Cameroon - Cholera outbreak 2021- 2023

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Douala. Cholera outbreak kills 4 inmates at New Bell prison

dailynews cameroon by dailynews cameroon March 28, 2022 in french

Thirty positive cases have been recorded there since March 21, 2022

New-Bell Central Prison officially recorded its first cholera deaths on Friday March 25, 2022. This is at least what our prison and health sources at Laquintinie Hospital in Douala claim. In detail, three died last Friday and on Saturday 26. This makes a total of four detainees killed by the disease which has been raging in Cameroon for five months. A crisis meeting was held yesterday with the officials of the penitentiary and those of the regional delegation of public health for the Littoral.

According to the latest figures, around thirty positive cases have been declared in this penitentiary. “The first cases were detected on Monday evening (March 21: Editor's note). We immediately referred them to the Laquintinie hospital” , informs our source close to the file within this prison. In fact, “The first cases were mentally ill people who fed on the trash ,” explains this one. It was therefore enough to trigger the epidemic in these places. Since then, our source says that the medical staff of this prison is hard at work to contain the epidemic.

Last Wednesday for example, “The whole prison, that is to say offices and cells, was disinfected with the help of the Regional Delegation of Public Health for the Littoral ”, we learn. Also, “We continue to raise awareness, apply strict hygiene measures and sanitation has been redoubled. Seals and chlorine were **** at all the entrances to the prison , ”lists the aforementioned source.

It should be noted that the central prison of Douala has more than 4,500 detainees for an initial capacity of 800 detainees. If a focus of the epidemic were to settle there, it would be worrying. Of the 5 regions in epidemic in Cameroon, that of the Littoral is the 2nd most affected, after the South-West. Thus, between March 21 and 24, this region recorded 46 new cases, according to official figures.

https://dailynewscameroon.com/douala-lepidemie-de-cholera-tue-4-detenus-a-la-prison-de-new-bell/

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 15: 4 – 10 April 2022
Data as reported by: 17:00; 10 April 2022
...

Cholera Cameroon

3 407 cases
83 Deaths
2.4% CFR

EVENT DESCRIPTION

Cameroon began experiencing increasing reports of cholera since
2021 and declared an outbreak in the last week of October 2021,
however cases have continued to increase into 2022. Between 29
October 2021 through 27 March 2022, at total of 3 407 cases and
83 deaths (CFR 2.4%) have been reported from South-West (2 570,
75.4%), Littoral (551, 16.2%), South (184, 5.4%), Centre (87, 2.6%),
Far North (8, 0.2%), and North (7, 0.2%) regions. The national attack
rate during the reporting period is 1.7 cases per 10 000 population in
a country estimated to have 20.5 million people in 2022.

Currently, there are five regions with active outbreaks including
Centre, Littoral, North, South, and South-West. During the reporting
period, at least 531 samples have been tested and 168 cultures are
positive with Vibrio cholerae O1 Ogawa as the dominant strain.
In South-West, the most affected region, Limbe district has reported
the highest number of cases during the reporting period accounting
for 48.2% (1 238) of all cases in the region. However, Bakassi district
has reported the highest case fatality rates at 3.5% and attack rates
at 94.1 cases per 10 000 people. Limbe is relatively close to the
commercial area of Douala and could pose a threat to spread in the
city, while Bakassi district is located along the Nigerian border which
is characterised by frequent cross-border movement.

In 2021, only sporadic cases were reported for the majority of the
year, but cases increased at the end of October (week 43 of 2021)
primarily affecting the South-West, Centre, and Littoral regions.
Regarding Centre region, the cholera outbreak seemed to have been
contained by November 2021 only to flare up again in week 9 2022
(ending 6 March) and since week 12 (ending 27 March), 31 cases
have been reported in the capital of Yaounde. In Littoral region,
notable outbreaks associated with a known water source occurred
in Njombé district affecting more than 100 people as well as in New
Bell prison during week 12 (ending 27 March 2022) affecting more
than 100 prisoners in the facility.

Poor healthcare seeking remains a challenge as many people
prefer to get treatment from traditional healers due to the lack of
transportation. More than 30% of all cases in Littoral and SouthWest
regions have been classified as severe, potentially meaning that there
is delayed detection or poor case management in these regions.

