DAILY CHOLERA UPDATE AND ALERTS 18 th January, 2009

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Email: cholera_taskforce@zw.afro.who.int http://ochaonline.un.org/default.aspx?alias=ochaonline.un.org/zimbabwe Toll free number for cholera alert is 08089001 or 08089002 or 08089000 Office of the WHO Representative in Zimbabwe Mobile number for cholera alerts is 0912 104 257 Water and Sanitation alert numbers 04 703 941-2 (during working hours) 2 917 710 (after hours) Date of issue:18 th January, 2008 DAILY CHOLERA UPDATE AND ALERTS 18 th January, 2009 A. Highlights of the day: 434 cases and 11 deaths (in comparison 650 cases and 45 deaths yesterday) 31.0 % of the areas affected have reported (18 out of 58 affected districts) 60 cases from Harare (Mbare- 11 cases; Glen View 10 cases; Budiriro- 5 cases; Mabvuku- 4 cases; Dzivarasekwa, Kuwadzana, Marlborough-3 cases each; Glen Norah, Mabelreign- 2 cases each; Mufakose, Borrowdale, Kambuzuma, Waterfalls, Whitecliffe, Tafara, Tynwald, Southerton, Hatfield, Chitungwiza, Crowborough 1 case each; Unspecified- 5 cases) 87.1 % of districts reported to be affected (54 districts/62) All 10 of the country's provinces are affected Districts reported an high Districts with a daily CFR > 5% : number of cases (cases > 30) 1. BRIDH (Harare) 1. Shamva 2. Makonde 2. Bindura 3. Kadoma 3. Kadoma 4. Chegutu 4. Beitbridge 5. Mwenezi Districts with high number of deaths outside health facility/ CTC > 3 1. Nil Districts which have not reported for more than 3 days: 1. Mbire 9. Nyanga 2. Mudzi 10. Chikomba 3. Hwedza 11. Ruwa (Goromonzi) 4. Mutasa 12. Masvingo 5. Mutare City 13. Chivi 6. Buhera 14. Gokwe South 7. Chipinge 8. Chimanimani B. Conclusion of the day: High priority districts to investigated BRIDH (Harare) Makonde Kadoma Chegutu Mwenezi Shamva Bindura Kadoma Beitbridge Priority districts to call back on the phone (as delay of more than 3 days to report) and in red High priority districts which needs field visit (no report for more than 7 days) Mbire Chipinge Chikomba Mudzi Chimanimani Ruwa (Goromonzi) Hwedza Nyanga Masvingo Mutasa Chivi Mutare City Gokwe South Buhera Source: Ministry of Health and Child Welfare Rapid Disease Notification System 1

C. Follow up actions Province District Flagged as a priority on MASH WEST Makonde 12/01/09 (Borehole not functioning) 16/01/09 (high number of cases & community deaths, high CFR) Zvimba 13/01/09 (Water problem) 16/01/09 (High CFR) MASH EAST MASH CENTRAL Hurungwe 12/01/09; 14/01/09; 15/01/09 (High number of cases & community deaths & CFR) Kariba Rural 17/01/09 (No report after 4 days) Norton 16/01/09 (High number of cases, High CFR) Kadoma 13/01/09 (High CFR) 14/01/09 (High CFR and High number of cases) Action taken and next step (when and who will be doing what) To contact partners to help with the repair of the borehole and water tank which is not functioning at Kamhonde CTC Partners in the area have been contacted. Assessment being done 16/01/09 District has problems with water supply at Dzivarasekwa Extension clinic CTC and Banket District Hospital CTC. No partners in the district 14/01/2009 GAA doing some assessment in the area 16/01/09 Mudzi 14/01/09 (non reporting) Hwedza 10/01/09 (non reporting) 14/01/09 (non reporting) Mutoko 13/01/09 (non reporting) 16/01/09 (high CFR) Responsible for Following up with WASH and Health Cluster with GAA Follow up Status NPO-EHA Follow-up with PMD Data Managers Reported over more than 1 day NPO-EHA NPO-EHA Telephone exchange not working Health information officer gone out to collect data for non reporting. Reported 20 cases and 9 deaths on 16/01/2009. Follow-up with PMD on high CFR UMP 16/01/09 (High CFR) Goromonzi 12/01/09 (High CFR) NPO-EHA Centenary 15/01/09 (High CFR & NPO-EHA community deaths>3) Bindura 16/01/09 (High number NPO-EHA Ongoing were coming from Chiwaridzo township which is densely populated. setting up a CTC 18/01/09 Follow-up on whether CTC was set up Source: Ministry of Health and Child Welfare Rapid Disease Notification System 2

