98.7 12/01/2009 2 Chimanimani - - - - 741 45 6.1 15 33.3 12/01/2009 2 Nyanga - - - - 38 2 5.3 2 100.0 12/01/2009 2 Matebeleland Lupane - - - - 2 0 0.0 0 - 07/01/2009 7 North Binga - - - - 200 26 13.0 0 0.0 13/01/2009 1 Matabeleland Gwanda 0 0 0 0 73 8 11.0 4 50.0 14/01/2009 0 South Plumtree 0 0 0 0 3 0 0.0 0 0.0 14/01/2009 0 Beitbridge 34 0 0.0 0 4316 134 3.1 45 33.6 14/01/2009 0

Masvingo Masvingo 35 0 0 0 558 45 8.1 17 37.8 14/01/2009 0 Gutu 0 0 0 0 26 3 11.5 1 33.3 14/01/2009 0 Chivi 96 23 24.0 17 721 86 11.9 69 80.2 14/01/2009 0 Bikita 501 21 4.2 21 1026 72 7.0 53 73.6 14/01/2009 0 Chiredzi - - - - 1145 50 4.4 31 62.0 12/01/2009 2 Mwenezi 104 0 0 0 347 28 8.1 20 71.4 14/01/2009 0 Zaka - - - - 179 21 11.7 21 100.0 12/01/2009 2 Midlands City 0 0 0.0 0 189 4 2.1 2 50.0 14/01/2009 0 (Mkoba) 24 1 4.2 0 172 14 8.1 8 57.1 14/01/2009 0 Mberengwa - - - - 114 20 17.5 18 90.0 12/01/2009 2 Gokwe North 80 16 20.0 12 226 24 10.6 20 83.3 14/01/2009 0 Gokwe South 90 2 2.2 2 264 9 3.4 8 88.9 14/01/2009 0 Kwekwe 4 1 0.0 0 42 6 14.3 3 50.0 14/01/2009 0 0 0 0.0 0 26 8 30.8 7 87.5 14/01/2009 0 Chirumhanzu 0 0 0.0 0 4 1 25.0 1 100.0 14/01/2009 0 Total 1550 104 6.7 88 41986 2201 5.2 1234 56.1

Key: - No Report Flagged for follow-up Report received after more than 1 day

Source: Ministry of Health and Child Welfare Rapid Disease Notification System 6