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Republic of the Congo (RC) - Declaration of cholera, shigellosis and typhoid fever epidemics in the city of Dolisie, department of Niari

Pathfinder

Editor, Senior Moderator
image.png - Click image for larger version  Name:	image.png Views:	2 Size:	32.2 KB ID:	976772

Niari, department of the Republic of the Congo
/https://en.wikipedia.org/wiki/Niari_Department

-------------------------------------------------------


Translation Google


Public health: a new epidemic breaks out in the Congo

Saturday, July 15, 2023 - 12:55 p.m.

Shigellosis, known as the dirty hands disease, broke out on July 11 in Dolisie, in the Niari department, already causing six deaths, according to a press release from the Ministry of Health and Population.

“As of July 13, 2023, 1,200 cases have been notified by health facilities in the city of Dolisie with unfortunately five deaths, i.e. a fatality rate of 0.42%. However, it appears that in the department of Pointe-Noire six cases have been notified, including one death, one case notified to the University Hospital Center of Brazzaville and two suspected cases in the department of Bouenza", according to a press release from the Ministry of Health and Population published, on July 14, in Brazzaville, by which the government offers its condolences to the bereaved families.

The same document recalls that on July 11 the health structures of Dolisie recorded patients presenting with an illness with symptoms: fever at 39° and 40°, headache, abdominal pain, vomiting and physical asthenia. Samples analyzed locally concluded that it is shigellosis, known as dirty hands disease. Confirmation by the National Public Health Laboratory is awaited.

The disease is transmitted by the faecal-oral route. Most of the time, it is direct. Water and food soiled with feces containing Shigella bacteria and flies can also transmit the disease. Symptoms include fever, nausea, vomiting, tenesmus, and usually bloody diarrhea.

The measures to observe

The Ministry of Health and Population calls for respecting general food safety practices: washing your hands regularly and correctly with soap or hydro-alcoholic gel; cook food to the correct temperature; wash raw fruits and vegetables before eating them; drink clean water from a safe source (treated or boiled); not preparing food for other people if you have suspicious signs of illness; observe good fecal hygiene. “The government is taking all the necessary measures to respond to this health emergency and urges the Congolese population to use the nearest health services, in the event of any suspected case,” the statement concluded .

https://www.adiac-congo.com/content/sante-publique-une-nouvelle-epidemie-se-declare-au-congo-149916


--------------------------------

Ministry of Health and Population CONGO
1d·
🚨COMMUNIQUE‼️🚨


On July 11, it was recorded in the health structures of the city of Dolisie, the presence of patients with an illness with symptoms: fever at 39° and 40°, headache, abdominal pain, vomiting and physical asthenia.
Samples analyzed locally concluded that it is Shigellosis known as dirty hands disease. We are awaiting confirmation from the National Public Health Laboratory.
The disease is transmitted by the faecal-oral route. Most of the time, it is direct.
Water and food soiled with feces containing Shigella bacteria
, as well as flies, can also transmit the disease.
Symptoms include fever, nausea, vomiting, tenesmus, and usually bloody diarrhea.
As of July 13, 2023, 1,200 cases have been notified by the health facilities of the city of Dolisie with unfortunately 5 deplored deaths, i.e. a lethality rate of 0.42%.

However, it appears that in the department of Pointe-Noire, six (6) cases were notified including one (1) death, one (1) case notified to the University Hospital Center of Brazzaville and two (2) suspected cases in the departments of Bouenza.

The Government of the Republic presents its condolences to the bereaved families.

To reduce the risk of contracting illness, it is important to observe the following measures:
» follow general food safety practices;
> wash your hands regularly and correctly with soap or with a hydro-alcoholic gel;
• cook food to the correct temperature;
» wash raw fruits and vegetables before eating them;
» drinking water from a safe source (treated or boiled);
> do not prepare food for other people if you have suspicious signs of illness;
• observe good fecal hygiene;
≥ go immediately to the nearest health center in the event of
any suspicion.

