West Africa cholera down but officials vigilant

Some 1,700 people in West Africa have contracted cholera since mid-June, a significant decline compared to the same seven-week period in 2012 when 11,834 were affected.

Overall, 50,439 people contracted cholera in West Africa in 2012, according to the UN Children’s Fund (UNICEF). Sierra Leone and Guinea saw 30,000 people infected and 400 deaths.

This year, most of the cases are in Guinea Bissau (652), Sierra Leone (367) and Niger (354).

“It seems we are winning the fight thus far, but we must strictly monitor the West African coastal countries [Guinea-Bissau, Guinea, Sierra Leone] since they were so affected by cholera last year,” said François Bellet, West Africa cholera focal point for UNICEF.

Cholera often follows two-year cycles, with immunity building following an epidemic.

In Guinea-Bissau between 11 March and 8 July, 158 cases were confirmed and 18 people died of cholera. Despite fatality rates of 11 percent, Guinea's health minister declared on 11 July “there is no scientific evidence about a cholera outbreak.”

In Mali, where no new cases have been reported in the past five weeks, the government and aid agencies launched aggressive prevention actions when cholera broke out across the border in Niger.

Guinean health officials have worked with Médecins sans Frontières (MSF) and UNICEF to vaccinate 3,740 people in the Mènyingbé Islands, near Conakry, to prevent cholera from spreading. Last year MSF launched the vaccine in Guinea for the first time. Guinea has registered 115 cases and seven deaths since 19 March.

The cholera caseload may be higher than reported, said Bellet. “Some deaths are not reported in order to avoid high fatality rates or for political reasons. But if they’re not identified, we can’t provide adequate response,” he told IRIN.

Further, the caseload usually peaks towards the end of the rainy season (in September) so health workers must remain alert, said Bruno Ngandu Kazadi, information focal point for cholera for the West Africa office of the UN Office for the Coordination of Humanitarian Affairs (OCHA). “If rains are as strong as in 2012, we risk similar outbreak spikes,” he said.

Correctly diagnosing transmission contexts, reinforcing risk reduction strategies in the most affected zones, national planning, and promoting an intersectoral approach are also essential for prevention and treatment, say aid agencies and health officials.

Pix: Sierra Leone's Kroo Bay slum, which is prone to cholera outbreaks. Courtesy Anna Jefferys.

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