The World Health Organization (WHO) and partners are battling South Sudan’s on-going cholera outbreak, providing thousands of people with life-saving treatment that is helping bring down the number of cases. Cholera cases have been declining since July 20, 2015 but continue to be a great threat to young children and other vulnerable groups in South Sudan. As of Aug. 10, 2015, a total of 1519 cholera cases have been reported since June with children under 5 and 5 to 9 years of age being most affected in Juba and Bor counties. Other at-risk groups include pregnant women, elderly people and those needing special attention such as people living with HIV/AIDS or people with chronic illnesses.
Cholera is a fast-acting bacterial infection that can kill within hours if left untreated and thrives in areas of overcrowding, scarcity of safe water, poor sanitation and waste management, poor nutritional status as a result of food shortages, and poor access to healthcare services.
“Cholera is a largely preventable and treatable disease and progress is being made in providing access to safe water and sanitation for all populations and improving access to health care services for those who are sick,” says Dr. Allan Mpairwe, head of outbreaks and disasters management at WHO in South Sudan.
Health education campaigns, adapted to local culture and beliefs, have promoted the adoption of appropriate hygiene practices such as handwashing with soap, safe preparation and storage of food and breastfeeding.
Primary prevention is possible by adopting a few simple rules of good hygiene and safe water and food preparation. These rules include thorough washing of hands with safe water and soap, especially before food preparation and eating, thorough cooking of food, and consumption while hot ("boil it, peel it or leave it"), boiling or treatment of drinking water, and use of sanitary facilities.
Up to 80 percent of cases can be successfully treated with oral rehydration salts (ORS), and early detection and effective case management reduces the case fatality rate to less than 1 percent. Antibiotic therapy is also recommended for severe cases.
WHO and partners such as the state Ministry of Health and UNICEF are working hard to scale-up the prevention and treatment of cholera for all at-risk populations. During the week of Aug. 3-6, a total of 52 health workers from public and private health facilities were trained in Juba county on cholera case management, detection, sensitization awareness. With support from WHO, surveillance activities have been intensified and referral systems strengthened with four standby ambulances stationed in hotspots in Juba and all drivers oriented on referral procedures.
Moreover through support from Médecins sans Frontières (MSF) Swiss and WHO, the state Ministry of Health conducted a vaccination campaign with oral cholera vaccine (OCV), targeting cholera transmission hotspots and vulnerable groups in Juba County. The eight-day OCV campaign started on July 31, 2015 and reached an estimated 138,440 persons at 19 vaccination sites.
In 2014, South Sudan witnessed a similar outbreak that affected more than 6,400 people and claimed 160 lives. Until all households at risk have access safe water, adopted good hygiene practices and have access to sanitary facilities, the threat of cholera to children and other vulnerable groups remains high.