The Government of the Republic is taking all the necessary measures to respond to this health emergency and urges the Congolese population to use the nearest health services, in the event of any suspected case.

Done in Brazzaville, on 1 4 JULY 2023

The Minister,

...https://www.facebook.com/permalink....TNoj3Vu2aql&id=100064439332381&ref=embed_page
 
Translation Google

Dolisie – Shigellosis epidemic: Minister of State Pierre Mabiala Honorary citizen of the city donates attack drugs for the urgent response to the disease

Respond to the people's distress call with an act that reflects the outpouring of heart and generosity, the donation of medicines made by the Minister of State Pierre Mabiala, in his capacity as Honorary Citizen of the city of Dolisie , was hailed by all as an eminently responsible punch operation, for the response to the Shigellosis epidemic commonly known as dirty hands disease, related to typhoid fever and dysentery, which is raging in the town of Dolisie.

“ It is in moments of distress that one recognizes one's own, true parents, those who run to your bedside, all business ceasing, as soon as the news has reached them. »

This popular saying, which translates the features of a natural empathy, one that commands admiration, the Minister of State Pierre Mabiala has once again experienced it in Dolisie, in an equally altruistic impulse, which translates the values which he has always defended and which he wears, anchored to the body.

Present in Dolisie for a non-governmental mission and requested by the notables and then the young people of Dolisie who invited him to realize the disastrous situation induced by the epidemic of shigellosis, Pierre Mabiala on personal initiative, urgently ordered Laborex Pointe-Noire, medicines, on the basis of the treatment protocol set up by the Ministry of Health, through the Departmental Directorate of Health in Niari and the two hospitals in Dolisie, including the General Hospital and the referral hospital.

For the delivery of the donation, a sober ceremony, in the presence of the prefect of Niari, Gilbert Mouanda Mouanda and the nursing staff.

No great speeches, as if to sympathize with the pain of the sick and the afflicted, but rather acts translated by the delivery of the imposing batch of drugs, the first phase of which, that of the emergency, calls for others .

This donation is, among other products, composed of antibiotics, paracetamol, solutes, compresses and other syringes.

" We were led to make this medical donation to you, to allow the technical health team to move on to a scientifically robust response, " said Pierre Mabiala to the prefect Gilbert Mouanda Mouanda.

Receiving the gift from the hands of the prefect, Pierre Inana, Departmental Director of Health in Niari, translated its meaning and scope.

Words that expressed the hope of the patients he meets on a daily basis, but also their gratitude towards the Minister, he who knows that we have to go quickly, very quickly, because time is running out.

“ You just stepped on the accelerator, to make us go faster. Rest assured, Mr. Minister of State, that the drugs will be used wisely. »

An envelope of money, the sum of which has not been made public, accompanied the batch of drugs. This envelope is intended for the care for a period of at least ten days, of the requisitioned nursing staff.

To follow up on this dynamic of aid, the Minister Pierre Mabiala invited to a meeting, the nationals of the city of Dolisie, all the sons and all the daughters of all political tendencies, residing in Brazzaville and in the other cities of the country. , Tuesday, July 18, in the conference room of the Ministry of Land Affairs and Public Domain, responsible for relations with Parliament.
Only one point is on the agenda, creating a solidarity fund for patients affected by the epidemic, and health personnel, almost requisitioned to provide care to the sick.

Remember that for almost a week, an epidemic of Shigellosis known as dirty hands disease has been raging in Dolisie.

The disease is transmitted by the faecal-oral route. Most of the time, it is direct. Water and food soiled with feces containing Shigella bacteria, as well as flies, can also transmit the disease.

Symptoms include fever, nausea, vomiting, tenesmus, and usually bloody diarrhea.

The last government point specifies that on July 13, 2023, 1,200 cases were notified by the health facilities of the city of Dolisie with unfortunately 5 deplored deaths, i.e. a fatality rate of 0.42%.

