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Outbreak update – Cholera in Somalia, 27 September 2018

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27 September 2018 – The Ministry of Health of Somalia has announced 34 new cases of cholera including one death for week 37 (10 to 16 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 6364, including 42 associated deaths (case-fatality rate 0.7%) since the beginning of the current outbreak in December 2017. Of 267 stool samples collected since the beginning of this year and tested in the National Public Health Laboratory in Mogadishu, 80 tested positive for Vibrio cholerae, serotype O1 Ogawa. 
The cholera outbreak started in December 2017 in Beletweyne along river Shabelle and has spread to Jowhar, Kismayo, Afgoye Merka and Banadir. For the past eight weeks, cholera cases have been localized in Lower Jubba and Banadir region. 
In week 37, active transmission of AWD/cholera was reported in Kismayo district in Lower Jubba, as well in 10 districts of Banadir region (Darkenly, Daynile, Hawlwadag, Hodan, Madina, Waberi, Hamarjabjab, Karaan, Abdilaziz, and Yaqshid districts). Banadir accounts for 88% (30) of the newly reported cases, and also has the highest concentration of IDPs living with limited safe water and sanitation. Among them, 30% are children below 5 years old. The oral cholera vaccination campaign that was implemented in 10 high risk districts in 2017 and 2018 across Somalia has greatly contributed to the reduction in the number of new cholera cases compared to the same period in 2017. 
WHO continues to provide leadership and support for activities with the Ministry of Health (MoH) to respond to this cholera outbreak, including case management, surveillance and laboratory investigations and water sanitation, hygine (WASH) and risk communication. This week, on the job training for health care workers were conducted in cholera treatment centers in Kismayo, Farjano, Banadir and Marka. Disease surveillance data has been collected from 415 health facilities across the country through early warning alert and response network (EWARN). This surveillance system was re-established in 2017 with support of WHO, and contributes to early detection of cases as well as prompt response to outbreaks, by using an electronic platform. 

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