Email: cholera_taskforce@zw.afro.who.int Toll free number for alert is 009001 or 009002 or 009000 Office of the WHO Representative in Zimbabwe Mobile number for alerts is 0912 104 257 Date of issue:04th January, 200 DAILY CHOLERA UPDATE 4th January, 2009 * Please note that daily information collection is a challenge du to communication and staff constraints. data cleaning may result in an increase or decrease in the numbers. Any change will then be explained. ** Daily information on new deaths should not imply that these deaths occurred in cases reported that day. Therefore daily CFRs >100% may occasionally result 1- Highlights of the day: 379 cases and 32 deaths (in comparison 693 cases and 9 deaths yesterday) 50 % of the districts affected have reported (27 out of 54 affected districts) 7 % of districts reported to be affected (54 districts/62) All 10 of the country's provinces are affected Districts reported an high number of cases (cases > 30) 1. Goromonzi 2. Makonde 3. Norton Districts with a daily CFR > 5% : 1. Chitungwisa 2. Goromonzi 3. Hwedza 4. Makonde 5. Zwimba 6. Norton 7. Makoni. Zvishavane Districts with high number of deaths outside health facility/ CTC > 3 Nil Districts which have not reported for more than 3 days: Goromonzi Gokwe North Mutoko Shurugwi Chikomba Buhera UMP Chivi 2- Conclusion of the day: High priority districts to investigated Goromonzi Makonde Norton Zvishavane Chitungwisa Hwedza Zwimba Makoni 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) Goromonzi Gokwe North Mutoko Shurugwi Chikomba Buhera UMP Chivi Source: Ministry of Health and Child Welfare Rapid Disease Notification System 1
3- Follow up actions District Flagged as a priority on Action taken and next step (when and who will be doing what) Status of the follow Makonde 27/12/0 (CFR High) Flag again on 31/12/09 (CFR High) Chegutu 27/12/0 (High Number of cases) Flag again on 31/12/09 (High number of cases) Contacted them again by phone on 29/12/0 Coordinator C4 has advised MoH+WHO to contact District Medical Officer and district environment health officer tomorrow Need fuel. PMD currently visiting districts to assess situation No communication, data sent by e mail Contacted them again by phone on 2/12/0 There was a problem of data reporting But still after correction more than 30 cases reported on one day Action? Need fuel. PMD currently visiting districts to assess situation up Kadoma 03/01/09 (High CFR) Communication problem Kwekwe 03/01/09 4 cases reported in new area (Zhombe). PNO relayed information. PMD office following On going up Communication problem 04/01/09 Chiredzi 03/12/0 (High CFR) PMD aware and still investigating. High CFR believed to be due to late presentation and weak active case finding The increase in cases and deaths was as a result of influx of cases last week in Human Ranch, Ingus and Mukati farms (New Resettlement). The cases were reported at Odzi and Mashoko (Bikita District) and Porepore, Nyangombe and Tshovani Polyclinic (Chiredzi District). The area is under close monitoring and the province is on alert of new areas and proactive Bikita 03/01/09 Four cases reported from Mangezi area. CTC set up The increase in cases and deaths was as a result of influx of cases last week in Human Ranch, Ingus and Mukati farms (New Resettlement). The cases were reported at Odzi and Mashoko (Bikita District) and Porepore, Nyangombe and Tshovani Polyclinic (Chiredzi District). The