Weekly Cholera Report

SIXTEENTH [16th] EPIDEMIOLOGICAL WEEKS

16- 22th February, 2015

Prepared by:

Epidemiology Unit

Community Health Sciences Unit

Ministry of Health

Private Bag 65,

Lilongwe

Tel: 01 757 205

Fax: 01 757 205

Introduction

First week of November every year is the beginning of a cholera season (agreed by National Epidemic Committee on 21st October 2009). For 2014/15 cholera season started on the week of 3 – 9th November 2015,

Malawi is now registering cholera cases since 11th February 2015 in Nsanje district. As of 22nd February 2015 which is 16th Epidemiological week (16 -22th February 2015) Malawi has registered 30 cases with 2deaths. One death occurred at the community. The affected districts are Nsanje (25 cases, 2 deaths) and Mwanza (5 cases, 0 death). In Nsanje cases are being imported from an outbreak at Jambawe illegalGold Mine in Mutarare district, while in Mwanza they are from Moartize in Mozambique. For details See the cholera table .

Need for health services for displaced people in camp

Cholera preparedness

Almost all districts prepositioned their supplies in November, 2014 but most of the supplies has now diminished. There is need for more assistance in readiness for any outbreak which may occur. Priority should be given to floods affected districts and cholera prone areas.

.

Partnerships.

Partners are highly involved in several areas such as health promotion, construction of sanitary facility in camps, establishments of treatment camp in cholera affected districts although they is no proper coordination between DHO office and some NGOs

Rumours of outbreak

See the table what the districts has report items of rumours

Rumour / Date of the event / District / Investigation / Findings / Comments
1 / 39 suspected cases of Cholera / 16/02/2015 / Chikwawa / District Rapid response team was sent / No case of case was found / continue surveillance
2 / 5 suspected case of typhoid fever / 14/02/2015 / Mchinji / District Rapid response team was sent and four samples collected / Two samples were positive (salmonela typhi) / continue active surveillance, IEC, and water chlorination
3 / 8 suspected cases of dysentary / 18/02/2015 / Phalombe / District Rapid response team was sent / Diarrhoea cases were observed among u/5. Most of them was due to hunger as the people from camp are surviving from pumpkin and beans leaves. The camp has not yet received any food item since establishment. / Need for urgent food supply,
Continue active surveillance, IEC, and water chlorination
4 / 12 suspected cases of shigella / 17/02/2015 / Zomba / District Rapid response team was sent and 1 sample collected / Pending lab results / continue active surveillance, IEC, and water chlorination
5 / 11 suspected cases of Typhoid fever / 19/02/2015 / kasungu / District Rapid response team and national were sent and 9 samples collected / Seven samples were positive (salmonela typhi) while two are Pending for lab results / continue active surveillance, IEC, and water chlorination
Cholera
Weekly Cholera Summary Per District and Per Zone - 2014 - 2015
ZONE / DISTRICT / Reporting Week / Cases reported to date (Cumulative) / LAB RESULTS
16/02/15 - 22/02/15 / 03/11/14-22/02/15
CASES / DEATHS / CASES / DEATHS / CFR(Cum) / (+)Ve / (-)Ve
South East / Mangochi / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Zomba / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Mulanje / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Phalombe / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Balaka / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Total / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
South West / Blantyre / 0 / 0 / 0 / 0 / 0 / 0 / 0
Chikwawa / 0 / 0 / 0 / 0 / 0 / 0 / 0
Thyolo / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Nsanje / 7 / 1 / 25 / 2 / 8 / 3 / 1
Mwanza / 5 / 0 / 5 / 0 / 0 / 1 / 1
Chiradzulu / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Neno / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Total / 12 / 1 / 30 / 2 / 0.069 / 4 / 2
Central East / Ntcheu / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Dedza / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Lilongwe / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Mchinji / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Total / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Central West / Kasungu / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Nkhotakota / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Dowa / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Salima / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Ntchisi / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Total / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
North / Likoma / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Chitipa / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Mzimba South / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Mzimba North / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Nkhata Bay / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Rumphi / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Karonga / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
Total / 0 / 0 / 0 / 0 / #DIV/0! / 0 / 0
NATIONAL TOTAL / 12 / 1 / 30 / 2 / 6.67 / 4 / 2

Most cholera cases registered in Malawi propagated from Mozambique as they have a history of visiting Mozambique which has been heavily affected by cholera at almost areas that surround us although few cases has got it from relatives who visited Mozambique.

Action taken

·  Treatments tents have been erected in all health facilities that are receiving cases.

·  The treatment sites has adequate supplies

.

Typhoid Fever

Some districts has confirmed cases of typhoid fever such as Mchinji at Guillime and Kasungu. Kasungu has sporadic cases as it has been reported in several areas. (Kasungu prison, Santhe and Mwalwanyenje area)

District / Cummulative cases / Death
Mchinji / 44 / 0
Kasungu / 86 / 0
Total / 130 / 0

Action taken

·  Health promotion has been intensified

·  Pot to pot chlorination

General issues that require attention

In order to make ensure we are safe against diarrhoeal outbreaks, the following ought to be done or strengthened immediately:.

·  Regular Epidemic Management Committee meetings at all levels (National and District).

·  Need to strengthen surveillance by training health workers on IDSR

·  Need for coordination meeting at both national and district level.

·  Enhanced health education in all districts (sensitization meetings etc)

·  Adequate stocks and prepositioning of cholera supplies in both flood affected districts and cholera prone districts ( diarrhoeal treatment and non treatment supplies)

·  Briefing of health workers on cholera case and camp management as well as cholera prevention and control in order to reduce case fatality rate

·  Regular supportive supervision to flood affected and cholera prone districts on diarrhoeal disease prevention and controls.

·  Continue weekly reporting at all levels

2