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Early Warning and Dise

This Bulletin is produced by MOH, RSS with Technical support from WHO

Republic of South Sudan

EARLY WARNING AND DISEASE SURVEILLANCE BULLETIN

(IDP CAMPS AND COMMUNITIES)

Week 32

General Overview

Completeness of weekly reporting in

week 32 when compared to week 3

Measles cases continue to be reported

measles vaccination is ongoing.

During week 32, Torit County in Eastern Equatoria

per 10,000) of 2.8, which represents a decline from the incidence of 29 in week 30

Hepatitis E Virus (HEV) cases in Mingkaman

[CFR] of 4.9%). During weeks 4 -

Syndrome (AJS) were reported in Bentiu, Lul,

other camps. All new AJS cases should be investigated and HEV prevention activities need to be prioritised

in all the camps.

Malaria, Acute Respiratory Infections

the highest disease risk in the Internally Displaced Persons (

During week 32, the under-5 and crude mortality rates

all the camps. Malnutrition remains the main cause of

Completeness and Timeliness of Reporting

2 1

5 68

1315

21

1720

17

0

5

10

15

20

25

30

35

40

51 52 01 02 03 04 05 06 07 08 09

Nu

mb

er

of

site

s

Number of sites (clinics) reporting per week (n=48)

Early Warning and Disease Surveillance System



(IDP CAMPS AND COMMUNITIES)

increased from 71% to 75% and timeliness increased from 3

31.

reported in Bentiu with six (6) cases reported in week

in Eastern Equatoria State had the highest weekly cholera

, which represents a decline from the incidence of 29 in week 30 and 11 in week 31

Mingkaman have increased to 83 with four (4) deaths

32 of 2014, seven (7) cases including two death

reported in Bentiu, Lul, Malakal, and Bor, highlighting the possible spread of HEV to

All new AJS cases should be investigated and HEV prevention activities need to be prioritised

Acute Respiratory Infections (ARI) and Acute Watery Diarrhoea (AWD) continue

Internally Displaced Persons (IDP) camps in week 32.

and crude mortality rates (CMR) remained below the emergency thr

Malnutrition remains the main cause of under-5 mortality in all the camp

Completeness and Timeliness of Reporting

17 17 1821

18 19

26 26

3229

2426

28 27 26

33

24 23

29

09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

Epidemiologic Week

Number of sites (clinics) reporting per week (n=48)

This Bulletin is produced by MOH, RSS with Technical support from WHO 1


4 – 10 August 2014

creased from 31% to 48% in

in week 32. Enhanced routine

cholera attack rate (cases

and 11 in week 31.

deaths (Case Fatality Rate

deaths of Acute Jaundice

ng the possible spread of HEV to

All new AJS cases should be investigated and HEV prevention activities need to be prioritised

continued to account for

remained below the emergency thresholds in

rtality in all the camps.

2931

34

38

3436

27 28 29 30 31 32



2

Completeness of weekly reporting increased from 34 (71%) in week 31, to 36 (75%) in week 32. Similarly,

timeliness for weekly reporting increased from 15 (31%) in week 31 to 23 (48%) in week 32.

Health facilities are reminded to submit their IDP consultation and mortality reports by COB on Monday.

Consultations (All patients seen at Outpatient and Inpatient)

The total number of consultations increased from 16,623 in week 31 to 20,010 in week 32. During week 32,

most of the consultations were reported from Awerial, Bentiu, Malakal, Tongping, and Renk (Figure 2).

Figure 2

Overall Trends of Priority Epidemic-prone Diseases

Figures 3 and 4 show the proportionate and incidence morbidity trends for ARI, Malaria, AWD, suspected

measles and Acute Bloody Diarrhoea (ABD) in the IDP camps and communities.

Figure 3

256

1122

363941

544

1794

1136

715

470759

858 686161

1341

6781780

204 440 203 467 701317 381

835

421

1444

278 2450500

1,0001,5002,0002,5003,0003,5004,0004,5005,000

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Tw

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ast

Ny

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Nu

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ati

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s

Consultations by IDP Camp & Partner, week 32, 2014

CCM IMC IOM MSF-CH MSF-OCB UNMISS MSF-OCA

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

mp

lete

ne

ss

Pe

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nt

of

all

co

nsu

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tio

ns

Epidemiologic Week

Priority Disease Proportionate Morbidity - for Week 1 - 32, 2014

Completeness ARI Bloody Diarrhea

Malaria Suspected Measles Watery Diarrhoea



3

Malaria, ARI and AWD were the top causes of morbidity among IDP s in week 32 (Figure 3 and 4).

