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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 39: 20 - 26 September 2021
Data as reported by: 17:00; 26 September 2021
...
Cholera Mali
10 Cases
4 Death
40% CFR
EVENT DESCRIPTION
The cholera outbreak which was declared by the Malian health
authorities on 11 September 2021 continues. The epicenter of the
outbreak is currently in the health area of Labbezanga, Ansongo
health district in the Gao region. As of 19 September 2021, 10
suspected cases with two confirmed and four deaths (case fatality
ratio (CFR) = 40%), have been reported. This current CFR is high
compared to the expected ratio of <1%.
Preliminary investigations have shown that the index case was a
Nigerien male from Ayorou town in the Tillabery region in Niger
where a cholera outbreak is ongoing with nearly 5 000 cases and
151 deaths reported so far. Ayorou also borders the Malian region
of Gao. He stayed with a family in Labbezanga for two days. After
his departure, a 17-year-old girl from the host family died on 5
September 2021, from diarrhoea and vomiting which is consistent
with a clinical picture suggesting cholera.
The onset date of this event was 8 September 2021, when the
Chief Medical Officer of Ansongo health District was alerted by
Labbezanga Community Health Center of two suspected cases of
cholera received at a health facility in Labbezanga city. These two
suspected cases revealed that they were from the same home as
the 17-year-old girl who died on 5 September 2021. They suffered
an acute illness with onset on 7 September 2021. They then
sought medical care at Labbezanga Community Health Center on 8
September 2021 presenting with diarrhoea and vomiting and died
the same evening.
On 11 September 2021, cholera was confirmed with the isolation
of Vibrio cholerae Ogawa 01 at National Institute of Public Health
laboratory, the same serotype causing the ongoing cholera outbreak
in Niger and Nigeria. Among the 10 reported cases, seven cases are
female (70%) and three cases are male (30%), the male-female sex
ratio is 2.3. The 25 and over age group is the most affected with
6 cases (60%). Regarding deaths, females are more affected with
three deaths (75%) against one death for males (25%). The age
groups affected by deaths are those of 25 years and over (2 deaths),
15-24 years (1 death) and 6-14 years (1 death).
The investigation team deployed in the affected area identified
several challenges, including the need for drugs and medical
supplies for the case management, inadequate sampling kits, and
poor community surveillance.
PUBLIC HEALTH ACTIONS
Emergency meeting of the Gao regional and Ansongo health
district incident management committees was held
The Ministry of health deployed an investigation team to the
affected areas
The National Institute of Public Health laboratory is currently
collecting stool samples for confirmation of cholera
Response teams are strengthening surveillance activities at
points of entries and health facilities.
A cholera treatment unit was set up at Labbezanga health center
and assigned a medical team for case management.
Regional and local teams sensitized communities around
Labbezanga city.
SITUATION INTERPRETATION
Since 1990, Mali regularly faces cholera outbreaks occurring in the
dry season or in the rainy season. However, during the rainy season
which runs from June to October, an increase in cases is seen. The
spread of these outbreaks to a large part of the country is often along
the Niger and Senegal rivers. Insufficient access to drinking water
as well as poor hygiene conditions especially in rural areas, have
been identified as the main risk factors of cholera outbreaks in Mali.
The current outbreak is the result of cross-border transmission from
Niger where another large-scale outbreak is underway. Although still
localized, the risk of this outbreak spreading throughout the country
is high because the implementation of the effective control measures
may be impeded given the volatile security situation in the affected
area.
PROPOSED ACTIONS
It is urgent that the main gaps identified by the investigation
team be quickly addressed, by increasing the supply of
medicines and medical supplies for the case management, as
well as strengthening of surveillance, especially at the points of
entries to prevent national and regional spreads of the outbreak.
Cross-border collaboration between Mali, Burkina-Faso, and
Niger, particularly in the border regions and districts, should
be reinforced.
At the same time, in areas at risk but not yet affected,
preparedness and response plans must be developed and
implemented. Sustainable programs for access to drinking
water, sanitation and hygiene must be considered as a priority
in all areas regularly affected especially in rural areas.
