先日、「世界手洗いの日」に関する記事で、アフリカのギニアビサウで大規模なコレラが発生している事を記しましたが、ケニア、ナイジェリア、モザンビーク、ジンバブエなどでも広がりを見せているようです。
コレラ対策のグローバルな取り組みについては、WHOの「The Global Task Force on Cholera Control」を参照してください。
Cholera Outbreak Threatens to Become Endemic 『UN Integrated Regional Information Networks』20 October 2008
A cholera outbreak that has bridged Zimbabwe's dry season is proving difficult to contain and has spread from the cities to rural areas.
There are fears that the onset of the rainy season could make the waterborne disease endemic if the authorities fail to address the water and sanitation crisis plaguing the county.
Cholera is an intestinal infection causing acute diarrhoea and vomiting and, if left untreated, can cause death from dehydration within 24 hours. It is easily treatable with rehydration salts.
An anthrax outbreak has also been reported in Hurungwe, a rural area in Mashonaland West Province, about 300km north of the capital, Harare, "where 10 cases have been reported, but no deaths as yet. WHO [World Health Organisation] is still investigating", the UN said in a recent situation report on cholera and anthrax.
Anthrax is caused by the bacterium, Bacillus anthracis, and mostly affects wild animals and domesticated cattle, although it can be transferred to humans through inhalation of the bacteria's spores from a live or infected dead animal, blood contact if the skin is broken, or by eating the undercooked meat of a diseased animal. Anthrax is curable if diagnosed early.
120 deaths
The UN noted that "a cholera outbreak has been a cause of concern in Zimbabwe since February 2008 ... so far 120 deaths have been recorded cumulatively, with the highest percentage found in Mashonaland Central" Province in the country's north.
The collapse of health and municipal services is seen as the cause for the spread of the disease, with local authorities failing to provide potable water, rubbish collection and adequate sanitation, forcing people to dig shallow wells to obtain household and drinking water in areas where sewerage spills into streets because of poor, or non-existent, maintenance regimes.
The state-owned Zimbabwe National Water Authority (ZINWA) has pumped raw sewerage into Lake Chivero, one of the reservoirs providing Harare with water; residents with access to piped water often have to contend with a smelly greenish discharge from their taps.
The UN noted in its report that Zimbabwe was battling three cholera outbreaks in different locations. Chitungwiza, a dormitory town 35km southeast of Harare, had recorded 144 cholera cases and 15 deaths up to 13 October. UNICEF has been trucking in 30,000 litres of water daily and providing hygiene education.
In Mola, in the western district of Kariba, there were 22 cases with one fatality as of 7 October, and "probably more cases within the community, unrecognised", the UN report said.
Chinhoyi, in Mashonaland West Province, had recorded 6 deaths by 13 October, and WHO reported another 15 cases the following day, but "many more are assumed to be in the community, and paediatric cases are being admitted to the hospital."
Recurring disease
A cholera outbreak on 31 August in Harare affected the townships of Mbare, Kuwadzana, Highfields, Chikurubi and Mbvuku, in which 19 cases and one death were recorded. The last case was reported on 24 September.
Nevertheless, even where the cholera outbreaks have been brought under control, the UN report warns: "These locations remain potentially risk areas, considering cholera [is a] recurring trend."
The Combined Harare Residents Association (CHRA) said in a statement that Zimbabwe's political deadlock between President Robert Mugabe's ZANU-PF and Morgan Tsvangirai's Movement for Democratic Change was having a direct impact on the provision of services.
"The water woes that have seen many Harare residents losing their lives to cholera outbreaks are a result of the ruthless decision to hand over the administration of water and sewer services to ZINWA," the statement said.
"CHRA urges the powers that be to stop burying their heads in the sand and attend to the governance stalemate as a matter of urgency."
Cholera Outbreak Claims 10『This Day (Lagos)』9 October 2008
An outbreak of cholera in Zonkwa, Zangon Kataf Local Government Area of Kaduna State has killed about 10 people with others still on admission at the Zonkwa General Hospital.
Their situation is not made easier by the fact that the town's general hospital and the only primary health care centre where most of the victims have been taken to doesn't even have adequate drugs for their treatment.
According to eyewitness report, when THISDAY visited the area, the outbreak was noticed early September but nothing serious was done by officials of the local council then which presently resulted in the high death rate.
This allegation was corroborated by the Head of the Health Department in the local council, Mr. David Maro, who confirmed the outbreak to THISDAY and also blamed the residents of the town for adopting unhealthy and unhygienic attitudes to living.
Mr. Maro, who blamed the council chairman for being less concerned over the outbreak of the disease added that "supposing the local government had provided enough medical facilities as directed by the state governor the outbreak would have not have lasted this long."
