15 July, 2011

Cholera in DRC, Massive Diarrheal Outbreak in China, & Lyssavirus in Australia

Poster by UNICEF

Cholera Hits Hard in the Democratic Republic of Congo

Cholera continues to affect the Democratic Republic of Congo, with 192 deaths and over 3,000 cases reported by the United Nations. The outbreak began in March in Kisangani and has spread along the Congo River to several provinces and the capital city Kinshasa. The Bandundu province has been especially hard hit, with 1,271 cases and 72 deaths.

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. The bacterium then produces an enterotoxin that causes extreme diarrhea and can rapidly lead to dehydration and death. Cholera is especially dangerous for children and can be fatal in a matter of hours. However, it can be successfully treated with oral rehydration therapy or with intravenous rehydration. Since the outbreak began, UNICEF has provided 2,700 liters of intravenous solution and 20,000 sachets of oral rehydration salts to health centers. The United Nations Stabilization Mission to the Democratic Republic of Congo and the Office for Coordination of Humanitarian affairs have provided additional logistical support so that supplies can reach affected areas.

Cholera is considered a key indicator of social development because it can be prevented with adequate sewage systems and water treatment facilities. However, it remains a problem in much of the developing world. Outbreaks have recently occurred in Haiti, Ghana, Nepal, and Nigeria, in addition to the DR Congo.

Hundreds of Thousands of Possible Cases Linked to Polluted Water Source in Huangchuan County

Since mid-June, Huangchuan County of Henan Province in China has seen a sharp rise in diarrhea cases, exceeding the capacity of local hospitals and causing many pharmacies to run out of medication. Despite initial claims that the increased diarrheal incidence was simply due to humid weather, dirty food, and aging water plant facilities, officials have since admitted that the tap water was contaminated from its unclean water source in the heavily polluted Xiaohuanghe River. Although the county stopped using this river as a water source four years ago as a result of its heavy pollution, a recent drought that dried up the previously used reservoirs forced the county to return to pulling water from the river using a water plant built in 1979 and had been out of use since 2008. Residents describe their tap water as “disgusting…yellow-black, and sometimes had dead mosquitoes…in it.” Recently, it was discovered that duck farms scattered along the river had been dumping duck excrement and dead animals directly into the river.

While 294 cases have been reported in this period, it is believed that some 100,000 individuals may have been sickened by the dirty drinking water. This discrepancy is partially due to failure to report many cases seen at local clinics. One physician reported that many patients have long-standing post-cure symptoms such as nausea and flatulence. While no one may know just how many people became ill, it appears that the number of new cases each day have slowly begun to decline.

Lyssavirus in Melbourne, Victoria

Australian Bat Lyssavirus has been detected in a colony of fruit bats in Yarra Bend Park, which is in the Melbourne suburb of Kew.  Lyssavirus is related to rabies and produces similar neurological symptoms: change in behaviour, paralysis, seizures. The only two humans cases have ever reported were in Queensland in 1996 and 1998; both resulted in death.  It has not been identified in any other animals, and humans can avoid the disease simply by not interacting with bats.

Australian Bat Lyssavirus is a completely different disease from Hendra virus, which is also bat-associated.  A Hendra virus outbreak in Queensland has led to calls from some of the public to cull the bat population.  The idea has been utterly dismissed by public health authorities; culling or relocating the bats would stress the urban bat population and thereby increase shedding of the virus, leading to more, not fewer, cases. Additionally, the flying foxes in question are critical for seed dispersal and pollination of many important plants and crops.

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