News
18 June 2009
Cholera in Zimbabwe and neighbouring countries: Update
This updates the previous News item: Cholera in Zimbabwe, 6 February 2009.
The cholera epidemic in Zimbabwe that started in August 2008 has gradually come under control [1,2].
Between August 2008 and 12 June 2009, 98,531 cases of cholera and 4,282 deaths were reported from provinces throughout Zimbabwe [3].,The number of cases reported per week has fallen from a peak of 8,000 cases in February 2009 to 100 cases at the end of May 2009. The proportion of deaths (case fatality rate) has also fallen, from a peak of nearly 6% in January 2009 to 1.5% at the end of May 2009 [2].
Sporadic cases continue to occur in some areas of the country [1].
Since November 2008, cholera outbreaks have been reported from countries bordering with Zimbabwe. As of 1 June 2009, 15 cases and two deaths had been reported from Botswana, 17,761 cases and 140 deaths from Mozambique, 12,752 cases and 65 deaths from South Africa, and 8,312 cases and 173 deaths from Zambia [4]. Only one case has been reported in the UK associated with this outbreak, in a traveller who had returned from Zimbabwe in December 2008 [5].
The World Health Organization (WHO) and other international and local agencies continue to support the Zimbabwean Ministry of Health and Child Welfare’s efforts to control the outbreak through promotion of hygiene measures and facilitating access to clean sanitation and water [2]. The situation continues to be closely monitored.
Information about cholera outbreaks in individual countries can be found on the NaTHNaC Outbreak Surveillance Database.
Advice for travellers
Cholera is an acute diarrhoeal illness caused by the bacterium Vibrio cholerae serogroup O1. It is transmitted through contaminated food and water in areas of poor sanitation. Travellers should practise food and water hygiene precautions. Those at higher risk, for whom cholera vaccination is usually recommended, include humanitarian aid workers and those travelling to areas in Zimbabwe experiencing an outbreak who will have limited access to safe drinking water or medical care [6, 7].
Recommendations for cholera vaccination can be found on the NaTHNaC Country Information pages.
Before travelling to Zimbabwe, it is essential that travellers check and follow the advice given in regards to security and safety on the Foreign and Commonwealth Office website.
References
1. United Nations Office for the Coordination of Humanitarian Affairs. Cholera in Zimbabwe 16 June 2009 [Accessed 16 June 2009). Available at http://ochaonline.un.org/Default.aspx?alias=ochaonline.un.org/z
2. World Health Organization. Cholera in Zimbabwe-Update 4. 9 June 2009. [Accessed 16 June 2009]. Available at http://www.who.int/csr/don/2009_06_09/en/index.html
3. Ministry of Health and Child Welfare, Zimbabwe. Daily cholera update and alers 12 June 2009. [Accessed 16 June 2009]. Available at http://www.reliefweb.int/rw/rwb.nsf/db900sid/EGUA-7T2LSF/$File/full_report.pdf
4. United Nations Office for the Coordination of Humanitarian Affairs. Cholera outbreaks/acute watery diarrhoea, South Africa. Cumulative outbreaks and deaths by province 1 June 2009. [Accessed 16 June 2009]. Available at http://www.reliefweb.int/rw/fullMaps_Af.nsf/luFullMap/BC25F0D3
260EB89DC12575CA00494DF5/$File/map.pdf?OpenElement
5. Health Protection Agency. Imported infections, England and Wales: Oct to Dec 2008. Health Protection Report HPR Wkly [serial online] 2009; 3 (13): travel health. Available at http://www.hpa.org.uk/hpr/archives/2009/hpr1309.pdf
6. Hill DR, Ford L and Lalloo, DG. Oral cholera vaccines: use in clinical practice. Lancet Infect Dis 2006;6:361-73.
7. Salisbury D, Ramsay M, Noakes K. [eds.] Immunisation against infectious disease. 2006. Chapter 14 Cholera. Department of Health, London. Available at http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcare
Links
NaTHNaC Country Information Pages
NaTHNaC Health Information Sheet on Cholera
NaTHNaC Health Information Sheet on Prevention of Food- and Water-Borne Diseases
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