However, it appears that in the department of Pointe-Noire, six (6) cases were notified including one (1) death, one (1) case notified to the University Hospital Center of Brazzaville and two (2) suspected cases in the departments of Bouenza.

To reduce the risk of contracting the disease, it is important to observe the following measures: follow general food safety practices; wash your hands regularly and correctly with soap or hydro-alcoholic gel; cook food to the correct temperature; wash raw fruits and vegetables before eating them; drink clean water from a safe source (treated or boiled); do not prepare food for other people if you have suspicious signs of illness; observe good fecal hygiene; go immediately to the nearest health center in the event of any suspicion.

The Government of the Republic is taking all the necessary measures to respond to this health emergency and urges the Congolese population to use the nearest health services, in the event of any suspected case.

Bertrand BOUKAKA/Echoes of Congo-Brazzaville

Posted on: July 17, 2023

https://lesechos-congobrazza.com/po...que-pour-la-riposte-urgente-contre-la-maladie
 
Translation Google

[FONT=var( --e-global-typography-primary-font-family )]DECLARATION OF CHOLERA, SHIGELLOSIS AND TYPHOID FEVER EPIDEMICS IN THE CITY OF DOLISIE, DEPARTMENT OF NIARI[/FONT]

[FONT=var( --e-global-typography-text-font-family )]
DSC01175-scaled.jpg
[/FONT]
[FONT=var( --e-global-typography-text-font-family )]Ladies and gentlemen

On July 14, the Ministry of Health and Population, in a press release, reported on the health situation in the town of Dolisie marked by a disease whose main symptoms are fever at 39°C and 40°C, headaches, abdominal pain, diarrhea, vomiting and general fatigue.
After analysis of 78 samples at the National Public Health Laboratory, the results revealed 3 types of bacteria, characteristic of the following diseases:
[/FONT]

  • [FONT=var( --e-global-typography-text-font-family )]Cholera with 15 positive samples;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]Shigellosis with 34 positive samples;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]food poisoning with 63 positive samples;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]cholera, shigellosis and food poisoning both with 11 positive samples;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]typhoid fever with 2 positive samples.[/FONT]
[FONT=var( --e-global-typography-text-font-family )]In accordance with the provisions of the International Health Regulations (IHR, 2005) of which the Republic of Congo is a signatory, the Government of the Republic declares the city of Dolisie in epidemic of cholera, shigellosis and typhoid fever.

The signs of these diseases are:
[/FONT]
[TABLE="width: 1020"]
[TR]
[TD][FONT=var( --e-global-typography-text-font-family )]Cholera: diarrhea, vomiting and general fatigue[/FONT][/TD]
[TD][FONT=var( --e-global-typography-text-font-family )]Shigellosis: abdominal pain, vomiting, fever and diarrhea with blood[/FONT][/TD]
[TD][FONT=var( --e-global-typography-text-font-family )]Typhoid fever: fever with headache, diarrhea, vomiting and abdominal pain [/FONT][/TD]
[/TR]
[/TABLE]
[FONT=var( --e-global-typography-text-font-family )]Anyone showing signs of these diseases is asked to contact an integrated health center or the nearest hospital as soon as possible for rapid treatment in order to avoid the often fatal complications.

To date, it has been recorded:
[/FONT]

  • [FONT=var( --e-global-typography-text-font-family )]1,365 suspected cases in Dolisie with 12 deaths;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]16 suspected cases in Pointe-Noire including 2 deaths;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]2 suspected cases in Mouyondzi, in the department of Bouenza;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]1 probable case in Brazzaville, deceased.[/FONT]
[FONT=var( --e-global-typography-text-font-family )] Samples of suspected cases from Pointe-Noire and Mouyondzi are being sent to the National Public Health Laboratory in Brazzaville for analysis.

Faced with this situation occurring during school holidays when the mobility of people is very important, the departments not yet in epidemic should also be on alert.

