Maiduguri, 08 September 2017-With more than 1000 suspected and confirmed cases of cholera including 30 deaths in Borno state as of 07 Sept 2017, World Health Organization (WHO) has intensified its response efforts to contain the outbreak in Muna internally displaced persons (IDPs)camp in Maiduguri, Jere, Monguno and Dikwa local government areas (LGAs).

Prior to the outbreak, WHO had prepositioned Inter-agency Diarrheal Disease Kits across the state for immediate response to diarrhea and cholera outbreaks and has trained health workers including doctors, nurses, laboratory technicians and pharmacists on cholera case management, and infection prevention and control (IPC). These kits and health workers are boosting capacity for rapid response, including treatment of people with the disease in the affected camps and localities.

As the outbreak escalates, WHO is also scaling-up its response framework by deploying a team of already trained field volunteers, LGA facilitators, and mobile health teams to support in early detection, sample collection and line listing of suspected cholera cases. Without early detection and rapid response, the ongoing cholera outbreak can spread rapidly to areas other where access to safe water, sanitary and hygiene conditions are poor as it is currently in many parts of Borno state due to the current crisis.

“We are not just keeping up with cases but also expanding our response framework including personnel to achieve early detection and prevent further spread of cholera in Borno state,” said WHO Emergency Manager, Dr Collins Owili.

“WHO is taking critical steps towards achieving containment of the ongoing outbreak by deploying its field volunteers and mobile health teams to support active case search, contact tracing, sample collection, line listing of suspected cases and geo-coordinate mapping of affected areas to inform targeted and rapid response”, he added.

With logistics support from WHO and partners, the Ministry of Health has set up cholera treatment centre and Oral Rehydration Points (ORP) in Muna IDPs camp. Risk communications activities, as well as active media are underway to ensure people in the communities are aware of the risk of cholera, how to prevent it and the importance of seeking treatment when they experience the symptoms.

Due to the rainy season and risk of spread not only within the IDPs camps, but also in the surrounding area, WHO is facilitating a request for 950 000 doses of oral cholera vaccine to the International Coordinating Group by the government of Nigeria for the first round of planned campaign. Furthermore, WHO has trained 213 health workers, including members of rapid response team (RRT), laboratory scientists, clinicians and public health workers on identifying and treating cholera.

Using mobile technology in active search and targeted response

In order to nip the cholera outbreaks in the bud, WHO has swiftly intensified active case search for cholera in Muna, Dikwa, Jere and Monguno LGAs, capturing geo-coordinates to map out the localities where cases are reported and rapidly apply epidemiological questionnaire to assess potential source of infection, water quality, adequacy of latrines, waste disposal and hygiene practices. With the geo-coordinate mapping of sectors/areas where suspected or confirmed cases have been reported, WHO guides the government and other partners to target, concentrate and intensify response efforts in the Sectors/areas including active case search, assessment of the water and sanitation quality, line-listing of suspected cases, environmental disinfection, hygiene promotion and distribution of soap, aqua tabs and community sensitization.

Disinfection of shelters, latrines to contain spread

Shelters, latrines and environmental disinfection is critical of efforts to contain spread of cholera especially in areas where sanitary and hygiene facilities are inadequate. WHO has deployed 23 field volunteers to Muna IDPs camp to provide supportive supervision to government and partners in order to ensure that shelters where cases have been reported, public toilets and are disinfected with chlorine solution. The field volunteers have supervised the disinfection of more than 600 latrines, nearly 200 shelters, and more than 10 garbage spots in Muna camp, Farm centre and Custom house IDPs camp.

Reaching inaccessible populations

In line with WHO’s top priority in emergencies which is to save lives, the organization has deployed five mobile health teams to scale up active case search to enhance early detection and targeted response. The mobile health teams comprise of one Nurse/Midwife, a community health extension worker (CHEW), a junior CHEW and health information officer. The teams have collectively reached 3672 households, with 18,771 individuals and reported cases 156-suspected cases with seven deaths; 59 of which are new cases referred to ORP or the cholera training centre.

The teams have also conducted community sensitization and health education at the IDPs camp and the affected communities in both Maiduguri Municipal Council and Jere LGAs (Bolori II tsangaya, Custom house IDP camp, Muna IDP camp, Haruna Alana Camp and Galameri settlements).

Technical contacts:

Dr Mary Stephen; Tel: +234 803 639 1332; Email: stephenm [at] who.int

Dr Chima Onuekwe; Tel: +234 803 535 4876 Email: onuekwec [at] who.in