There have also been problems with communicating awareness
about cholera in the communities affected. Certain regions have low
capacity for cholera case management in their facilities due to the
lack of resources for medical care which increases the risk of poor
health outcomes for cholera patients.

Additionally, Cameroon continues to experience conflict and
movement of internally displaced persons (IDPs) predominantly in
the affected region of South-West, but also in other regions that have
not been substantially affected by the current cholera outbreak such
as in Far North and North regions.

PUBLIC HEALTH ACTIONS

The national incident management system holds regular
coordination meetings with its partners to support district
teams.

A costed response plan was created by the Ministry of Health
and includes response partners.

An international order for cholera kits was launched to aid the
response.

Advocacy meetings are held with local and international
partners for their continued support with the response including
humanitarian actors working in areas of conflict.

The first round of cholera vaccination campaign was completed
and the second round has been planned for April 2022.

Response teams were deployed to major outbreak sites to
supplement the response and conduct investigations.

Decontamination of outbreak sites such as prison facilities and
households of confirmed cases have been conducted.

Surveillance activities have been strengthened for active case
searching and patient referrals in affected districts.

Community members and leaders were trained on hand
washing, purification of water and disinfection of homes and
public spaces.

SITUATION INTERPRETATION

The cholera outbreak in Cameroon that began surging in late October
2021 has deteriorated to even higher levels in March 2022. The
regions have faced challenges of insecurity in some areas, high
population movement of IDPs, as well as health system problems to
combat the outbreak such as low diagnostic capacity, rejections of
patients at health facilities, and low risk communication for cholera.
The country is conducting cholera vaccination which should aid in
the decreasing of cases but will need to be supplemented by more
successful interventions in order to control the outbreak.

PROPOSED ACTIONS

Further develop a case management strategy for cholera in the
country to improve health services at various levels. Severe
health outcomes and deaths can be prevented if access to
healthcare is improved.

Enhance risk communication methods to increase awareness on
cholera and prevent delayed healthcare seeking.

Improve access to safe water and sanitation, conduct proper
waste management, promote food safety and hygiene practices.

Build laboratory capacitation and logistical facilitation networks
at lower levels to shorten diagnostic turnaround times.

View/Open

OEW15-0410042022.pdf (2.192Mb)

https://apps.who.int/iris/handle/10665/353065

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Source: https://www.plenglish.com/news/2022/...lera-epidemic/


English-speaking region of Cameroon suffers cholera epidemic
April 17, 2022
CDT10:57 (GMT) -0400
Published by: Alina Ramos Martin

Malachie informed that so far 4,627 cholera cases with 105 deaths have been reported throughout the country, with the greatest impact in the English-speaking regions of Bamenda and Buea.

Cholera was accentuated by the spread of Covid-19. It is a shocking situation in a disturbed state like ours. Cameroon should review its national health policy in case of crisis, he said.

The disease aggravates the situation in the area, which since 2017 has been experiencing a deadly conflict rooted in colonization by the French and British governments, and the two languages that came with it, French and English...

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Source: https://www.who.int/emergencies/dise...em/2022-DON374


Cholera - Cameroon

16 May 2022



Outbreak at a glance

Cameroon is among several countries in West and Central Africa experiencing recurrent cholera outbreaks. Between 29 October 2021 and 30 April 2022, a total of 6652 suspected cases including 134 deaths (case fatality ratio 2%) have been reported.

Several risk factors can be attributed to the ongoing cholera outbreaks in Cameroon, including wide circulation of Vibrio cholerae in the country, limited access to safe drinking water in some areas, a seasonal pattern of cholera occurrence and inadequate WASH conditions.

Description of the outbreak

Cameroon has been reporting suspected cases of cholera since the beginning of 2021. The outbreak was declared by health authorities on 29 October 2021 and has been ongoing since then. As of 30 April 2022, 6652 suspected cases of cholera including 134 deaths (CFR 2%) have been reported from six regions - the South-West (4617 cases, 77 deaths), Littoral (1704 cases, 51 deaths), South (183 cases, two deaths), Central (125 cases, four deaths), North (15 cases, no death) and Far North (eight cases, no death) regions. Of the 6652 suspected cases, 5960 cases (90%) including 93 deaths (69%) have been reported in 2022. Between 29 October 2021 and 30 April 2022, a total of 1008 stool samples were tested from all six regions and 40 % (403) were confirmed positive for Vibrio cholerae O1 by culture.