area is under close monitoring and the province is on alert of new areas and proactive Chivi 03/01/09 (No reported Communication problem cases) Mberengwa 03//01/2009 (High CFR) Communication Problems Mwenezi 03//01/2009 (High CFR) PMD aware and still investigating. High CFR believed to be due to late presentation and weak active case finding Mutare City 29/12/0 Communication problem Flag again on 31/12/0 Nyanga 03/01/09 Done Flag again 04/01/09 Cholera cases reported from Chikore (bordering Makoni and Mudzi) Districts. District quantifying the problem. Will appraise District coordinating committee on Monday. Partners to be dispatched from Provincial level if need arise To folloup on updates Chikore (in Nyanga) data was captured under Makoni where the CTC was available (10 cases and 1 death). In response to Nyanga cases being attended in Makoni, a CTC was opened at Nyanómbe. Supplies collected from PMD on 03 January 2009 and CTC was to Done Done Source: Ministry of Health and Child Welfare Rapid Disease Notification System 2
District Flagged as a priority on Action taken and next step (when and who will be doing what) Status of the follow up be in place on 03/01/2009 Guruve 29/12/0 Communication problem. Radio not working, No fuel, only 1 vehicle in PMDs office Beitbridge 03/01/09 Flag again 04/01/09 Cases from Chiturapasi area were there have been no cholera cases for two weeks. DEHO and CHS have gone for investigation. To update tomorrow CTC not yet opened in Bubi area. District to decide where to establish the CTC and update No report from Chituripasi but there were 9 cases admitted. Flora farm is on the border between Mat South and Masvingo. MSF in Mat South is limited to Beitbridge and setting of CTC is difficult. Mwenezi not responding to the call for SOS. Contacted PHO Masvingo, nearest CTC is at Mwenezi. There is MSF in Masvingo as well. Response team will be sent to assess situation. Conditions permitting a CTC will be set. Beitbridge has a comparative advantage in terms of transport and being a district hospital, patients prefer going there. Shurugwi 30/12/0 Communication problem Zvishavane 03/01/09 Out of stock of Ringers lactate Flag again 04/01/09 Logistician to liaise with province on quantity required Kariba rural 30/12/0 Flag again on 02/01/09 Hurungwe 30/12/0 Flag again on 31/12/0 03/01/09 (High number of cases) Out of stock of Chloride of lime. Asked to list everything which is out of stock and quantify No communication, data sent by e mail Follow up with Save the Children and PMD Alert increase of cases in Mola received on 02/01/2009 Dr Charimari to FU Communication problem as of 03/01/09 No communication, data sent by e mail Follow up with PMD (03/01/09) Communication problem Goromonzi 31/12/0 Communication problem Centenary 31/12/0 No update because of communication problems. Flag again 03/01/09 Access to Muzarabani still a problem because of floods. Patients failing to get through to (High CFR) the treatment centres Seke 31/12/0 Update received Run out of Chloride of lime, protective clothing and spray pumps List forwarded to Logistician Chikomba 04/01/09 There are no CTCs set up at Sadza and Chivhu areas. No fuel, tents and supplies although there are some cases being reported. Source: Ministry of Health and Child Welfare Rapid Disease Notification System 3
