Cholera

Cholera
 
Mortality and Morbidity Weekly Bulletin (MMWB) – Cox’s Bazar, Bangladesh   Volume No 2: 22 October 2017
[Excerpt]
5.1 Cholera vaccination campaign in Cox’s Bazar and Bandarban
Since August 2017, an influx of approximately 600,000 from Myanmar arrived in Bangladesh. Overcrowding, bad sanitation and malnutrition were prevalent and outbreaks of cholera resulting in thousands of cases anticipated. Considering lack of safe drinking water, proper sanitation facilities and poor personal hygiene practices, the UMN camps of two sub-districts, Teknaf and Ukhia, were at high risk of spreading cholera as experience from similar situations in other countries has shown. Moreover, it has been reported that a huge number of people are suffering from acute watery diarrhoea.

Based on field assessments conducted by WHO in the newly established settlements and makeshift camps, the water and sanitation conductions are dire. Sanitation facilities range between 1 latrine per 1,000 to 5,000 people, open defecation is a widespread practice. Coupled with rainfall these pose serious public health threats…

On 10 October 2017, the Government of Bangladesh launched an oral cholera vaccination (OCV) campaign with the support of WHO for 10 days, targeting over 650,000 people in 11 camps/settlements in Cox’s Bazar district, Chittagong division. It was the first OCV campaign to be conducted in the country, and comes at a critical time after UMNs influx to the country since August 2017.

Because of the large numbers of UMNs living in the camps and within the host community and the limited supply of OCV, the vaccination campaign in Cox’s Bazar Bangladesh was limited to UMN camps at full capacity or overcrowded and to all host community areas. The large influx of UMNs increased uncertainty about the size of the target population, data from the most recent measles vaccination campaign (2017) were used to estimate the population aged >1-year-old.

The vaccination campaign was preceded by extensive social mobilization efforts to inform the community of the benefits, availability and necessity of the vaccine. The main message included that vaccination is a preventive measure against cholera that supplements, but does not replace, other traditional cholera control measures such as improving access to safe water and sanitation and hygiene measures/interventions.

The vaccination strategy included a combination of fixed sites and mobile teams for door-to-door vaccine delivery. The vaccine cold chain was maintained, and vaccines were transported using a sufficient number of vaccine carriers and ice packs for a door-to-door strategy.     Experience from WHO’s technical staff supported the implementation of this campaign during the public health emergency.

As of October 18, 2017, a total of 700,487 persons were reported to have been vaccinated of them; 691,574 representing 105% % (691,574/658,372) of the target population (Table 2). An additional 8,913 (not included in the original micro-plan) were vaccination in 2 sites; Anjumanpara, and Sabrang Entry Point…
 
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