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Somalia: Cholera Outbreak - Apr 2016

Status
Ongoing
Countries
Somalia
Disaster types
Epidemic

Humanitarian partners have stepped up response to the outbreak...Projections of 15,000 severe and 60,000 moderate cases over the coming months have led to plans for a significant and rapid scale up of the response. To help stabilize and contain the outbreak, the CERF rapid response grant of $2 million will strengthen and complement response activities already underway by WASH and Health partners. (OCHA, 30 May 2016)

Since the beginning of [2016], a total of 14165 case of AWD and 497 deaths have been reported in different parts of Somalia. Of these 47.7% are female while 57.9% are children below 5 years. [...] there has been a gradual reduction in number of cases from the peak 1,853 cases and 187 deaths (CFR 10.0%) in week 15 to 194 cases and 0 death in week 46. (WHO, 20 Nov 2016)

Drought conditions have increased the spread of epidemic-prone diseases such as acute watery diarrhoea, cholera and measles. In the first 7 weeks of 2017, more than 6000 cases and 65 deaths by acute watery diarrhoea/ cholera were reported. (WHO, 27 Feb 2017)

The AWD/cholera epidemic in Hiraan, Nugal, Mudug and Bari and Banadir region has been controlled and the cholera treatment centre in Beletweyne has been closed. 2016's outbreak was one of the worst and longest in which the country has experienced in the last five years. (WHO, 5 Mar 2017)

On 15 March 2017, the Government of Somalia, together with humanitarian partners, launched an Oral Cholera Vaccination campaign, the first of its kind in Somalia, targeting over 450,000 people in seven high-risk areas around the country...WASH partners have furthermore scaled up response to AWD/Cholera, reaching 316,000 people in southern and central Somalia through distribution of hygiene kits, chlorination of water points and hygiene promotion campaigns as of end of February. In total, some 568,600 people were assisted with temporary and/or sustainable access to safe water, 36,000 people with safe sanitation and 498,000 people with hygiene promotion activities. (OCHA, 24 Mar 2017)

In 2017, a total of 53,015 AWD/Cholera cases have been reported across 52 districts in 16 regions, including 795 deaths (CFR 1.5 per cent). This represents the worst case scenario with an attack rate (AR) of 5.5 per 1,000 people. 41 per cent of the cases are among children below five years with a slightly higher CFR (1.8%) compared to children above five years (1.4 per cent). The number of AWD/Cholera cases in 2017 is more than three times the 2016 caseload, and 10 times the 2015 caseload. Whilst the cumulative CFR is declining from 2.3 per cent at the beginning of the outbreak to 1.5 per cent as of last week, the reported CFR from inaccessible areas is still four times higher. (UNICEF, 30 Jun 2017)

The month of August has seen a sustained decline in the number of cases of cholera reported from across Somalia. The 917 cases recorded in August 2017 now approximate to the averaged monthly figures recorded in 2015 of 440 cases and during 2016 of 1,300 cases/month. (Health Cluster, 29 Sep 2017)

Over the past two months there has been a significant reduction in the number of new AWD/Cholera cases in all regions of Somalia. No AWD/cholera related deaths have been reported since August in any region across Somalia. (Health Cluster, 31 Oct 2017)

Cholera cases and deaths have declined significantly during the month of November 2017 with less districts reporting cases as compared to previous months. (WHO, 30 Nov 2017)

Since the start of the year, a total of 78,560 cumulative cases of AWD/cholera recorded from health facilities across the country and 1,160 deaths have been reported in 55 districts of 16 regions across Somalia. [...] Whilst an overall decline is being reported, new AWD/cholera cases have been reported from Beletweyne district of Hiran region during December. (Health Cluster, 31 Dec 2017)

As of 18 March 2018, a total of 1613 cholera cases, including nine deaths (case fatality rate = 0.6%), have been reported from four regions: Hiraan, Banadir, Lower Juba and Middle Shabelle. The outbreak started in Beletweyne, Hiraan Region; it spread to Banadir Region in early January 2018, to Lower Juba in early February 2018, and to Middle Shabelle in early February 2018... Banadir Region is one of the regions with the highest concentration of internally displaced persons (IDPs). (WHO, 29 Mar 2018)

Following the heavy rains that have led to the floods in the Juba land and Shabelle basins, there has been an observed increase in the number of new AWD/Cholera cases. The cholera outbreak that started in December 2017 in Beletweyne along river Shabelle has spread to Jowhar, Kismayo, Afgoye and Banadir. The cholera spread is expected to increase due to the floods that have led to contamination of water sources in the flood affected regions. Floods have also led to blockage of access of health services which will contribute to delayed health seeking by the affected populations with... A cumulative total of 3,280 cases including 21 deaths have been reported since December 2017. (WHO, 13 May 2018)

The cholera spread is expected to increase due to the floods that have led to contamination of water sources in the flood affected regions...Over the past 2 weeks, there has been decrease in the number of AWD/Cholera cases reported in Lower Shabelle, Banadir and Lower Jubba; the regions that are affected by floods. In week ending 8th July, active transmission of AWD/cholera was reported in Kismayo district in Lower Jubba, Afgoye Kurtunwarey, Brava and Merka in Lower Shabelle as well as in 14 districts of Banadir region (Darkenly, Daynile, Hodan, Madina, Waberi, HamarWeine, Hamarjabjab, Wardhigley, Shibis,Yaqshid, Abdiaziz, Kaaran, Huruwa, and Howlwadag districts). In Kismayo, affected communities especially in Farjano IDP are reportedly using contaminated water due to floods. There was a decrease in the number of cases reported from 344 in week 26 to 151 in week 27. (WHO/Gov't, 8 Jul 2018)