During week 32, malaria had the highest proportionate morbidity and incidence when compared to the

other top five causes of morbidity among IDPs (Figure 3 and 4). The incidence for ARI, ABD and measles

decreased while the incidence for malaria and AWD increased in week 32 when compared to week 31.

Despite the ongoing cholera outbreak in South Sudan, AWD trends among IDPs have continued to decline, a

trend that is attributable in part to the OCV vaccination and WASH interventions.

Since December 2013, the following cumulative cases have been reported:

o Malaria 83,152

o AWD 44,653

o ARI 72,837

o ABD 7,417

o Measles 1,371

Figure 4

Specific Priority Epidemic-Prone Diseases

Acute Respiratory Infection

ARI registered the second highest proportionate morbidity of 16.4% and incidence (61 cases per 10,000

population) in week 32 (Figure 5).

During week 32, 3,284 cases of ARI were reported with the highest ARI incidence (cases per 10,000) being

reported in Malakal (445), Bentiu (118), Tongping (322), Kodok (80) and UN House (117).

-

20

40

60

80

100

120

140

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Ca

ses

pe

r 1

0,0

00

Epidemiological Week 2014

Incidence for Priority Diseases, week 1 - 32, 2014

ARI Bloody Diarrhea Malaria Suspected Measles Watery Diarrhoea



4

Figure 5

Acute Watery Diarrhoea

As seen from Figure 6, the AWD proportionate morbidity increased from 5.2% to 5.5% while the overall AWD

incidence (cases per 10,000) increased from 18 to 20 in week 32 when compared to week 31 (Figure 4).

Figure 6

During week 32, a total of 1,103 AWD cases were reported with the highest AWD incidence (cases per 10,000)

being reported in Bentiu (59), Malakal (59), Renk (58), UN House (53) and Akoka (50), see Figure 7.

1.7%0.7%

19.3%

0

2.3%3.6%3.5%

4.4%5.5%

2.1%

5.1%

11.4%

19.0%17.5%

11.7%

16.3%

12.6%

14.7%

22.1%

27.1%

25%

19%

16%

20%

31%

26%

17%

25%

22%

18%19%

16%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

5%

10%

15%

20%

25%

30%

35%

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

mp

lete

ne

ss [

%]

Pe

rce

nt

of

tota

l c

on

sult

ati

on

s

Epidemiologic Week

ARI Adjusted Proportionate Morbidity for week 1 - 32, 2014

22%23%

21%

8%

10%9%

7%

10%

13%

9%

11%11%10%

11%

8%

11%

9%

11%11%

13%13%

11%11%

8%

10%10.1%

6.2%5.0%5.4%5.8%5.4%5.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

10%

20%

30%

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

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of

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on

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s

Epidemiologic week

AWD Adjusted Proportionate Morbidity, for week 1 - week 32, 2014



5

Figure 7

In light of the ongoing cholera outbreak in South Sudan that started in week 17 in Juba, AWD trends have been

presented by age-group (Figure 7.1). The incidence (cases per 10,000) of AWD has remained significantly higher

in children under-5 during the pre-epidemic and epidemic phases. As seen from Figure 7.1, there are at least

three peaks with the highest and most protracted peak occurring during weeks 17-25, a period that

corresponds to the onset and peak of the cholera outbreak in Juba County. These trends indicate that the

background risk for AWD is very high especially in children under-5.

