Rise in water-food borne Cholera case prompts national emergency in Sierra Leone

Cholera infection begins in the small intestines, caused by bacterium Vibrio cholera (a comma-shaped bacterium). Symptoms start with watery diarrhea and vomiting. Transmission occurs primarily by drinking water of eating food that has been contaminated by the feces of an infected person, even if the person had no symptoms. The disease can become severe if victim becomes extremely dehydrated, consequently leading to death. Treatment should consist of oral rehydration therapy to replace water and electrolytes. In severe cause fluid can be administered intravenously.

The United Nations health agency today reported that the cholera outbreak in Sierra Leone was escalating and stressed the need to rapidly scale up the response to the spread of the of the frequently fatal water and food-borne disease.

Sierra Leone’s government has declared a cholera outbreak a national emergency after 176 deaths and 10,800 reported cases since January, health ministry sources said.

“A decision has been taken to declare cholera as a national emergency,” a source at the health ministry said on Thursday on condition of anonymity.

Since the beginning of the year, Sierra Leone has recorded 11,653 cases of cholera, with 216 deaths (Case Fatality Rate of 1.9%). The rate of new cases has accelerated rapidly since the beginning of August: since then, 5706 cases have been recorded, and two new districts, Bonthe and Kono, have been affected by the epidemic . Ten of the country’s 13 districts are now registering cases and this spread emphasizes the need to rapidly scale up the response.

The two most heavily affected districts are Western Area and Tonkolili.

The President of Sierra Leone has declared the escalating cholera epidemic a “humanitarian crisis”. Consequently, a multi-sectoral approach to the response has been adopted involving the Ministry of Health and Sanitation (MOHS), as well as other line ministries such as Finance, Information and Communication, and Local government, together with partners and stakeholders. A National Emergency Task force has been established with sub-committees dealing with surveillance, case management, water and sanitation, logistics and social mobilization. The WHO Country Office (WCO) in Sierra Leone is chairing a weekly meeting of partners and stakeholders to better coordinate harmonize and strategize support.

The MOHS, in partnership with Médecins sans Frontières (MSF), UNICEF, WHO, and other partners, is implementing the following prevention and control activities: epidemiological investigation, surveillance, case management at established cholera treatment centres, water and sanitation control measures, social mobilization and community education.

WHO is supporting Sierra Leone in the areas of epidemiology, social mobilization and surveillance. WHO has deployed two (2) epidemiologists, and three (3) cholera experts from Zimbabwe to support coordination, public information, social mobilization, case management and infection control.

WHO does not recommend that any travel or trade restrictions be applied to Sierra

“All of this is the aftermath of the 11 years rebel war when we had a huge rural-to-urban migration and a huge population clustered in the urban area where adequate provision has not been made for water and sanitation. This is what we have been witnessing today, “she said.

“This current outbreak of cholera has the potential to be devastating and is proving very difficult to control,” said Amanda McClelland, IFRC Emergency Health Coordinator. “We are particularly concerned by the rising numbers in Freetown which suffers from overcrowding, poor sanitation and lack of safe water access — all factors which contribute to this deadly disease.”

Abass Kamara, a health ministry spokesman, rejected criticism from the public that government was doing little to stem the tide of the outbreak.

“A series of robust resource mobilisation including the setting up of dozens of cholera treatment units in affected areas have been undertaken.”

State doctor Harrison Williams said patients came from areas with limited access to proper water drainage and sanitation as the country is at the height of its rainy season.

“We are many times overstretched working from mornings to late evenings. The unprecedented rainfall which is dislodging clogged-up gutters and bringing garbage into the streets has added to the filth.”

The small west African nation of six million people has one of the worlds worst health systems with only one doctor per 34,744 people, according to United Nations figures.

The water-borne disease has also hit Guinea, neighbouring Sierra Leone to the north, leaving 60 people dead in that country since February, and Mali and Niger have also been hit by the outbreak.

Poor water and sanitation systems give rise to the disease, an acute intestinal infection caused by ingesting contaminated food and water which causes acute diarrhoea and vomiting and can kill in hours, according to the WHO

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