Clinical Presentation and Management for Haiti Cholera Outbreak, 2010
The Lancet Global Health, published online 18 August 2017;
http://dx.doi.org/10.1016/S2214-109X(17)30332-7
This review of the IFRC support to the Sierra Leone Red Cross Society response to the 2012 cholera outbreak provides ideas and concepts to promote a more coherent and evidence based rationale on how to make more effective use of IFRC global assets to stop, control, mitigate and respond to cholera ep...idemics. No fit and healthy person should die from cholera – that should be the indicator of success.
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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Cholera epidemics continue to be a major public health problem in many countries around the
world. When epidemics strike, they can spread rapidly. The disease can also evolve quickly;
patients with severe disease can die of dehydration hours after showing the first symptoms of
cholera.
For several years, agencies supporting preparedness and response to cholera outbreaks have supplied medicines and medical devices through the Interagency Diarrhoeal Disease Kits (IDDK).
In an effort to better align the presentation and content of the kits to field needs, the composition of the ch...olera kits has been reviewed by WHO and its partners in 2015 and again in 2020. The content of all modules have been slightly revised with no changes except for the cholera laboratory check list.
The revised cholera kits 2020 are designed to help prepare for a potential cholera outbreak and to support the first month of the initial response for 100 cases. The overall package consists of six different kits, each divided in several modules.
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Lancet Glob Health 2016; 4: e856–63. Open Access
In 2016 WHO introduced the Cholera Kits. These kits replace the Interagency Diarrhoeal Disease Kit (IDDK) which had been used for many years. The Cholera Kit is designed to be flexible and adaptable for preparedness and outbreak response in different contexts. The overall Cholera Kit is made up of a...n Investigation Kit, Laboratory materials, 3 Treatment Kits (community, periphery and central) and a Hardware Kit. The Treatment and Hardware Kits are each composed of individual modules. Each of the kits and modules can be ordered independently based on field need. To support orders, a Cholera Kit Calculation Tool was developed.
The information note, packing lists and the Kit Calculation Tool are all available from the WHO website at: http://www.who.int/cholera/kit/en/
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N Engl J Med 2018; 378:577-579; DOI: 10.1056/NEJMc1711583
A dose of oral vaccine provides effective short-term protection against cholera during an outbreak, a study in Zambia shows.
According to researchers, a shortage in the global stockpile of cholera vaccines meant that single-dose oral vacc...ination was necessary to tackle an outbreak in Lusaka, Zambia, in February 2016. The emergency vaccination campaign was implemented in April 2016, targeting more than 500,000 people in Lusaka’s overcrowded township areas.
The 2016 outbreak happened when Zambia had not reported a case of cholera in four years.
To determine the effectiveness of the single-dose cholera vaccine, the researchers enrolled 66 patients with confirmed cholera and 330 people without the disease who were neighbours of the patients.
According to the study the effectiveness of the single dose vaccination was about 90 per cent.
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Detection, confirmation and management Salmonella Typhi outbreak
CORE Group has developed a module to improve preparedness for and response of communities in countries at risk of a cholera epidemic. The module consists of four lesson plans with accompanying flipcharts, intended to be delivered through community health workers. The lessons target mothers and careg...ivers of children under age five, a group that is at particular risk of death if infected. The module shares information about symptoms and risks; what families can do to prevent infection; how, when, and where to seek care; and what actions to take in the aftermath of an outbreak.
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BMC Health Services Research (2019) 19:458 https://doi.org/10.1186/s12913-019-4315-7
World Report on the risk of cholera outbreak in Syria due to deteriorated drinking water systems as side effect of war.
Published:September 24, 2022DOI:https://doi.org/10.1016/S0140-6736(22)01836-0
The Ministry of Health (MoH) of Syria officially declared a cholera outbreak on 10 September 2022, with the majority of cases reported from Aleppo, Deir-ez-Zor and Al-Hasakeh governorates. Since the situation report issued on 26 September 2022, the number of confirmed and suspected cases continues t...o rise. A total of 13 of 14 governorates are now affected, compared with 10 during the last reporting period.
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The cholera outbreak has affected 14 countries in the WHO African Region. The climate-induced natural disasters such as cyclone and flooding in the southern African region and drought in the Horn of Africa led to increase in cases of cholera in many of the affected countries. With the rainy season c...ommencement in the west African region there is risk of more cholera outbreaks on the horizon. The trend across the region is being closely monitored and this highlights the need for Member States to enhance readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border infection. Since 1 January 2022, a cumulative number of 213 443 cholera cases has been reported to the WHO Regional Office for Africa (AFRO), including 3 951 deaths with a case fatality ratio (CFR) of 1.9% as of 16 July 2023 (Table 1). Malawi accounts for 28% (58 941) of the total cases and 45% (1 766) of all deaths reported, and together with Cameroon, Democratic Republic of the Congo, Mozambique, and Nigeria contribute to 85% (181 300) of the overall caseload and 88% (3 464) of cumulative deaths. In Epidemiologic week 28, six countries Burundi, Cameroon, Ethiopia, Kenya, Malawi and Mozambique reported a total of 667 new cases.
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More than 8,000 children under 5 years infected in North Kivu during first seven months of this year, over six times as many cases as in all of 2022
The cholera outbreak in the WHO African Region has affected 17 countries over the last two years. The are six countries categorised to be in acute crisis 1 (Democratic Republic of the Congo, Ethiopia, Mozambique, United Republic of Tanzania, Zambia and Zimbabwe). The southern region of the continen...t now in the rainy season with outbreaks now resurging. The increase in rainfall levels is now increasing floods in communities and landslides with increased for outbreaks in countries not reporting new confirmed cases. The seasonality of cholera outbreaks are issues for countries to consider and there is need to enhance preparedness and readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border transmission.
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