Figure 7.1

-

100

200

300

400

500

600

700

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Ca

ses

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r 1

0,0

00

Epidemiological week 2014

AWD Incidence, by Camp, for week 1 - 32 2014

Bentiu Renk Akoka Malakal UN House

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

20

40

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200

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

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s

ca

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r 1

0,0

00


AWD incidence by age group, for week 1 to 32, 2014

Completenes ≥5 yrs <5 yrs



6

Dysentery / Acute Bloody Diarrhoea

Figure 8 shows Acute Bloody Diarrhoea (ABD) trends during weeks 1-32 of 2014. ABD morbidity was very

high at the onset of the crisis with the highest peak registered in week 4 of 2014, but declined drastically in

the subsequent weeks reaching its lowest point in week 9. The ABD trend increased steadily from week 10

to week 21, declined from week 21 to 24, increased in week 25 but continued to decline thereafter.

Figure 8

Figure 9 shows ABD incidence trends by campsite from week 1 to 32 in 2014. During the period under

review, the highest incidence of ABD was reported in Renk as compared to other camps.

During week 32, a total of 180 ABD cases was reported with the highest ABD incidence (cases per 10,000)

being reported in Renk (20), AwerialMalakal (15), Ogod (15.2), Man Awan (26), Man Anguei (16) and Akoka

(16).

Figure 9

2.1%

5.5%

2.8%

1.0%1.0%

1.3%

1.0%

1.5%1.3%

0.9%1.0%

1.4%1.3%1.3%1.3%

1.8%1.9%2.0%2.0%

2.7%2.8%

1.8%

1.3%1.3%

1.8%1.7%

1.2%1.4%

1.2%

1.5%

1.2%0.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

1%

2%

3%

4%

5%

6%

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

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Pe

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of

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Epidemiologic Week

ABD Proportionate Morbidity , for week 1 - 32, 2014

-

20

40

60

80

100

120

140

160

180

200

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Ca

ses

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r 1

0,0

00


ABD Incidence, by Camp for week 1 - 32, 2014

Malakal Renk Ogod Man-Awan Akoka Man-Anguei



7

Measles

Figure 10

The measles trend peaked at the beginning of the crisis with the highest peak occurring in week 3, followed

by a declining trend with subsequently shorter peaks in week 5 and 13 (Figure 10). This trend is attributed

to a series of reactive measles vaccination campaigns conducted to contain the outbreaks in UN House,

Tongping IDP camp, Bor, Yuai, Lankien, Cueibet, and in Thol Payam (Nyirol) County, Jonglei State.

During week 32, a total of eight (8) measles cases were reported with six (6) cases being reported from

Bentiu, while Awerial reported two (2) cases.

In response to the measles cases in Bentiu, accelerated routine measles vaccination is being implemented.

An integrated measles and Polio vaccination campaign is slated for 18 August 2014 in Chotbora and Wudier

Payam, Longochuk County in Upper Nile State with support from MedAir. The target population is 50,000.

Malaria

Figure 11

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

1%

2%

3%

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

mp

lete

ne

ss

Pe

rc

en

t o

f to

tal

co

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lta

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ns

Epidemiologic week

Suspected Measles Proportionate Morbidity, for week 1 - 32 2014

Completeness Suspected Measles Adj.

28.8%

22.8%

26.8%

11.1%12.8%12.8%

9.3%

16.3%

12.4%

16.3%

11.4%12.0%

14.8%16.7%

13.7%12.5%11.8%

15.4%

19.7%

31.3%

19.1%

21.8%20.0%

18.3%

28.2%26.8%

15.5%16.1%17.4%17.5%

20.0%

23.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

5%

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15%

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35%

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

Co

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Epidemiologic week

Suspected Malaria Adjusted Proportionate Morbidity , week 1 - 32 2014

Completeness Malaria Adj.



8

As seen from Figure 11, since the beginning of the year, three peaks of malaria transmission have been

registered with the highest occurring at the beginning of the crisis (weeks 1-3), while the other peaks were

registered in weeks 20 and 25. The malaria trend has been on the increase since week 25.

During week 32, malaria recorded the highest proportionate morbidity of 23.5% and the incidence (cases

per 10,000) increased from 65 in week 31 to 87 in week 32.

During week 32, a total of 4,711 malaria cases was reported with the highest malaria incidence (cases per

10,000) being reported in Tongping (211), Malakal (299), Akoka (316), Bentiu (52), Renk (217) and UN

House (114). See Figure 12.

