Ministry of Health and Child Welfare Email: cholera_taskforce@zw.afro.who.int http://ochaline.un.org/zimbabwe Toll free numbers for cholera alert are ( Ecet ly) 08089001 or 08089002 or 08089000 Mobile number for cholera alerts and SMS is 0912 104 257 Water and Sanitati alert numbers 04 703 941-2 (during working hours) 2 917 710 (after hours) Office of the WHO Representative in Zimbabwe Date of issue:28 th January, 2008 DAILY CHOLERA UPDATE AND ALERTS 28 th January, 2009 * Please note that daily informati collecti is a challenge due to communicati and staff cstraints. On-going data cleaning may result in an increase or decrease in the numbers. Any change will then be explained. ** Daily informati new deaths should not imply that these deaths occurred in cases reported that day. Therefore daily CFRs >100% may occasially result A. Highlights of the day: 1291 cases and 67 deaths (in comparis 1579 cases and 57 deaths yesterday) 55.2% of the districts affected have reported (32 out of 58 affected districts) 88.7 % of districts reported to be affected (55 districts/62) Beitbridge district updated retrospect data which was not captured in the system (319 Cases). Chikomba District Sadza CTC reported data for the first time (105 Cases). Mbire updated deaths ly which were not captured when cases were reported. Institutial Case Fatality Rate 2.1% Daily Institutial Case Fatality Rate 1.7% B. High priority districts to be investigated Districts reported high number of cases (cases > 30 1. BRIDH 2. Budiriro 3. Chikomba 4. Kadoma 5. Makombe 6. Mutare 7. Beitbridge 8. Chiredzi 9. Gokwe North Districts with a daily CFR > 5% : 1. Budiriro 2. Bulawayo 3. Chikomba 4. Chikomba 5. Chegutu 6. Hurungwe 7. Zvimba 8. Mutare 9. Zaka Districts with high number of deaths outside health facility/ CTC > 3 1. Mutare 2. Mbire 3. Chikomba 4. Hurungwe Districts with cases reoccurring after more than 14 days Nil Districts which have not reported for more than 3 days: 1. Hwedza 2. Makumbe (Goromzi) 3. Mardera 4. Chipinge 5. Masvingo Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 1
C. Follow up actis Province District/Area Flagged as a priority Cause for flagging, Acti taken to be taken (when and who will be doing what) Respsible for Following up Follow up with HARARE BRIDH (High number 47 cases reported NPO-EHA CITY DIRECTORATE On-going 139 cases reported 28.01.09 Budiriro 28.01.09 (High number 33 cases and 3 deaths reported NPO-EHA CITY DIRECTORATE On-going 28.01.09 Bulawayo 28.01.09 (High CFR) 2 cases and 2 deaths NPO-EHA CITY DIRECTORATE On-going MASH Mbire 187 cases reported NPO-EHA/MOH PMD Office On-going CENTRAL Shamva 21/01/09; 26.01.01 (High number f cases) Bindura 16/01/09 (High number of cases, CTC setup) 19/01/09; 22/01/09 (High number 81 cases reported 21.01.09 67 cases reported To follow up with PMD the discrepancy between the figures purpoted to be supplied by the Governor and the PMDs office 51 cases reported 25.01.09 60 cases reported 179 cases reported Rushinga (High CFR) 4 cases and 4 deaths reported NPO-EHA/MOH PMD Office Case management experts Provincial team 28.01/09 NPO-EHA/MOH PMD office Case management experts Provincial team 28.01/09 NPO-EHA/MOH PMD office Case management experts