The Ministry of Health of Somalia has announced 30 new cases of cholera and no deaths for week 38 (17 to 23 September) of 2018. Since week 28, there has been a decreasing trend in the number of cholera cases reported. The cumulative total of cases is 6394, including 42 associated deaths (case-fatality rate 0.7%) since the beginning of the current outbreak in December 2017...Over the past five weeks, there has been a decrease in the number of cases reported in Banadir and Lower Jubba, while during week 38 active transmission was reported in Kismayo district of Lower Jubba, and 7 districts of Banadir region (Darkenly, Daynile, Hodan, Madina, Waberi, Hamarjabjab, and Heliwa districts). (WHO, 4 Oct 2018)

There has been a consecutive weekly downward trend of suspected cases reported since week 28. The peak was 296 cases in epidemiological week 23, dropping to 18 cases in this reporting period. In week 45, active transmission of Acute Watery Diarrhoea (AWD)/cholera was reported in six districts in the Banadir region: Darkenley, Daynile, Hodan, Madina, Shibis, and Yaqsid. All cases reported this week are among the internally displaced people (IDPs). None of the reported cases had previously received the oral cholera vaccine (OCV). OCV campaigns have contributed significantly to the reduction of reported cases in the country. (WHO, 07 Dec 2018)

The current cholera outbreak started in Beletweyne in Hir-Shabelle state in December 2017. This followed heavy rains that caused flash floods and contamination of water sources in the state. The outbreak spread down the river to Middle Shabelle, Kismayo and capital Mogadishu. There has been a decline in the number of AWD/Cholera cases reported from the peak of 396 in week 23 to 30 cases in week 52.
The cholera outbreak been contained in Middle Shabelle, Kismayo and Hiraan (table 1) due to the implementation of Oral Cholera Vaccination (OCV) in these areas and other interventions, however active transmission were reported AWD/cholera 8 districts of Banadir region (Darkenly, Daynile,
Hodan, Madina, Abdiaziz, Hamarjabjab, Heliwa, Hamarweyne). ... there was increase in the number of cases reported from 26 in week 51 to 30 in week 52. in Banadir region which has a higher concentration of people living in camps where access to safe water and proper sanitation is limited. (WHO/Gov't, 07 Jan 2019)

Since epidemiological week 28, when 396 suspected cholera cases were reported, there has been a significant downward trend in the number of new suspected cholera cases reported by treatment facilities. The cumulative total of cases is 6761, including 46 associated deaths (case-fatality rate 0.68%), since the beginning of the current outbreak in December 2017 along the Shabelle River. (WHO, 08 Jan 2019)

The Ministry of Health of Somalia has announced 61 new suspected cases of cholera, with no deaths, for epidemiological week 8 (18 to 24 February) in 2019. No suspected cholera cases were reported between epidemiological weeks 1 and 7 due to closure of cholera treatment centers, from which the data is collected. The cumulative total number of suspected cholera cases since the beginning of this outbreak in December 2017 is 6509, including 45 associated deaths. During this reporting period, all of the cases were reported from 11 out of 17 districts in Banadir region, with Howlwadag, Shangani and Madina the most affected districts. Of the 61 cases reported during week 8, 59% (36) are children below 5 years of age. The cholera outbreak was contained in the districts of Jubaland, Hirshabelle and South West States following implementation of oral cholera vaccination (OCV) campaigns and other health interventions. However, active transmission is still being reported in 11 districts of the Banadir region (Darkenly, Daynile, Hodan, Madina, Abdiaziz, Hamarjabjab, Howlwadag, Kaaran, Wardigley Waberi and Shangani). (WHO, 07 Mar 2019)

A slight increase in the epidemic trend has been noted in the last two weeks. During week 11, 34 new cases were reported from Banadir Region compared to 32 cases reported in week 10 (week ending 10 March 2019). Cumulatively a total of 635 cases with no deaths have been reported since the beginning of 2019. Children under five years bear the brunt of the cholera outbreak, representing 50% of the total case load reported in week 10 and 44% in epidemiological week 11. (UNICEF, 01 Apr 2019)

The current cholera outbreak started in December 2017 following floods that affected the districts in the basins of rivers Shabelle and Jubba. As of week 16, the outbreak has been contained in 5 regions with only Banadir reporting active transmission. Since the beginning of the outbreak a total of 7,104 including 46 deaths (CFR 0.7%). However; the drought affecting many parts of the country has led to limited access to safe water and food insecurity and this is expected to lead to increased spread of cholera cases to other regions. (WHO/Health Cluster, 30 Apr 2019)

The Ministry of Health of Somalia has announced 55 new suspected cases of cholera, with no deaths, for epidemiological week 20 (13 to 19 May) in 2019. No suspected cholera cases were reported between epidemiological weeks 1 and 7 due to closure of main cholera treatment center, from which the data is collected. The cumulative total number of suspected cholera cases since the beginning of this outbreak in December 2017 is 7290, including 46 associated deaths. (WHO, 30 May 2019)

During week 25, a new cholera outbreak was confirmed in Belet hawa district of Gedo region in Southwest state. A total of 192 new cholera cases and no deaths were reported in 14 districts of Banadir region and 1 district of Gedo region. Since December 2017, a total of 7,994 cumulative cases including 46 deaths (CFR 0.6%) were reported from 3 states of Somalia (Hirshabelle, Jubbaland and South West state) and Banadir region. The first round of Oral cholera vaccination (OCV) campaign targeting 650,000 people aged 1 year and above was started on 22 June 2019 in the districts of Kahda, Heliwa, Harmajajab, Balad, Afgoi and Kismayo. (WHO, 23 Jun 2019)