Malaria prevention and control interventions should be strengthened in the camps with priority accorded

to eliminating vector breeding grounds, while providing Indoor Residual Spraying activities, distribution of

insecticide treated bed nets, as well as prompt and effective management of all cases.

Figure 12

Hepatitis E Virus (HEV)

As seen in Figure 13, AJS cases were first reported in week 10 in Mingkaman where the number has

increased over subsequent weeks to 83 cases by week 32. Laboratory tests have since confirmed HEV in at

least seven samples from Mingkaman.

Cases of AJS cases have been reported in several other camps including Juba 3 (1 case), Bentiu (3 cases), Lul

(1 case), Malakal (1 case including 1 death) and most recently Bor (1 case and 1 death).

These AJS trends highlight the possible spread of HEV to at least four other camps besides Mingkaman.

All new AJS cases should be investigated and HEV prevention activities need to be prioritised in all the

camps.

As seen in Figure 14, the HEV cases in Mingkaman increased from week 10 reaching the highest peak in

week 26 but declined thereafter till week 28. The cases have been rising steadily during weeks 28 - 32. In

week 32, nine (9) new HEV cases were reported bringing the cumulative HEV cases in Mingkaman to 83.

A total of four deaths CFR of 4.9%, have been registered with three (75%) of the deaths occurring in

pregnant women. The majority of the cases are female (54%) and most (82%) of the cases are under 30

years old.

-

200

400

600

800

1,000

1,200

1,400

1,600

1,800

01 03 05 07 09 11 13 15 17 19 21 23 25 27 29 31

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Malaria Incidence, by Camp, for week 1 - 32, 2014

Bentiu Malakal Tongping Akoka Renk UN House



9

Figure 13

An outbreak declaration needs to be expedited as this has implications for enhancing community

awareness, identification of other affected areas and mobilizing a coordinated response to ensure the

outbreak is rapidly contained from spreading.

Enhancing water, sanitation and hygiene standards should be prioritised in all camps.

Figure 14

Targeted interventions for pregnant women including improving antenatal care attendance, health

education on HEV prevention and control and the need seek healthcare promptly following the onset of

disease symptoms should be initiated in all the camps.



10

Cholera

The Ministry of Health, working with partners, rolled out a comprehensive response to the cholera outbreak

that started in Juba in week 17 of 2014. The national cholera taskforce is coordinating the implementation of

comprehensive interventions for cholera prevention and control. By the close of week 32, a total of 5,682

cholera cases including 123 deaths (CFR 2.16%) had been reported from five (5) states and 12 counties in South

Sudan (table 1). The outbreak has declined in Juba County but satellite outbreaks have been reported in 11

other counties.

Table 1: Cholera Statistics by County, South Sudan, week 17-32, 2014

No. State County

New cases by epi-week Cumulative

No. cases

2014

Cumulative

No. Deaths

Case

Fatality Rate

[%}

28

29

30

31

32

1.0

CES

(IDP)

Juba - Tongping

UNMISS

4

7

3

4 0 70 3 4.3

2.0

Juba - Juba 3

UN House

8

12

19

5 2 85 - -

3.0

CES

Juba

57

40

22

23 14 2,002 36 1.8

4.0 Kajo-Keji

5

-

10

5 1 70 4 5.7

5.0 Yei River

-

-

-

- 0 47 2 4.3

6.0 JS Bor

-

-

-

- 0 1 - -

7.0

EES

Torit

414

271

400

156 39 1,955 37 1.9

8.0 Lopa-Lafon

4

24

17

23 31 164 9 5.5

Kapoeta North

11

6

12

3 2 68 1 1.5

9.0 Magwi

20

28

13

21 15 208 10 4.8

10.0

UNS

Manyo

-

-

- 0 1 - -

11.0 Malakal

302

59

53

7 15 1,008 21 2.1

12.0 WES Mundri East

-

-

- 3 - -

Total South Sudan

825

447

549

247 119 5,682 123 2.2

Figure 15 shows the cumulative attack rates (cases per 10,000) for cholera with the most affected counties

being Torit (141.6), Malakal (68.4) and the two IDP camps in Juba County.

During week 32, Torit had the highest weekly attack rate for cholera of 2.8 cases per 10,000, which

represents a significant decline from the attack rate of 11.3 cases per 10,000 registered during week 31

(Figure 16).