Although the cholera outbreak started in late October, the number of weekly suspected cases increased from less than 200 in week nine of 2022 (ending 6 March) to 1262 in week 12 (ending 27 March). The overall CFR reported so far in 2022 (CFR 2%) is lower than CFR reported in 2021 (CFR 3.6%), however, it remains higher than the CFR of 1% expected during a cholera outbreak when timely treatment is available. Furthermore, the Central and Littoral regions continue to report high CFRs (CFR 2.9% and 3%, respectively).

While two regions, Central and South-West, reported cases of cholera in 2021, there has been a geographical expansion of the outbreak to five regions (Central, Littoral, North, South, South-West) since March 2022.

As of 30 April, the South-West region continues to be the most affected region with 4617 cases (69%) including 77 deaths (CFR 1.6%), of which 4069 cases (88%) were reported in 2022. Littoral is the second most affected region with 1704 (26%) cases and 51 deaths (CFR 3%), including 1684 (99%) cases reported in 2022.
Figure-1: Epi curve of cholera cases by date of symptom onset and outcome, Cholera, from 29 October to 30 April (n=6652)

Note: SE corresponds to Epidemiological week. Also, SE 41 to SE 52 corresponds to 2021 while SE1 to SE17 to 2022.
*CEN: Central region; LIT: Littoral region; EN: Far North region; NO: North region; SU: South region and SW: South-West region.
Figure 2: Distribution of cholera cases in Cameroon, from 29 October 2021 to 30 April (n=6552)Epidemiology of Cholera

Epidemiology of Cholera
Cholera is an acute enteric infection caused by ingesting the bacteria Vibrio cholerae present in contaminated water or food. It is mainly linked to insufficient access to safe drinking water and inadequate sanitation. It is an extremely virulent disease that can cause severe acute watery diarrhoea resulting in high morbidity and mortality, and can spread rapidly, depending on the frequency of exposure, the exposed population and the setting. Cholera affects both children and adults and can be fatal if untreated.


The incubation period is between 12 hours and five days after ingestion of contaminated food or water. Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people. Among people who develop symptoms, the majority have mild or moderate symptoms, while a minority develop acute watery diarrhoea with severe dehydration. Cholera is an easily treatable disease. Most people can be treated successfully through prompt administration of oral rehydration solution (ORS).

Cholera can be endemic or epidemic. A cholera-endemic area is an area where confirmed cholera cases were detected during the last three years with evidence of local transmission (cases are not imported from elsewhere). A cholera epidemic can occur in both endemic countries and in non-endemic countries.

The consequences of a humanitarian crisis – such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps – can increase the risk of cholera transmission, should the bacteria be present or introduced. Uninfected dead bodies have never been reported as the source of epidemics.

A multifaceted approach including a combination of surveillance, water, sanitation and hygiene, social mobilization, treatment, and oral cholera vaccines is essential to control cholera outbreaks and to reduce deaths.




Public health response

WHO has deployed teams of experts to support the response and is providing technical, logistical and financial support to the government. In addition,

• The national incident management system is conducting regular coordination meetings with partners at the central and regional levels to support district teams.
• A response plan was developed by the Ministry of Health and includes response partners.
• Cholera kits have been provided to aid the response.
• Advocacy meetings continue to be conducted with local and international partners.
• Response teams were deployed to major outbreak sites to support the response activities and conduct investigations.
• From 18 to 23 February, the first round of an oral cholera vaccine (OCV) campaign was organized in four health districts in South-West region. This campaign targeted 204 800 people with 85.5% administrative coverage. The vaccination campaign was extended to 11 more districts in the Littoral, South and the South-West Regions from 8 to 12 April 2022, targeting 842 086 people with an administrative coverage of 89%. This was combined with WASH interventions including distribution of water purification tablets (Aquatabs).
• Mass chemoprophylaxis with OCV was performed in a prison region where a cholera outbreak was reported in late March.
• Surveillance activities have been strengthened for active case finding and patient referrals in affected districts.
• Decontamination of outbreak sites and households of confirmed cases have been conducted.
• Community members and leaders were trained on hand washing, purification of water and disinfection of homes and public spaces.