Province District Flagged as a priority on MANICALAND Chipinge 08/01/09; 11/01/09; 12/01/09 (High number MASVINGO Mutare City 06/01/09; 08/01/09; 12/01/09 (High CFR & number Action taken and next step (when and who will be doing what) Mutasa 10/01/09 (non reporting) Chimanimani Buhera 12/01/09 (High number 12/01/09 (High number Responsible for Following up with MDM Follow up Status Nyanga 16/01/09 Mutare 12/01/09; 15/01/09 (High number Governors visit to the District will be there tomorrow (15/01/09) 16/01/09 Chiredzi 15/01/09 (High number of cases and CFR) Communication problem due to electricity problems (18/01/09) Bikita 16/01/09 (High number of cases & community Communication problem due to electricity problems (18/01/09) deaths, High CFR) Mwenezi 15/01/09 (High number of cases and CFR) 16/01/09 (High number Zaka 16/01/09 (High number reported over a period of days of cases, High CFR) Follow-up with PMD Chivi 14/01/09 (New area) Newly affected area called Chigwikwi Patients travelling long distance to get to the nearest CTC Team send out for investigations 16/01/09 Newly affected area Chidyamakono, ward 4,7,9,10 and 13 Borehole not functioning MIDLANDS Gokwe South 05/01/09; 07/01/09 (High CFR) New cases and deaths reported in Gokwe in Mutenga area. Health cluster coordinator making a follow up NPO-EHA follow-up with WASH with MSF Spain, IFRC Source: Ministry of Health and Child Welfare Rapid Disease Notification System 3

Province District Flagged as a priority on 08/01/09 (High number 13/01/09 (New cases) 14/01/09 (High number Gokwe North 16/01/09 (High number Kwekwe 03/01/09 08/01/09 (Rumour) 16/01/09 (New area) Action taken and next step (when and who will be doing what) reported from 4 households in Mateta area 08/01/2009 No medical facilities in the ward. Nearest facility is 30km away Follow up email send out. Waiting for response Sesame reported 2 new cases. Responsible for Following up and Zimbwe Red Cross, CONCERN Follow up Status 4 cases reported in new area (Zhombe). PNO relayed information. PMD office following up Communication problem 04/01/09 Rumour of cholera cases from Munyati area PMD has been contacted. DEHO has gone to investigate No fuel available to go and do investigations 12/01/09 Fuel to be available as from Friday this week A new area called Mayoka reported some cases Mberengwa 12/01/09 (new area) A new area in Mberengwa named Ngungumane reported 5 cases and zero deaths. in Mberengwa are scattered throughout the district. Red cross pulled out of the district. Mberengwa district is requesting for fuel to make a follow up on the issue of fuel MAT NORTH Binga 13/01/09 (High number MAT SOUTH Beitbridge 16/01/09 (High number of cases, High CFR) Binga reported 200 cases and 26 deaths from Pashu, Shaba, Chunga and Siyabuwa areas SAVE the children to provide supplies UNICEF has been sending supplies 600 litres available to send supplies 4 teams have been send out to make investigations in the affected areas. Meeting to be held on Satarday by the team The reported 200 cases were over a period of time To find out if there is a CTC in Binga have been revised. Waiting for feedback from PMD 16/01/09 NPO-EHA follow up with CONCERN with WASH and Save the Children NPO-EHA to follow up with World Vision Follow-up with PMD NPO-EHA Source: Ministry of Health and Child Welfare Rapid Disease Notification System 4

D. Epidemiological data Province District/area affected Today's update CFR of cases (%) (included in the total) CFR (%) (included in the total) Proportion (%) Date last updated Number of days since previous report Harare Chitungwiza - - - - 992 153 15.4 115 75.2 17/01/2009 1 BRIDH 33 0 0.0 0 4055 160 3.9 18/01/2009 0 Budiriro 27 0 0.0 0 7112 79 1.1 16 20.3 18/01/2009 0 Bulawayo Bulawayo urban 11 0 0.0 0 402 14 3.5 9 64.3 18/01/2009 0 Mashonaland Central Mashonaland East Mashonaland West Shamva 14 2 14.3 1 149 17 11.4 16 94.1 18/01/2009 0 Centenary - - - - 161 19 11.8 15 78.9 15/01/2009 3 Mazowe - - - - 175 4 2.3 3 75.0 16/01/2009 2 Guruve - - - - 126 10 7.9 7 70.0 15/01/2009 3 Mbire - - - - 28 7 25.0 0 0.0 13/01/2009 5 Mt Darwin 8 0 0.0 0 235 6 2.6 5 83.3 18/01/2009 0 Bindura 26 2 7.7 2 622 19 3.1 17 89.5 18/01/2009 0 Rushinga - - - - 98 5 5.1 5 100.0 16/01/2009 2 Mudzi - - - - 2051 125 6.1 62 49.6 10/01/2009 8 Murehwa - - - - 117 19 16.2 13 68.4 17/01/2009 1 Makumbe - - - - 250 22 8.8 17 77.3 16/01/2009 2 (Goromonzi) Ruwa - - - - 332 16 4.8 11 68.8 14/01/2009 4 (Goromonzi) Mutoko - - - - 174 29 16.7 23 79.3 16/01/2009 2 Marondera 10 0 0.0 0 103 8 7.8 6 75.0 18/01/2009 0 Chikomba - - - - 80 17 21.3 16 94.1 14/01/2009 4 Hwedza - - - - 27 1 3.7 1 100.0 06/01/2009 12 UMP - - - - 189 25 13.2 11 44.0 17/01/2009 1 Seke 8 0 0.0 0 555 19 3.4 12 63.2 18/01/2009 0 Makonde 124 2 1.6 1 3374 118 3.5 73 61.9 18/01/2009 0 Kariba Mahombekombe 6 0 0 0 304 14 4.6 2 14.3 18/01/2009 0 Source: Ministry of Health and Child Welfare Rapid Disease Notification System 5