Provincial team 28.01/09 Mt Darwin 21.01.09; 23.01.09; 24.01.09 (High number MASVINGO Bikita 16.01.09; 19.01.09 ; 22.01.09; 23.01.09; (High number of cases & community deaths, High CFR) 126 cases reported 21.01.09 39 cases reported 23.01.09 69 cases and 8 deaths (4 community) reported 24.01.09 45 cases reported Case management experts to provide training to the Provincial team 28.01/09 207 cases reported 22/01/09 Minister to visit the province the 29 th 23.01.09 23 deaths (17 community) and 111 cases were reported 23.01.09 222 cases reported What needs to be procured for the Province has been identified. Waiting for the supplies to be delivered NPO-EHA/MOH PMD office Case management experts Provincial team 28.01/09 NPO-EHA/MOH PMD office Minister of Health to visit the Province Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 2
Province District/Area Flagged as a priority Masvingo ; ; 28.01.09 (n Chivi 19/01/09 (High CFR) 20/01/09 (>3 community deaths) 23.01.09 (High community deaths) Chiredzi 22/01/09; (High number of cases and CFR) MASH EAST Mwenezi 15/01/09; 16/01/09; 18/01/09 (High number 20/01/09 (High CFR & community deaths >3) Mudzi 23.01.09 (High number Seke 23.01.09 (High number Hwedza ; ; 28.01.09 (n UMP 25.01.09 (> 3 community deaths) Mardera Chikomba Makumbe (Goromzi) Ruwa (Goromzi) ; 28.01.09 (n 28.01.09 (High number ; 28.01.09 (n of cases & CFR; community > 3) Cause for flagging, Acti taken to be Respsible for Follow up with taken (when and who will be doing what) Following up N reporting Data Manager PMD office On-going 47 cases reported 23.01.09 6 community deaths reported 23.01.09 62 cases and 23 (15 community deaths) cases were reported 13 deaths and 215 cases reported 22/01/09 481 cases reported 173 cases reported 28.01.09 5 deaths and 15 cases reported 20/01/09 NPO-EHA/MOH PMD office On-going NPO-EHA/MOH PMD office On-going MOH/MOH PMD office On-going 31 cases reported 23.01.09 103 cases reported (last reported 24.01.09) MOH PMD office On-going 5 deaths and 39 cases reported MOH PMD office On-going 23.01.09 Data Manager PMD office On-going More than 3 community deaths reported 25.01.09 37 cases and 4 deaths reported NPO-EHA PMD office Ongoing Data Manager PMD office On-going 120 cases and 10 deaths reported 28.01.09 NPO-EHA PMD office Sadza CTC reported batched cases for the first time Data Manager PMD office On-going 46 cases and 7 deaths reported 21/01/09 Frequent visits to be made to some districts which are nearby the MOH PMD office Visit to the district for investigati and assessment being arranged most likely to take place 29.01.09 Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 3
Province District/Area Flagged as a priority MASH WEST MIDLANDS Zvimba 22/01/09 (High number Makde 24.01.09; 25.01.09 ; (High number Kadoma Hurungwe 24.01.09 (High number 28.01.09 (High CFR) Gokwe South (High number of cases and High CFR) 21/01/09; 22/01/09 (High number Gokwe North 22/01/09; 23.01.09 (High number of cases & CFR) Cause for flagging, Acti taken to be taken (when and who will be doing what) command centre 23/01/09 37 cases reported 22/01/09 Water problems still not solved in Kamhde, (Borehole needs repair, leaking tank which needs replacement) Dzivarasekwa