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WHO Warns of Cholera Spread in South Sudan

FILE - A South Sudanese child suffering from cholera sits on a bed in Juba Teaching Hospital in Juba, May 27, 2014.
The World Health Organization reports that cholera is spreading rapidly in South Sudan’s capital city, Juba. The WHO says aid agencies and the Ministry of Health are intensifying efforts to stop the spread of the disease in the city and to prevent outbreaks in other parts of the country.

The WHO reports more than 1,000 cases of the disease, including 27 deaths in Juba, with unconfirmed cases reported in other parts of this war-torn country, including in Jonglei, Lakes and Upper Nile states.

Dr. Dominique Legros, a WHO cholera specialist, says the unsanitary conditions of the displaced persons' camps and the onset of the rainy season are expected to accelerate the spread of this often fatal disease.

“I think that we have to be ready for a situation of a large epidemic, if you want to call it an epidemic in the country.… It is very difficult to predict how outbreaks of cholera evolve. We know that they go very fast and we have seen this, again this time in Juba. For the moment, outside Juba we do not see, so far, big outbreaks," he said.

Many challenges

Legros says controlling the outbreak in more remote areas will be complicated during the rainy season, as roads become impassable, cutting off access. He says this period usually provokes an upsurge in cholera cases due to flooding that contaminates water sources.

Cholera spreads through contaminated food and water. It causes severe vomiting and acute diarrhea, which can lead to dehydration. It can kill within hours if left untreated. But, most cases are successfully treated with oral rehydration salts.

Legros says two main strategies are in place for containing the disease. In Juba, he says aid workers are trying to improve sanitation and provide safe water. He says they also are setting up treatment centers, so people can easily access health care.

“Then outside Juba, we have a system in place that we have already before, that we have reinforced with notably rapid tests for cholera, to detect as early as possible an upsurge of cholera cases, beginning of outbreaks, so that we can try to contain them. And, of course, to similar settings pre-position material for treatment and staff when needed,” he said.

Legros says security concerns because of the ongoing war hamper efforts to control the disease. For example, an evening curfew in Juba limits movement, making it difficult for both cholera patients and health care workers to go to treatment centers.

He says a few weeks ago, WHO and partners vaccinated displaced people at a camp in the northern part of South Sudan. But, because of heightened security, health workers are not able to return to the camp to carry out a second round.

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