WHO risk assessment

Cameroon is among several countries in West and Central Africa experiencing recurrent cholera outbreaks. Several risk factors including circulation of Vibrio cholerae especially in the North, Littoral, Central, and South-West regions, limited access to safe drinking water in some areas including in the capital city of Yaoundé, as well as cultural practices that contribute to unsafe WASH conditions exist in the country. There is a seasonal pattern of cholera occurrence in Cameroon that varies by region. In South-West and Littoral, currently the most affected regions, cholera is most often reported during the rainy season (November - April) or the transition between the rainy and the dry season. In the Central region, cholera is more frequently reported during the rainy season that occurs in May-June and October-November. The ongoing rainy season may increase the likelihood of further transmission in the country.

In addition, some affected areas of the country are insecure which further reduces the access to services making outbreak response more complex.

The cholera outbreak began surging in late October 2021, deteriorated further in March 2022 with the South-West region reporting 70% of cases. Limited geographic accessibility of some areas, security constraints, and suboptimal communication networks lead to irregular epidemiological updates and potential underreporting of cases. Additionally, high population movement of Internally Displaced Persons (IDPs), weak health system, insufficient human resources, poor knowledge of treatment protocols and low risk communication for cholera continue to pose challenges.

Furthermore, in the northern areas, Cameroon is bordered by Adamawa, Borno and Taraba states of Nigeria and there is frequent and substantial cross border movement posing a risk of transmission. There is also a risk of further international spread especially to the Republic of Chad which borders both Nigeria and Cameroon.

The country is conducting cholera vaccination which should help contain the outbreak, however, additional efforts supplemented by other interventions including access to adequate treatment and clean water are needed in order to control the outbreak.



WHO advice

WHO recommends improving access to clean water and sanitation, good waste management, food safety practices and hygienic practices to prevent the transmission of cholera. Oral cholera vaccines should be used in combination with improvements in water and sanitation to control cholera outbreaks and for prevention in areas known to be high risk for cholera.
Strengthening surveillance, especially at the community level, is advised. Appropriate case management, including improving access to care, should be implemented in outbreak-affected areas to reduce mortality. There is a need to ensure that countries are ready to quickly detect and respond to this cholera outbreak to reduce the risk of spread to new areas. Setting up oral rehydration points (ORPs) in communities is also critical to provide early management through oral rehydration, screening and referral of patients. As the outbreak is occurring in border areas where there is significant cross border movement, WHO encourages the respective countries to ensure cooperation and regular information sharing.
International travel or trade: WHO does not recommend any restriction on travel and trade to and from Cameroon based on the information available on the current outbreak...

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 21: 16 – 22 May 2022
Data as reported by: 17:00; 22 May 2022
...
All events currently being monitored by WHO AFRO
...

Cameroon Cholera Grade 2

Date notified to WCO 1-Jan-21
Start of reporting period 25-Oct-21
End of reporting period 23-May-2022

Total cases 7 287
Cases Confirmed 413
Deaths 140
CFR 1.9%

From 25 Oct 2021 to 13 May 2022, a total of 7 287 suspected cases of cholera including 413 confirmed by culture and 140 deaths (CFR 1.9%) have been reported in Cameroon, from South-West (4 979 cases, 80 deaths; CFR 1.6%), Littoral (1 967 cases, 53 deaths; CFR 2.7%), South (182 cases, two deaths; CFR 1.1%), Centre (125 cases, four deaths; CFR 3.2%), Far-North (8 cases, no death), and North (26 cases, one death; CFR 3.8%) regions. The outbreak is currently active in three regions (Littoral, North and South-West) and 11 districts, out of the 30 that have already reported a suspected cholera case since October 2021.

https://apps.who.int/iris/bitstream/handle/10665/354552/OEW21-1622052022.pdf

https://www.afro.who.int/countries/mozambique/publication/outbreaks-and-emergencies-bulletin-week-21-16-22-may-2022

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Source: https://www.barrons.com/news/resurge...144707?tesla=y


Resurgence Of Cholera Kills 150 People In Cameroon
By AFP - Agence France Presse
June 13, 2022

More than 150 people have died during a resurgence of cholera in Cameroon over the last eight months, the United Nations said on Monday.

"The health ministry registered 8,241 cases and 154 deaths," to the end of May, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) said.

Seven of the West African nation's 10 regions have reported cholera cases.

The worst-hit is the English-speaking Southwest with 5,628 cases and 90 deaths, followed by the Littoral with 2,208 cases and 58 deaths, OCHA said...

