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SASTM Newsflash - Cholera - South Africa and Republic of Congo


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SASTM Newsflash


Cholera - South Africa (Limpopo Province)

Cholera - Republic of Congo (Pointe-Noire)


A Zimbabwean man found to have cholera has sparked fears of an outbreak in Limpopo. The 25-year-old man was diagnosed with the infection on Wed 13 Mar 2013, after tests conducted on him revealed he had the _Vibrio cholerae_ bacterium.


The man was allegedly kept at the Lindela Repatriation Camp before he was deported to Harare, Zimbabwe 2 weeks ago. He returned to South Africa and was kept at a shelter in Musina, where he became ill. He was taken to the local hospital where he is still undergoing treatment.


Limpopo MEC [Member of the Executive Council] for health Norman Mabasa confirmed 17 Mar 2013 the 1st tests conducted on the man had discovered _V. cholerae_. He said they were working very hard to establish the facts surrounding the man's illness.


"We are worried about the possibility of a cholera outbreak." He said a team from the provincial department would work with the national response team "to guide us on curbing the outbreak".


Cholera - Republic of Congo (Pointe-Noire)


An influx of migrants from the countryside into the Republic of Congo's 2nd largest city, Pointe-Noire, is exacerbating a cholera outbreak that began in November 2012. The outbreak infected at least 389 and killed 10, according to the health ministry and local authorities.


"Heavy rain in the port city in recent weeks and sanitation problems triggered the cholera outbreak," said Health Minister Francois Ibovi.


According to the mayor of Pointe-Noire, Roland Bouiti Viaudo, the booming city has seen a large influx of migrants from rural areas. "People build and settle in prohibited areas, including [around] sewers, blocking the free flow of wastewater, which explains the repeated outbreaks of cholera," he told IRIN. "To stop the disease...

everyone -- the authorities, NGOs and communities -- should mobilize and become aware of this danger."


In early March 2013, during a council of ministers' meeting, the government announced that emergency aid had been released to combat the outbreak, but it did not specify the amount.


Health authorities in Pointe-Noire, a city of more than 800 000, have set up an intensive cholera treatment centre on the grounds of the 200-bed Loandjili Hospital. "This center is run by 6 specialists in infectious diseases and the gastrointestinal tract. It also has a team of 28 nurses with disposable gowns, gloves, masks, and shoes to avoid contamination," said the country's director-general of health, Alexis Elira Dokekias. "So far... of all cases reported by the Pointe-Noire health services,

347 have already returned home, 10 have died, and 32 are still hospitalized," he said.


Communicated by: ProMED-mail


Fri 15 Mar 2013, was the 200th anniversary of the birth of John Snow, an early epidemiologist who discovered contaminated water as the source of cholera in 1854. The following is a discussion of the discovery:


How often does a map change the world? In 1854, one produced by Doctor John Snow, altered it forever.


In the world of the 1850s, cholera was believed to be spread by miasma in the air, germs were not yet understood, and the sudden and serious outbreak of cholera in London's Soho was a mystery. So Snow did something data journalists often do now: he mapped the cases. The map essentially represented each death as a bar, and you can see them in the smaller image above [to see the map, refer to the source URL above]. It became apparent that the cases were clustered around the pump in Broad (now Broadwick) street.


There were some outliers though and Snow wrote that: In some of the instance, where the deaths are scattered a little further from the rest on the map, the malady was probably contracted at a nearer point to the pump."


One 59-year-old woman sent daily for water from the Broad street pump because she liked its taste. Wrote Snow: "I was informed by this lady's son that she had not been in the neighbourhood of Broad Street for many months. A cart went from broad Street to West End every day and it was the custom to take out a large bottle of the water from the pump in Broad Street, as she preferred it. The water was taken on Thursday 31 August, and she drank of it in the evening, and also on Friday. She was seized with cholera on the evening of the latter day, and died on Saturday."


At a local brewery, the workers were allowed all the beer they could drink -- it was believed they didn't drink water at all. But it had its own water supply too and there were consequently fewer cases.


In nearby Poland street, a workhouse was surrounded by cases but appeared unaffected: this was because, again, it had its own water supply.


It turned out that the water for the pump was polluted by sewage from a nearby cesspit where a baby's nappy contaminated with cholera had been dumped. But Snow didn't just produce a map; it was one part of a detailed statistical analysis.


As the Public Health Perspectives blog says, it changed how we see data visualisations, and how we see microbes. Snow was born 200 years ago (15 Mar 1813) and is the subject of an exhibition at the London School of Hygiene and Tropical Medicine.





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