These trends highlight the need to enhance and sustain the recommended interventions for cholera

prevention and control.

Early Warning and Dise


Figure15

The sustained transmission of cholera in Eastern Equatoria

coverage for social mobilisation, WASH, and early case

oral rehydration points, and at the designated cholera treatment centres.

Figure 16

48.0 49.0 40.5

2.6

-

20.0

40.0

60.0

80.0

100.0

120.0

140.0

160.0 Ju

ba

-T

on

gp

ing

UN

MIS

S

Jub

a -

Jub

a 3

UN

Ho

use

Jub

a

Ka

jo-K

eji

Ca

ses

pe

r 1

0,0

00

Cumulative attack rate for cholera by county, week 17



ed transmission of cholera in Eastern Equatoria State calls for enhanced efforts to improve the

, WASH, and early case identification and initiation of treatment at home

oral rehydration points, and at the designated cholera treatment centres.

2.6 1.8 0.1

141.6

12.5 5.8 10.3

0.2 Y

ei

Riv

er

Bo

r

To

rit

Lo

pa

-La

fon

Ka

po

eta

No

rth

Ma

gw

i

Ma

ny

o

Cumulative attack rate for cholera by county, week 17-32, 2014

This Bulletin is produced by MOH, RSS with Technical support from WHO 11

calls for enhanced efforts to improve the

and initiation of treatment at home,

68.4

0.5

Ma

lak

al

Mu

nd

ri E

ast

32, 2014



12

Acute Flaccid Paralysis (AFP)

During week 32, no new AFP cases were reported from the IDP camps although nine cases were reported from

rest of the population living outside the camps. Since the beginning of 2014, a cumulative of 161 AFP cases has

been notified (Table 2). The annualised non-Polio AFP (NPAFP) rate is 3.18 cases per 100,000 population

children 0-14 years (national target ≥4 per 100,000 children 0-14 years). Only four(40%) of the states, namely

Lakes, Western Bahr el Ghazal, Eastern Equatoria and Western Equatoria have attained the targeted NPAFP rate

(Table 2). The non-Polio Enterovirus (NPEV) isolation rate (a measure of the quality of the specimen cold chain)

is 13%, which is above the national target of ≥10%. Stool adequacy is 90%, a rate that is higher than the national

target of ≥80% (Table 2).

Table 2: Summary of AFP indicators by state for 2013 and 2014

Other diseases of public health importance

There were no new cases of Guinea Worm or Viral Haemorrhagic Fever (VHF) reported during week 32.

In response to the escalating global threat of Ebola virus disease, the following actions have been prioritised

to enhance preparedness and response in South Sudan:

o A multi-sectoral national taskforce has been established to coordinate the response;

o A national contingency plan has been developed to facilitate the mobilisation of resources and

implementation of activities to improve readiness;

o A health screening desk has been established at Juba International Airport and this will be escalated

to other major border entry points;

o Isolation facilities have been designated at Juba Teaching Hospital and UNMISS;



13

o Additional state level activities are planned and are well articulated in the contingency plan.

All-Causes Mortality Data

During week 32, mortality lists were received from Mingkaman, Juba 3, Bentiu, Tongping, Bor and Malakal.

A total of eight (8) deaths were reported in week 32; with the majority 6 (75%) of the deaths reported from

Bentiu, one from Malakal and one from Tongping. During week 32, four (50%) of the deaths occurred in

children under five years of age. The major causes of death during week 32 are shown in the table below:

Table 2: Causes of death by IDP camp during week 32 of 2014

Deaths by camp & cause

Deaths by age-group

Total deaths <5yrs ≥5yrs

Bentiu 3 3 6

Tuberculosis 1 1

Unknown 2 2

SAM 2 2

Septic burns 1 1

Malakal 1 1

Kala azar/anaemia 1 1

Tomping 1 1

Perinatal death 1 1

Total deaths 4 4 8

Under-5 Mortality Rate

The under-5 mortality rates (U5MR) from week 51 of 2013 to week 32 of 2014 are shown in Figure 17. A

decline in under-5 mortality rates was observed in all IDP camps except from weeks 21 to 26 in Bentiu.