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Translation Google

Cameroon: the cholera epidemic claims its first victims in the East region

19 Jul 2022 by Martin Atcha

The first cases of the cholera epidemic have been reported in the East region of Cameroon.

Until then spared, the Eastern region recorded its first cases of cholera. According to Radio Balafon, which quotes a press release from Grégoire Mvongo, governor of the East, three suspected cases including one death have been reported in the health district of Abong-Mbang, department of Haut-Nyong.

These are cases from the same family residing in the village of Mampang, a locality in the commune of Doumé. In order to contain the epidemic in this part of the country long spared, the administrative authorities of the region have activated the health alert system.

For his part, the Regional Public Health Delegate instructed all health district heads to strengthen epidemiological surveillance at all levels and in all reporting platforms, and to intensify community awareness on preventive measures. cholera, says the media.

The Southwest and Littoral regions are the most affected by this epidemic which continues to spread. Seven regions are now affected with more than 164 dead.

https://actucameroun.com/2022/07/19/cameroun-lepidemie-de-cholera-fait-ses-premieres-victimes-dans-la-region-de-lest/

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 32: 1 - 7 August 2022
Data as reported by: 17:00; 7 August 2022
...
All events currently being monitored by WHO AFRO
...
Cameroon Cholera Grade 2

Date notified to WCO 1-Jan-21
Start of reporting period 25-Oct-21
End of reporting period 3-Aug-22

Total cases 10 348
Cases Confirmed 904
Deaths 200
CFR 1.9%

Between 25 July and 3 August, 172 new suspected cases of cholera including three deaths have been reported from four active Regions (Centre, East, Littoral and West). As of 3 August 2022, 10 348 suspected cases including 200 deaths (CFR 1.9%) have been reported since October 2021, from eight Regions and 48 Districts of which 27 remain active. South-West (6 010 cases) and Littoral (3 581 cases) Regions have reported majority of cases. Of note, it has been 18 days without a case
notified in South-West.

https://apps.who.int/iris/bitstream/handle/10665/361525/OEW32-0107082022.pdf?sequence=1&isAllowed=y

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Source: https://news.cgtn.com/news/2022-10-1...mkE/index.html

Africa 07:19, 19-Oct-2022
Cholera outbreak kills 10 in Cameroon's Far North region
CGTN

Authorities in Cameroon's Far North region on Tuesday declared an outbreak of cholera after recording at least 10 deaths arising from the disease.

A total of 113 suspected cases of cholera had been recorded as of Monday, the official media outlet CRTV reported, quoting the region's Governor Midjiyawa Bakari as saying. Bakari made the disclosure during a crisis meeting held Tuesday in Maroua, the region's capital...

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Cholera: the Far North on alert, as the number of deaths increases

RELEASED ON TUESDAY, 25 OCTOBER 2022 12:40

The governor of the Far North, Midjiyawa Bakari (photo), convened a crisis meeting on October 17 in Maroua to deal with a new outbreak of cholera raging in the region. The administrative authority attributed this resurgence of the disease to poor local sanitation and invited all the forces to take the necessary measures to stop the spread of the epidemic.

He asked the mayors to revitalize the public awareness campaign on hygiene and sanitation measures. The regional delegation of Public Health has been instructed to strengthen epidemiological surveillance, while the regional delegation of Water and Energy must quickly make drinking water available to residents and coordinate services sanitation to avoid the transmission of the cholera vibrio. According to local health authorities, this new cholera epidemic has been raging since the beginning of the current month and is imported from neighboring Nigeria.

At least 176 cases have already been recorded, including 11 deaths. The Regional Public Health Delegate, Dr. Hamadou Bava Boubakary, said that 9 deaths have been recorded in the community, notably in Magdémé in the Mora health district in the Mayo-Sava department, reports Cameroon Tribune .in its current edition. The other two deaths, he said, were recorded at the Minawao refugee camp health center in Mokolo health district, Mayo-Tsanaga department. The United Nations High Commissioner for Refugees (UNHCR) said on Thursday October 19 that three deaths had been recorded in the camp. The UN agency then indicated that efforts are also underway to urgently intensify existing awareness campaigns on cholera and good hygiene practices in Minawao.

https://www.stopblablacam.com/societe/2510-9554-cholera-l-extreme-nord-en-etat-d-alerte-alors-que-le-nombre-de-morts-augmente