To protect themselves from these diseases, the Government invites the population to observe the following measures:
[/FONT]

  • [FONT=var( --e-global-typography-text-font-family )]wash your hands regularly and correctly with clean water and soap or by using a hydroalcoholic solution:[/FONT]
    • [FONT=var( --e-global-typography-text-font-family )]before cooking;[/FONT]
    • [FONT=var( --e-global-typography-text-font-family )]before eating ;[/FONT]
    • [FONT=var( --e-global-typography-text-font-family )]before caring for a baby;[/FONT]
    • [FONT=var( --e-global-typography-text-font-family )]after going to the toilet;[/FONT]
    • [FONT=var( --e-global-typography-text-font-family )]before and after handling food;[/FONT]
    • [FONT=var( --e-global-typography-text-font-family )]after doing some work with his hands.[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]Thoroughly cook food (meat, eggs, poultry) to at least 70°C;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]not eating uncooked foods unless they can be peeled or shelled;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]wash fruits and vegetables before consumption;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]drink potable water (treated or boiled);[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]bowel movements in the toilet and not in the open air;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]cover cooked food and store it carefully;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]keep all kitchen surfaces clean;[/FONT]
  • [FONT=var( --e-global-typography-text-font-family )]clean living quarters.[/FONT]
[FONT=var( --e-global-typography-text-font-family )]The Government reassures the population that the personnel of the Ministry of Health and Population, in collaboration with the local authorities, are hard at work on the ground to control these epidemics. The Government urges the population to use the nearest health services, in the event of any suspicious case.

THANK YOU
[/FONT]



https://sante.gouv.cg/declaration-d...ans-la-ville-de-dolisie-departement-du-niari/
----------------------------------------

Ministry of Health and Population CONGO
2h ·

The barrier measures to follow and respect, in the face of epidemics of cholera, shigellosis and typhoid fever.​

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...https://www.facebook.com/people/Ministère-de-la-Santé-et-de-la-Population-CONGO/100064439332381/
 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 29: 17 - 23 July 2023
Data as reported by: 17:00; 23 July 2023

...
All events currently being monitored by WHO AFRO
...​

Congo

Cholera/Shigellosis/Salmonellosis


Grade Ungraded
Date notified to WCO 14-Jul-23
Start of reporting period 30-Jun-23
End of reporting period 20-Jul-23

Total cases 1 856
Cases Confirmed
Deaths 27
CFR


Cumulatively, from 28 June through 20 July 2023, a total of 1 856 cases with 27 deaths are reported from five departments: Bouenza, Brazzaville, Kouilou, Niari and PointeNoire. A total of 39 cases have been operated for intestinal perforation including 28 cases from Dolisie and 11 cases from Pointe-Noire departments. Most cases are reported from Niari department with Dolisie city the epicenter reporting 1 793 cases and 18 deaths which represents 97 % of the cumulative cases reported to date.
...
https://apps.who.int/iris/bitstream/handle/10665/371956/OEW29-1723072023.pdf​
 
Translation Google


Shigellosis epidemic in Dolisie: people are leaving the city en masse for the camps and villages of Mayombe


Incredible but true ! For the past few days, many Dolisiens have been leaving the capital of green gold for the camps and villages of Mayombe to flee the epidemic of Shigellosis which continues to kill every day.

This is an opportunity to challenge the public authorities on the need to educate candidates for this exodus but also the populations of the hinterland on the measures to be taken to protect themselves against this epidemic of Shigellosis.

It is true that people leave the prefectural city of Niari (south) to try to survive. But it is also true that they claim to be safe from this virus far from the capital of green gold. Which is absolutely false.

The risk to be feared, if we are not careful, is that this exodus will promote the spread of this epidemic throughout the national territory.

Of the 1,752 cases recorded in hospitals in Dolisie, 26 have died, according to the Congolese Minister of Health and Population, Gilbert Mokoki.

It seems established that there are now local contaminations, the number of which remains to be determined.

Congolese Prime Minister Anatole Collinet Makosso was on Tuesday, July 25, 2023 at the bedside of patients who were victims of the shigellosis epidemic in Dolisie in order to provide patients and response teams with effective state support.