Province District/area affected Today's update CFR of cases (%) (included in the total) CFR (%) (included in the total) Proportion (%) Date last updated Number of days since previous report Kariba Rural 12 0 0.0 0 366 34 9.3 24 70.6 18/01/2009 0 Zvimba 2 0 0.0 0 266 25 9.4 23 92.0 18/01/2009 0 Kadoma 66 4 6.1 2 1743 125 7.2 73 58.4 18/01/2009 0 Hurungwe - - - - 1255 72 5.7 47 65.3 17/01/2009 1 Norton - - - - 835 36 4.3 13 36.1 17/01/2009 1 Chegutu 38 0 0.0 0 2281 141 6.2 30 21.3 18/01/2009 0 Manicaland Mutasa - - - - 9 5 55.6 5 100.0 12/01/2009 6 Mutare City - - - - 18 1 5.6 0 0.0 12/01/2009 6 Buhera - - - - 1229 43 3.5 37 86.0 12/01/2009 6 Chipinge - - - - 1174 56 4.8 32 57.1 12/01/2009 6 Makoni - - - - 415 49 11.8 44 89.8 15/01/2009 3 Mutare - - - - 1716 156 9.1 154 98.7 15/01/2009 3 Chimanimani - - - - 741 45 6.1 15 33.3 12/01/2009 6 Matebeleland North Nyanga - - - - 38 2 5.3 2 100.0 12/01/2009 6 Lupane - - - - 2 0 0.0 0 0.0 16/01/2009 2 Binga - - - - 385 29 7.5 0 0.0 16/01/2009 2 Matabeleland Gwanda 0 0 0 0 73 8 11.0 4 50.0 18/01/2009 0 South Plumtree 0 0 0 0 3 0 0.0 0 0.0 18/01/2009 0 Beitbridge 15 1 6.7 0 4394 138 3.1 45 32.6 18/01/2009 0 Masvingo Masvingo - - - - 558 45 8.1 17 37.8 14/01/2009 4 Gutu - - - - 26 3 11.5 1 33.3 17/01/2009 1 Chivi - - - - 721 86 11.9 69 80.2 14/01/2009 4 Bikita - - - - 1147 79 6.9 58 73.4 17/01/2009 1 Chiredzi - - - - 1264 82 6.5 42 51.2 17/01/2009 1 Mwenezi 34 0 0.0 0 450 30 6.7 20 66.7 18/01/2009 0 Zaka - - - - 291 38 13.1 38 100.0 17/01/2009 1 Midlands Gweru City - - - - 192 4 2.1 2 50.0 17/01/2009 1 (Mkoba) Zvishavane - - - - 271 14 5.2 8 57.1 17/01/2009 1 Source: Ministry of Health and Child Welfare Rapid Disease Notification System 6

Province District/area affected Today's update CFR of cases (%) (included in the total) CFR (%) (included in the total) Proportion (%) Date last updated Number of days since previous report Mberengwa - - - - 124 20 16.1 18 90.0 16/01/2009 2 Gokwe North - - - - 425 39 9.2 34 87.2 17/01/2009 1 Gokwe South - - - - 264 9 3.4 8 88.9 14/01/2009 4 Kwekwe - - - - 45 7 15.6 4 57.1 17/01/2009 1 Shurugwi - - - - 26 8 30.8 7 87.5 17/01/2009 1 Chirumhanzu - - - - 5 2 40.0 2 100.0 17/01/2009 1 Total 434 11 2.5 6 44463 2337 5.3 1331 57.0 Key: - No Report Flagged for follow-up Report received after more than 1 day Source: Ministry of Health and Child Welfare Rapid Disease Notification System 7