4- Epidemiological data Today's update Province District/area affected Cases Deaths CFR of cases e Cases e Deaths Lethality/ e CFR (included in the total) Proportion Date last updated Number of days since previous report Harare Chitungwiza 5 1 20.0 79 14 16. 4/01/2009 0 Harare 25 0 0.0 0 10419 234 2.2 16 6. 4/01/2009 0 Bulawayo Bulawayo 0 0 0.0-375 12 3.2 66.7 4/01/2009 0 Mashonalan d Central Mashonalan d East Mashonalan d West urban Shamva - - - - 39 20.5 100.0 4/01/2009 0 Centenary - - - 2 117 13 11.1 9 69.2 2/01/2009 2 Mazowe - - - 0 131 4 3.1 3 75.0 4/01/2009 0 Guruve - - - - 44 7 15.9 7 100.0 4/01/2009 0 Mbire - - - - 7 0 0.0 0-4/01/2009 0 Mt Darwin - - - - 36 2 5.6 1 50.0 4/01/2009 0 Bindura - - - 0 129 6.2 6 75.0 4/01/2009 0 Rushinga - - - - 7 4 5.1 4 100.0 4/01/2009 0 Mudzi - - - - 1966 120 6.1 60 50.0 3/01/2009 1 Murehwa - - - - 9 14 14.3 10 71.4 31/12/200 4 Goromonzi 113 7.1 5 502 34 6. 24 70.6 4/01/2009 0 Mutoko - - - - 154 32 20. 25 7.1 31/12/200 4 Marondera 1 0 69 7 10.1 5 71.4 4/01/2009 0 Chikomba - - - 67 5 7.5 5 100.0 31/12/200 4 Hwedza 9 1 11.1 1 24 2.3 1 50.0 4/01/2009 0 UMP - - - 47 19 40.4 5 26.3 31/12/200 4 Seke - - - 0 437 20 4.6 16 0.0 4/01/2009 0 Makonde 113 11 9.7 7 2766 7 3.1 37 42.5 4/01/2009 0 Kariba Mahombekomb e - - 0 233 5 2.1 1 20.0 2/01/2009 2 Source: Ministry of Health and Child Welfare Rapid Disease Notification System 4
Province District/area affected Cases Today's update Deaths CFR of cases e Cases e Deaths Lethality/ e CFR (included in the total) Proportion Date last updated Number of days since previous report Kariba Rural - - 0 29 1 6.2 10 55.6 2/01/2009 2 Zvimba 4 1 25.0 1 150 12.0 6 50.0 4/01/2009 0 Kadoma - - 0 1061 50 4.7 27 54.0 2/01/2009 2 Hurungwe 2 0 0.0 0 527 27 5.1 1 66.7 4/01/2009 0 Norton 45 3 6.7 0 739 31 4.2 11 35.5 4/01/2009 0 Chegutu 25 0 0.0 0 2027 141 7.0 29 20.6 4/01/2009 0 Manicaland Mutasa - - - - 9 5 55.6 5 100.0 3/01/2009 1 Mutare City 0 0 - - 16 1 6.3 0 0.0 4/01/2009 0 Matebelelan d North Buhera - - - - 756 31 4.1 27 7.1 29/12/200 6 Chipinge - - - - 657 42 6.4 27 64.3 3/01/2009 1 Makoni 17 3 17.6 3 363 4 13.2 40 3.3 4/01/2009 0 Mutare - 3 - - 1239 67 5.4 65 97.0 4/01/2009 0 Chimanimani - - - 65 35 5.3 15 42.9 3/01/2009 1 Lupane 0 0 - - 2 0 0.0 0-4/01/2009 0 Matabelelan Gwanda 0 0 0 69 7 10.1 3 42.9 4/01/2009 0 d South Plumtree 0 0 - - 3 0 0.0 0-4/01/2009 0 Beitbridge 19 0 0.0 0 370 119 3.1 39 32. 4/01/2009 0 Masvingo Masvingo - - - 0 437 45 10.3 17 37. 3/01/2009 1 Gutu - - - 0 26 3 11.5 1 33.3 3/01/2009 1 Chivi - - - - 441 54 12.2 42 77. 30/12/200 5 Bikita - - - - 303 31 10.2 21 67.7 3/01/2009 1 Chiredzi - - - 0 620 31 5.0 1 5.1 3/01/2009 1 Mwenezi - - 0 179 1 10.1 12 66.7 2/01/2009 2 Zaka - - 0 111 21 1.9 21 100.0 2/01/2009 2 Midlands Gweru City 0 0 - - 12 4 2.2 2 50.0 4/01/2009 0 (Mkoba) Zvishavane 1 1 100.0 1 116 11 9.5 72.7 4/01/2009 0 Mberengwa - - 4 103 20 19.4 1 90.0 2/01/2009 2 Source: Ministry of Health and Child Welfare Rapid Disease Notification System 5
Province District/area affected Cases Today's update Deaths CFR of cases e Cases e Deaths Lethality/ e CFR (included in the total) Proportion Date last updated Number of days since previous report 4 Gokwe North - - - - 12 5 41.7 5 100.0 31/12/200 Gokwe South - - 1 32 1 3.1 1 100.0 2/01/2009 2 Kwekwe - - - 0 30 1 3.3 0 0.0 3/01/2009 1 Shurugwi - - - - 23 6 26.1 6 100.0 12/12/200 23 Chirumhanzu - - - - 2 1 50.0 1 100.0 3/01/2009 1 Total 379 32.4 25 33579 1671 5.0 746 44.6 Source: Ministry of Health and Child Welfare Rapid Disease Notification System 6