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Source: World Health Organization (WHO)
BhutanBetween 15 August 1998 and 28 August 1998, a total of 13 cases were officially notified to WHO. Bhutan has suffered previous cholera outbreaks in 1992 (494 cases) and in 1995 (25 cases).
Afghanistan (update)As of 2 September 1998, the national outbreak of acute gastroenteritis and suspected cholera, which began in July, was reported as continuing and worsening. Six hospitals in Kabul reported 1400 cases of acute severe diarrhoea, gastroenteritis, and suspected cholera in one week. Between 19 - 26 August 1998, Bamyan reported 328 cases of acute severe diarrhoea and suspected cholera, including 28 deaths. In Herat, 1 died and 86 were hospitalised with acute gastroenteritis. Other areas of Afghanistan involved in the outbreak included Baghlan, Laghman, Takhar, Samangan, Kunduz, Badakhshan, Uruzgan and Ghazni. Control of the outbreak, and city-wide and nation-wide efforts to provide long-term improvements in water and sanitation, are being hampered by the continuing civil war and isolation of many of the areas affected.
Comoros Islands (update)The country, which consists of 4 islands (Grande Comore, Moheli, Anjouan and Mayotte) has been experiencing a cholera outbreak since February 1998. By mid-August, the cumulative total for 1998 had reached 3199 cases and 40 deaths. Most cases have occurred in a number of districts on the island of Grande Comore, including the capital city, Moroni. However, at least one case has occurred on the island of Mayotte. Poor basic sanitation, very limited personal and environmental hygiene and poor access to safe water are the major contributors to the outbreak.
ArmeniaAn outbreak of cholera has occurred in a village, about 60 km from Yerevan. As of 6 September, a total of 25 cases had been reported. Cholera was confirmed by laboratory analysis as Vibrio cholerae El Tor.
Uganda (update)As of 21 September 1998, a total of 43911 cases and 1777 deaths (case fatality rate 4%) had been reported in Uganda since the beginning of the epidemic in late 1997. There was a stable or a downward trend in most areas, but the districts of Arua and Moyo in the Northern Region, Kamuli in the Eastern Region and Bushenyi in the Western Region were still reporting high numbers of cases.
Sierra LeoneAs of 16 September 1998, the outbreak of cholera affecting Sierra Leone had resulted in 1770 cases and 55 deaths. The organism has been identified by the Pasteur Institute in Abidjan, Cote d'Ivoire, as Vibrio cholerae O1 El Tor.
KyrgyzstanA outbreak of typhoid fever has occurred in Osh Oblast, beginning on 7 September 1998. As of 21 September 1998, 458 patients had been hospitalised and 46 cases had been confirmed as typhoid fever.
This article was published in Communicable Diseases Intelligence Volume 22, No 10, 1 October 1998.