Germaine MAPANGA / Les Echos du Congo-Brazzaville

Posted on: July 26, 2023

https://lesechos-congobrazza.com/so...e-pour-les-campements-et-villages-du-mayombe​
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 30: 24 - 30 July 2023
Data as reported by: 17:00; 30 July 2023

...

Republic of Congo

Cholera | Shigellosis | Typhoid Fever


1 689 Cases
37 Deaths
2.2 % CFR
Ungraded


EVENT DESCRIPTION
...
On 14 July 2023, the Ministry of Health of the Republic
of Congo notified WHO regarding a cluster of cases of
unknown aetiology in Dolisie City, Niari Department. The
notification followed an observed increase in persons
presenting at local health facilities in the city with signs
and symptoms of fever, abdominal pain, headache,
vertigo, anorexia, asthenia, diarrhoea, and vomiting.
The index case in this cluster was registered on 28 June
2023.

The Directorate of Health of Niari Department
commenced an investigation of the cases following the
observed increase on 8 July 2023. From 8 to 13 July
2023, a total of 78 stool samples were collected from
case patients who presented at local health facilities in
the department and sent to the National Public Health
Laboratory for testing. The samples were subjected
to culture and microscopic examinations. Results of
laboratory analysis released on 16 July 2023 showed
bacteria isolates in 63 samples, while 15 were negative.
All 63 positive samples had isolates of Campylobacter
jejuni, a bacterium that causes a common foodborne
illness known as campylobacteriosis. Vibrio cholerae,
the pathogen that causes cholera, was also isolated
from 15 samples, while Shigella flexneri, the bacteria
causing shigellosis or bloody diarrhoea was isolated
from 34 samples. Salmonella spp, the pathogen which
causes typhoid fever, and Escherichia coli O157 were
also isolated from two stool samples respectively.
Further clinical examination also showed 61 patients
with intestinal perforations indicative of typhoid fever
infection.
Antibiotic sensitivity tests showed all bacteria
isolates were sensitive to ciprofloxacin. Except for Vibrio
cholerae, the other bacteria isolated were sensitive to
Amikacin and Gentamycin. Meropenem showed strong
activity against Vibrio cholerae isolates.

Following the release of the results of laboratory
investigation and clinical examinations, the Ministry of
Health of the Republic of Congo officially declared a
concurrent outbreak of cholera, shigellosis, and typhoid
fever in the country on 17 July 2023.

From 28 June to 29 July 2023, a cumulative total of 1
689 cases with 37 deaths (case fatality ratio 2.2%) have
been reported from five departments (Niari, Pointe Noire,
Bouenza, Kouilou, and Brazzaville) in the country. Based
on clinical diagnosis and laboratory investigations, the
cases have been disaggregated according to disease
conditions as follows: shigellosis (919 cases), typhoid
fever (705 cases), and cholera (65 cases). Dolisie City in
Niari department remains the epicentre of the outbreaks,
reporting 93.8% (n = 61) of the cholera cases, 98.0% (n =
901) of shigellosis cases, and 95.9% (n = 649) of typhoid
fever cases.

Children between 5-14 years old are the most affected
in all three disease outbreaks, constituting 18% of the
cholera cases, 43% of the cases of shigellosis, and 31%
of typhoid fever cases. Sex distribution of the cases
showed that females appear to be the most affected by
cholera and typhoid, accounting for 61% and 52% of
the respective cases. Conversely, males show a slightly
higher incidence in the shigellosis outbreak, constituting
51% of the total cases for this particular disease.

The current outbreak is suspected to have originated
in early June 2023 among primary school students who
were exposed to contaminated food and drinks sold by
street vendors during the national examination period
.

PUBLIC HEALTH ACTIONS

The Ministry of Health of Congo officially declared the
outbreak on 17 July 2023, emphasizing the importance
of early detection, confirmation, and management of
cases.