and Banket Hospital. Zvimba reported 63 cases 63 cases and 7 deaths reported 24.01.09 More than 3 community deaths reported 25.01.09 107 cases and 4 deaths reported 95 cases reported 28.01.09 356 cases reported 24.01.09 135 cases reported 25.01.09 416 cases and 9 deaths reported 85 cases reported 28.01.09 114 cases reported 21/01/09 Case management experts to visit the district 21/01/09 109 cases reported 25.01.09 147 cases reported 25 cases and 15 deaths reported 28.01.09 A team from the Province ge out to make some investigatis 23/01/09 163 cases reported Strategise how to handle the situati during floods To find out if there are enough supplies and predict what might be required 23/01/09 9 deaths (7 community) and 85 cases 23/01/09 193 cases and 5 deaths reported Respsible for Following up Follow up with NPO-EHA PMD office On-going NPO-EHA PMD office Visit to the district for investigati and assessment being arranged NPO-EHA PMD office Case management Educati has been cducted. NPO-EHA PMD office Case management Educati has been cducted MOH (Dr Midzi) follow up with MSF Spain, IFRC and Zimbabwe Red Cross, CONCERN PMD office On going EHA PMD Office On-going Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 4
Province District/Area Flagged as a priority Cause for flagging, Acti taken to be Respsible for Follow up with taken (when and who will be doing what) Following up 106 cases reported 63 cases reported 28.01.09 Mberengwa (N Not reporting Data Manager PMD office On-going Kwekwe (High number NPO-EHA PMD Office On-going 60 cases reported Manicaland Nyanga (High CFR) 13 cases and 11 deaths reported NPO-EHA PMD office On-going Chipinge 19/01/09 (High number NPO-EHA PMD office On-going 23.01.09; 24.01.09; ; ; 28.01.09 (n Maki 23.01.09; 24.01.09 (n 38 cases and 6 deaths reported Data Manager PMD office cases for more than 3 days reported (High CFR) Maki reported 17 cases and 5 Mutare 12/01/09; 15/01/09 (High number 19/01/09; 22/01/09 (High number of cases and High CFR) Chimanimani 23.01.09; (High number deaths 27.01.01 93 cases reported 22/01/09 PMD, Minister and Governor to visit the district 91 cases and 7 deaths reported 69 cases reported 28.01.09 109 cases and 12 deaths reported 23.01.09 191 cases reported MOH PMD office On-going MOH PMD office On-going MAT SOUTH Beitbridge 20/01/09 (High number (High CFR) MAT NORTH Binga 23.01.09; 24.01.09 (High number 10 cases and 6 deaths reported 334 cases reported 28.01.09 264 cases reported 24.01.09 150 cases reported NPO-EHA PMD office On-going NPO-EHA PMD office Case management experts visted Binga and managed to provide some training. There are currently 5 CTCs in Binga. Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 5
D. Epidemiological Data Province District/area affected Cases Death s Today's update CFR of cases (%) (included in the total) Cases CFR (%) (included in the total) Proporti (%) Date last updated Number of days since previous report Harare Chitungwiza 12 0 0.0 0 2143 153 7.1 115 75.2 28/01/2009 0 BRIDH 139 2 1.4 0 4450 249 5.6 83 33.3 28/01/2009 0 Budiriro 33 3 9.1 3 7383 185 2.5 104 56.2 28/01/2009 0 Bulawayo Bulawayo urban 2 2 100.0 1 413 17 4.1 11 64.7 28/01/2009 0 Mashaland Shamva - - - - 316 19 6.0 18 94.7 