AND OTHER EMERGENCIES
Week 39: 20 - 26 September 2021
Data as reported by: 17:00; 26 September 2021
...
Cholera Mali
10 Cases
4 Death
40% CFR
EVENT DESCRIPTION
The cholera outbreak which was declared by the Malian health
authorities on 11 September 2021 continues. The epicenter of the
outbreak is currently in the health area of Labbezanga, Ansongo
health district in the Gao region. As of 19 September 2021, 10
suspected cases with two confirmed and four deaths (case fatality
ratio (CFR) = 40%), have been reported. This current CFR is high
compared to the expected ratio of <1%.
Preliminary investigations have shown that the index case was a
Nigerien male from Ayorou town in the Tillabery region in Niger
where a cholera outbreak is ongoing with nearly 5 000 cases and
151 deaths reported so far. Ayorou also borders the Malian region
of Gao. He stayed with a family in Labbezanga for two days. After
his departure, a 17-year-old girl from the host family died on 5
September 2021, from diarrhoea and vomiting which is consistent
with a clinical picture suggesting cholera.
The onset date of this event was 8 September 2021, when the
Chief Medical Officer of Ansongo health District was alerted by
Labbezanga Community Health Center of two suspected cases of
cholera received at a health facility in Labbezanga city. These two
suspected cases revealed that they were from the same home as
the 17-year-old girl who died on 5 September 2021. They suffered
an acute illness with onset on 7 September 2021. They then
sought medical care at Labbezanga Community Health Center on 8
September 2021 presenting with diarrhoea and vomiting and died
the same evening.
On 11 September 2021, cholera was confirmed with the isolation
of Vibrio cholerae Ogawa 01 at National Institute of Public Health
laboratory, the same serotype causing the ongoing cholera outbreak
in Niger and Nigeria. Among the 10 reported cases, seven cases are
female (70%) and three cases are male (30%), the male-female sex
ratio is 2.3. The 25 and over age group is the most affected with
6 cases (60%). Regarding deaths, females are more affected with
three deaths (75%) against one death for males (25%). The age
groups affected by deaths are those of 25 years and over (2 deaths),
15-24 years (1 death) and 6-14 years (1 death).
The investigation team deployed in the affected area identified
several challenges, including the need for drugs and medical
supplies for the case management, inadequate sampling kits, and
poor community surveillance.
PUBLIC HEALTH ACTIONS
Emergency meeting of the Gao regional and Ansongo health
district incident management committees was held
The Ministry of health deployed an investigation team to the
affected areas
The National Institute of Public Health laboratory is currently
collecting stool samples for confirmation of cholera
Response teams are strengthening surveillance activities at
points of entries and health facilities.
A cholera treatment unit was set up at Labbezanga health center
and assigned a medical team for case management.
Regional and local teams sensitized communities around
Labbezanga city.
SITUATION INTERPRETATION
Since 1990, Mali regularly faces cholera outbreaks occurring in the
dry season or in the rainy season. However, during the rainy season
which runs from June to October, an increase in cases is seen. The
spread of these outbreaks to a large part of the country is often along
the Niger and Senegal rivers. Insufficient access to drinking water
as well as poor hygiene conditions especially in rural areas, have
been identified as the main risk factors of cholera outbreaks in Mali.
The current outbreak is the result of cross-border transmission from
Niger where another large-scale outbreak is underway. Although still
localized, the risk of this outbreak spreading throughout the country
is high because the implementation of the effective control measures
may be impeded given the volatile security situation in the affected
area.
PROPOSED ACTIONS
It is urgent that the main gaps identified by the investigation
team be quickly addressed, by increasing the supply of
medicines and medical supplies for the case management, as
well as strengthening of surveillance, especially at the points of
entries to prevent national and regional spreads of the outbreak.
Cross-border collaboration between Mali, Burkina-Faso, and
Niger, particularly in the border regions and districts, should
be reinforced.
At the same time, in areas at risk but not yet affected,
preparedness and response plans must be developed and
implemented. Sustainable programs for access to drinking
water, sanitation and hygiene must be considered as a priority
in all areas regularly affected especially in rural areas.