An outbreak management team involving the Ministry
of Health, WHO and partners have been set up to
coordinate response to the event. Daily meetings
of the team are being held to assess the event and
coordinate technical and operational support to the
response.

Health workers at the facility and community levels in
the affected departments have been orientated with
the case definitions as part of enhanced surveillance
for the early detection of cases. Case investigation
activities are also ongoing.

Samples are being routinely collected from suspected cases and sent to the National Public Health Laboratory in
Brazzaville for testing.

Case management activities are ongoing at local health facilities in the affected departments. Additional clinicians
have been deployed to manage cases, including the provision of surgical services for those with intestinal
perforation. Drugs and other medical supplies have been dispatched to facilities in the affected department to
enhance the clinical management of cases.

Risk communication activities have been scaled up in the affected areas. Local non-government organizations
are also involved with community engagement activities, including town hall meetings to create awareness and
promote preventive practices in the affected areas.

SITUATION INTERPRETATION

The occurrence of concurrent outbreaks of cholera, shigellosis, and typhoid fever, along with co-infections among
case patients, is unusual and concerning, requiring further investigation. The high number of cases with intestinal
perforation indicates a severe form of typhoid fever, demanding close monitoring and appropriate management.

Health authorities in the Republic of Congo need to implement a comprehensive and multidisciplinary response,
including active surveillance, epidemiological investigations, early case management, improved hygiene measures,
and effective communication strategies to control the spread of infections and mitigate their impact on public health.

https://apps.who.int/iris/bitstream/handle/10665/372200/OEW30-2430072023.pdf


 
WHO - Suspected triple outbreak of typhoid fever, shigellosis and cholera - Congo. 21 September 2023

21 September 2023

Situation at a glance

The Ministry of Health and Population (Ministère de la Santé et de la Population - MSP) of the Republic of the Congo, declared on 17 July 2023 a suspected triple outbreak of gastroenteritis, with typhoid fever, shigellosis, and cholera as probable causes.

Since the first case was reported on 28 June 2023, and as of 29 August 2023, a total of 2389 suspected cases have been reported, including 52 deaths (overall Case Fatality Rate (CFR) 2.2%).

Laboratory analyses performed by the National Public Health Laboratory, identified 83 cases of Shigella, 22 of Salmonella Typhi (S. Typhi) and 21 cases of Vibrio cholerae with toxigenicity testing of the strain not performed.

The city of Dolisie, the capital of Niari Department in the western part of the country is the epicentre of this outbreak.

With WHO support, the MSP has activated a multisectoral coordination mechanism, strengthening surveillance, laboratory and clinical care capacities, and implementing decontamination and risk communication activities. An in-depth epidemiological investigation is also being led by the MSP.

WHO assesses the risk posed by this triple outbreak as high at the national level, moderate at the regional level and low at the global level.

Description of the situation

On 14 July 2023, the Ministry of Health and Population of the Republic of the Congo reported 1384 cases whose dominant symptomatology was fever (39°C and 40°C), headaches, abdominal pain, diarrhoea, vomiting, and fatigue.

On 17 July 2023, the MSP officially declared a suspected triple outbreak of gastroenteritis, with typhoid fever, shigellosis, and cholera as probable causes.

The first case of the outbreak was reported on 28 June 2023. Since then, and as of 29 August 2023, a total of 2389 suspected cases have been reported, including 52 deaths (overall CFR 2.2%). Suspected typhoid fever cases accounted for 50.2% (n=1200) of all cases, followed by shigellosis (46.9%; n=1120) and cholera (2.9%; n=69).

Eighty-eight (3.7%) of the suspected cases have undergone emergency surgery due to an intestinal perforation, a complication known to occur in untreated typhoid fever.

The city of Dolisie - the capital of Niari Department with a population of more than 110 000 inhabitants - is the current epicentre of this outbreak, with 2178 suspected cases (91.2% of all cases) and 33 deaths (CFR 1.5%) reported for all three infectious diseases combined. ...

https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON488

 
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