27/01/2009 1 Central Mashaland East Mashaland West Manicaland Centenary - - - - 181 19 10.5 15 78.9 27/01/2009 1 Mazowe - - - - 210 4 1.9 2 50.0 27/01/2009 1 Guruve - - - - 309 14 4.5 12 85.7 26/01/2009 2 Mbire 0 12 12 293 21 7.2 19 0.0 28/01/2009 0 Mt Darwin 24 0 0.0 0 564 20 3.5 11 55.0 28/01/2009 0 Bindura - - - - 1007 22 2.2 20 90.9 27/01/2009 1 Rushinga 2 0 0.0 0 120 10 8.3 10 100.0 28/01/2009 0 Chikomba 120 10 8.3 9 245 25 10.2 21 84.0 28/01/2009 0 Hwedza - - - - 31 3 9.7 2 66.7 21/01/2009 7 Makumbe (Goromzi) - - - - 340 22 6.5 17 77.3 23/01/2009 5 Mardera - - - - 116 8 6.9 6 75.0 23/01/2009 5 Mudzi 22 0 0.0 0 2393 141 5.9 72 51.1 28/01/2009 0 Murehwa - - - - 136 23 16.9 15 65.2 27/01/2009 1 Mutoko - - - - 206 35 17.0 29 82.9 27/01/2009 1 Ruwa (Goromzi) - - - - 403 23 5.7 18 78.3 26/01/2009 2 Seke - - - - 659 29 4.4 18 62.1 27/01/2009 1 UMP - - - - 311 37 11.9 20 54.1 27/01/2009 1 Chegutu 7 1 14.3 0 2521 143 5.7 30 21.0 28/01/2009 0 Hurungwe 25 15 60.0 10 1812 92 5.1 59 64.1 28/01/2009 0 Kadoma 85 1 1.2 0 3545 162 4.6 87 53.7 28/01/2009 0 Kariba Rural 0 0 0.0 0 395 34 8.6 24 70.6 28/01/2009 0 Kariba Urban 1 0 0.0 0 316 21 6.6 2 9.5 28/01/2009 0 Makde 95 0 0.0 0 3908 143 3.7 88 61.5 28/01/2009 0 Nort 16 0 0.0 0 911 38 4.2 13 34.2 28/01/2009 0 Zvimba 2 1 50.0 0 479 36 7.5 30 83.3 28/01/2009 0 Buhera - - - - 1905 60 3.1 45 75.0 26/01/2009 2 Chimanimani - - - - 1041 57 5.5 15 26.3 26/01/2009 2 Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 6
Province District/area affected Cases Death s Today's update CFR of cases (%) (included in the total) Cases CFR (%) (included in the total) Proporti (%) Date last updated Number of days since previous report Chipinge - - - - 1416 62 4.4 38 61.3 19/01/2009 9 Maki - - - 486 62 12.8 56 90.3 27/01/2009 1 Mutare 69 6 8.7 6 2034 197 9.7 192 97.5 28/01/2009 0 Mutare City 0 0 0.0 0 26 2 7.7 2 100.0 28/01/2009 0 Mutasa - - - - 11 5 45.5 5 100.0 26/01/2009 2 Nyanga - - - - 75 13 17.3 13 100.0 26/01/2009 2 Lupane - - - - 2 0 0.0 0 0.0 27/01/2009 1 Matebeleland North Binga 24 1 4.2 0 1015 47 4.6 1 2.1 28/01/2009 0 Matabeleland Gwanda 0 0 0.0 0 73 9 12.3 5 55.6 28/01/2009 0 South Masvingo Midlands Plumtree 0 0 0.0 0 3 0 0.0 0 0.0 28/01/2009 0 Beitbridge 334 0 0.0 0 4891 143 2.9 46 32.2 28/01/2009 0 Masvingo - - - - 588 52 8.8 23 44.2 22/01/2009 6 Gutu 0 0 0.0 0 67 7 10.4 4 57.1 28/01/2009 0 Chivi - - - 889 125 14.1 96 76.8 27/01/2009 1 Bikita - - - - 1953 154 7.9 117 76.0 27/01/2009 1 Chiredzi 173 8 4.6 2 1976 85 4.3 53 62.4 28/01/2009 0 Mwenezi 1 0 0.0 0 562 41 7.3 27 65.9 28/01/2009 0 Zaka 18 2 11.1 2 485 45 9.3 45 100.0 28/01/2009 0 Chirumhanzu 10 0 0.0 0 19 2 10.5 2 100.0 28/01/2009 0 Gokwe North 63 3 4.8 1 1359 73 5.4 59 80.8 28/01/2009 0 Gokwe South - - - - 875 33 3.8 25 75.8 27/01/2009 1 Gweru City (Mkoba) 0 0 0.0 0 198 5 2.5 2 40.0 28/01/2009 0 Kwekwe - - - - 134 21 15.7 15 71.4 27/01/2009 1 Mberengwa - - - - 149 22 14.8 20 90.9 27/01/2009 1 Shurugwi 0 0 0.0 0 26 8 30.8 7 87.5 28/01/2009 0 Zvishavane 14 0 0.0 0 446 17 3.8 9 52.9 28/01/2009 0 Total 1291 67 5.2 46 58820 3095 5.3 1893 61.2 - : No report, - Flagged for follow up -Report received after more than 1 day Source: Ministry of Health and Child Welfare Rapid Disease Notificati System 7