During week 32, the under-5 mortality for Bentiu was 0.53 deaths per 10,000 per day, which is lower than

the emergency threshold of 2 deaths per 10,000 per day. The major cause of death in under-5 year olds in

week 32 was Severe Acute Malnutrition (SAM), see Table 2.

Figure 17

0

2

4

6

8

10

12

14

16

18

51 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33

Ra

te p

er

10

,00

0

Epidemiologic Week

Under-5 Mortality by Site - week 51 of 2013 to week 32 of 2014

Bentiu Bor Juba 3 Malakal



14

Crude Mortality Rate

The crude mortality rates (CMR) for week 32 are shown in Figure 18. During week 32, the CMR was below

the emergency threshold for the six camps that submitted mortality statistics.

Figure 18

Disease specific mortality

Acute watery diarrhoea related deaths

Figure 19

0

1

2

3

4

5

6

7

8

52 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32

Ra

te p

er

10

,00

0

Epidemiologic week

Crude Mortality Rate per 10,000 persons per day, week 51 of 2013 to week 32 of

2014

Bentiu Bor Juba 3 Malakal

Mingkaman Tongping Melut Threshold

0

5

10

15

20

25

51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 20 22 21 23 24 25 26 27 28

2013 2014

No

. de

ath

s


AWD Deaths by Camp week 51 of 2013 to week 32 of 2014

Bentiu Bor Juba 3 Malakal Mingkaman Tomping



15

Figure 19 shows mortality due to AWD from week 52 in 2013 to week 32 in 2014. No new AWD deaths have

been reported since week 28 of 2014. AWD has caused the highest number of deaths with a cumulative of 140

deaths since the onset of the crisis. The majority of AWD related deaths have been reported from Mingkaman,

Tongping, Malakal and Bentiu.

Overall Mortality

Since the onset of the crisis, at least 1,033 deaths have been reported from the IDP camps. Children under five

years of age have accounted for 526 (51%) of the deaths. The majority of the deaths occurred in Tongping,

Bentiu, Malakal and Bor. The top causes of mortality during the period included AWD, measles, severe

pnuemonia and malnutrition (Table 3).

Table 3

Camp TB

SA

M

Pn

eu

mo

nia

Pe

rin

ata

l

de

ath

Me

asl

es

Ma

tern

al

de

ath

Ma

lari

a

Gu

nsh

ot

wo

un

d

Blo

od

y

dia

rrh

oe

a

Acu

te w

ate

ry

dia

rrh

oe

a

AJS

Oth

ers

Gra

nd

To

tal

Bentiu 7 44 37 2 10 11 6 2 43 104 266

Bor 2 3 9 2 42 1 2 58 119

Juba 3 4 3 6 11 1 3 1 5 1 14 49

Malakal 13 14 2 8 8 38 27 1 99 210

Melut 1 3 3 1 2 7 9 26

Mingkaman 3 2 8 7 4 1 7 4 30 6 44 116

Tomping 1 14 20 15 37 9 6 2 32 109 245

(Blank) 1 0 1

Kodok 1 0 1

Grand Total 31 83 86 46 94 3 46 51 8 140 8 437 1033

General recommendations

Consolidate cholera response interventions in the 12 counties where cholera has been confirmed and

enhance epidemic readiness and prevention in the rest of the counties.

Alerts of suspected cholera should be reported to the Ministry of Health cholera alert desk by calling

0912000098.

Obtain stools samples from all new suspect cases in the IDP camps to allow microbiological culturing.

Scale up coverage for social mobilization and WASH interventions in Eastern Equatorial State where

cholera trends have remained persistently high.

Submit biological samples to allow laboratory confirmation of emerging outbreaks of suspect measles,

AJS and cholera.

Partners are urged to strengthen public health prevention and control measures for malaria, ARI, AWD

(including cholera), ABD and HEV.

Please send all disease surveillance information and any outbreak rumours to

[email protected].

IDSR reports and mortality line lists should be submitted by COB Monday after the close of each

epidemiologic week.



16

For comments or questions, please contact

Department of Epidemics, Preparedness and Response, MoH-RSS

E-mail: [email protected],

HF radio frequency: 8015 USP; Selcall: 7002

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