On The Cholera Trail

The only certainties in this world are death, taxes and cholera. Since my last report, there have been several new outbreaks of cholera and "acute diarrhea" in Africa and Asia.

Uganda (southeast)
Four districts fed by the Manafwa River in the southeast of Uganda experienced a cholera outbreak after heavy April rains flushed contaminated water from Bugobero into the Manafwa. Thirty-one people died, out of a total of at least 290 infected individuals, in the six weeks following the rains.

South Africa (KwaZulu-Natal)
Health officials implemented precautionary measures in late June at a shelter in the coastal area of KwaZulu-Natal after an unspecified number of people – including a one-month-old baby boy – began to experience diarrhea. Cholera is suspected, but hadn't been confirmed at the time of the report.

Kenya (Nyanza and Western provinces)
Several outbreaks of cholera have been reported in this region of Kenya since the beginning of 2008. At least 46 people died out of a total of 832 confirmed cases of cholera by early April. After a lull during which no new cases appeared, approximately 30 new cases were reported in the first half of June.

Vietnam (northern)
Cholera broke out again last month in three northern provinces of this Southeast Asian country. Nearly 60 cases of cholera have been confirmed, many of them from Chan Lac Village. Health officials warned villagers not to use water from the lake, after it was tested and found to contain Vibrio cholerae. The lake has since been disinfected. Vietnam has experienced some 500 confirmed cases of cholera so far this year.

Nepal (mid-western)
A remote village in the Jumla district of Nepal has been devastated by an outbreak of cholera, which claimed at least six lives – mostly children – and sickened more than 100 villagers. The village is accessible only on foot, and is a seven-hour trek from the district headquarters. But distances made no difference in this case. According to the Xinhua news agency, the health district had no medicines to distribute to the afflicted village.

Myanmar
There is still a de facto news blackout on the cholera situation in the cyclone-devastated regions of this country. On May 9th, a spokesperson for Medecins Sans Frontieres reported "many" cases of diarrhea, as well as outbreaks of cholera and malaria.

A resident of Bogalay village, in the cyclone-hit area, also reported cases of cholera and dysentery among survivors of the storm. But on May 18th, the Myanmar government denied the existence of any disease outbreaks, "...except usually occurring diseases..."

Unfortunately, the number of "usually occurring diseases" in Myanmar is probably high enough to mask the additional number of cases due to the cyclone's aftermath.