According to him, the Governor of Kaduna State, Namadi Sambo has given the clearance for the local government to purchase hospital equipment worth about N11 million .
He disclosed that the governor has also given the approval for statutory equipment, saying all these have not been purchased now.
"If these equipment have been purchased and made available to the hospitals around the town, the treatment of these people would have been better and we would have saved so many lives," he stated.
The council chairman, Mr. Timothy Kambai who denied the allegation of not making drugs available to the hospitals in the town, however sympathized with the family of the deceased and said the local government is working hard to ensure that the medical equipment and drugs are provided in the hospitals. He also appealed to residents of the area to adopt hygienic way of living so as to minimize the occurrences of such outbreak.
Cholera Kills 12 in Cuamba『Agencia de Informacao de Mocambique (Maputo)』8 October 2008
A cholera outbreak in the town of Cuamba, in the northern Mozambican province of Niassa, has killed 12 of the 277 people diagnosed with the disease so far, according to a report in Wednesday's issue of the Maputo daily "Noticias".
The local health authorities say that, despite all the logistical support from the government and its partners, they are still facing serious difficulties in dealing with the situation, partly due to disinformation by "some political circles".
Laisson Daniel, director of the Cuamba district health services, said that the main cause of the cholera outbreak is the poor supply of drinking water in the town, together with poor hygiene habits. The outbreak began in late August, and this is the first time that Cuamba has been struck by cholera outside of the rainy season.
The town is going through a serious water crisis. "In the few rivers where one can still find some water, it is highly contaminated, but this is the only alternative for the residents, because the wells have completely dried up", said Daniel.
He added that, in order to minimise the effects of this situation, the authorities have been using tractors to transport water in tanks to supply the residents, particularly in centres with large concentrations of people, such as schools, health units, and prisons.
An average of seven people suffering from cholera are being admitted to the Cuamba Rural Hospital every day, which the authorities regard as a very high figure.
Commenting on the disinformation, Daniel said that "we have reported cases of attacks on our technicians, who have been accused of spreading cholera among the communities on the orders of the government, allegedly to test a new vaccine against cholera".
"On the other hand, people are reluctant to use the chlorine that we distribute, with the support of Doctors Without Borders (a European NGO) to disinfect water fetched from the rivers, and this contributes to worsening the outbreak", he added.
Daniel further added that the majority of the 12 deaths occurred in the areas where the disinformation is most serious.
Previous cholera outbreaks in Niassa have also seen attacks on health staff, and claims, attributed to members of the former rebel movement Renamo, that the government is deliberately spreading the disease.
Cholera Outbreak Kills Three in Kampala『New Vision (Kampala)』(25 September 2008)
Cholera has broken out in Kinawataka, a Kampala suburb in Nakawa Division. Three people, including a five-year-old child, have died in the last two weeks, the division health inspector, James Ategeka, said.
The three cases originated from Katogo zone.
Ategeka said yesterday that 29 people had reported to different health centres in the area with signs and symptoms associated with cholera.
"We are monitoring the situation closely to prevent the disease from spreading," Ategeka said.
A team from Uganda Red Cross Society has started sensitising the residents on proper hygiene.
"We are carrying out assessment and mobilising resources to see how we can respond effectively. Sensitisation is already on," the Red Cross public relation officer, Catherine Ntabadde, said.
Kampala Division medical officer Dr. Joseph Senzoga said two specimens had been taken to Mulago Hospital for tests.
Cholera normally hits different suburbs of the city during rainy seasons. The most cholera-prone areas are Kawempe, Kisenyi, Kamwokya and Kalerwe.
Last January, six people, including four from the same family, were admitted at the cholera camp in Mulago Hospital.
Facts about Cholera
Cholera is an acute, diarrhoea illness caused by a bacterial infection of the intestine. The infection can be mild or severe. About one in 20 infected people gets watery diarrhoea, vomiting and leg cramps. Rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
How cholera is spread
By drinking water or eating food contaminated with the cholera bacteria
In an epidemic, the source of contamination is usually the faeces of an infected person
The disease spreads rapidly in areas with inadequate treatment of sewage and drinking water.
Shellfish eaten raw can also be a source of cholera
The disease is not likely to spread directly from one person to another, therefore, casual contact with an infected person is not a risk.
Precautions
Drink only boiled water or that treated with chlorine
Safer beverages include tea and coffee made with boiled water and carbonated bottled beverages with no ice
Eat food that is thoroughly cooked and is still hot
Peel fruits and wash them with boiled water
Avoid undercooked, raw fish or shellfish
Make sure all vegetables are cooked and avoid raw salads.
Avoid foods and beverages from street vendors.
