Global Alert and Response (GAR)

Cholera in Liberia - update 6

30 September 2003

Disease Outbreak Reported

The cholera outbreak in Monrovia remains a public health concern. As of 21 September the total number of cases since the beginning of the year is 18 038 cases with 17 561 cases occurring since the beginning of the epidemic in June (see previous report). During 15-21 September, 2352 cases were reported by 12 of the 22 organizations participating in the emergency surveillance system developed by WHO. The case fatality rate is low (below 1% ) in the cholera treatment centres run by Médecins sans Frontières France and Belgium and by MERLIN. Many nongovernmental organizations have opened oral rehydration corners to increase the coverage of the population.

The most affected places in Monrovia are Central Monrovia, Paynesville and Sinkor. The caseload seems to be decreasing in Paynesville and Sinkor, probably as the result of the widespread chlorination of wells undertaken during the last four weeks by WHO and UNICEF. In Central Monrovia, the low access to safe water and sanitation remains critical and limits the effectiveness of control measures. An increase in cholera cases has also occurred in Buchanan (Grand Bassa County).

An additional concern is the increase in bloody diarrhoea cases (141 cases reported during 15-21 September mainly in Central Monrovia and Paynesville) which might be due to shigellosis. Laboratory tests are currently underway.

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