14 June 2018 – The Ministry of Health of Somalia has announced 396 new cases of cholera, including one associated deaths for week 22 (28 May to 3 June) of 2018. There has been a slight upward trend in the cases. The cumulative total of cases is 4 300, including 28 associated deaths (case-fatality rate 0.7%) since the beginning of the current outbreak in December 2017. Of the 193 stool samples so far collected from six cholera treatment centers (CTCs) in four regions since the beginning of the year, 63 tested positive for Vibrio cholera.

Since the beginning of the outbreak, 20 districts in five regions have been affected: 14 districts in Banadir; one district (Jowhar) in Middle Shabelle; two districts (Beletweyne and Bulobadre) in Hiran; two districts (Afgoye and Merka) in Lower Shabelle; and one (Kismayo) in Lower Jubba. This week, active transmission of AWD/cholera was reported in three regions; Kismayo district in Lower Jubba, Afgoye, and Merka in Lower Shabelle as well as in 11 districts of Banadir region. 

Following heavy rains in Ethiopia and Somalia, flash floods have been reported in the basins of Juba and Shabelle in 4 states. An estimated 718,000 people have been affected of which 220,000 have been displaced. Floods contribute to contamination of water sources as well as disruption of health services which are precursors of cholera outbreaks. Of the flood-affected regions, cholera cases have been reported in Kismayo (146 cases) and Afgoye (24 cases) Merka (16 cases).

WHO is providing leadership and support for activities with the Ministry of Health to respond to this outbreak as well as coordinating with WASH, Health Cluster partners, and local health authorities on the planning and implementation of response activities. This includes support for: clinical care delivery; support for case management in cholera treatment centers; surveillance; deployment of rapid response teams; engagement of community health workers; provision and preposition of medical supplies; health and hygiene education in affected communities; and distribution of hygiene kits. On-the-job training was conducted for health workers in cholera treatment centres in Kismayo,Farjano, and Banadir Merka (Ayuub Health Centre, and Afgoye Hospital CTCs.