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SP5-12 Outbreak of cholera, East-Akim Municipality, Ghana, November 2010
  1. J Opare1,2,
  2. J Der1,2,
  3. K Afakye1,
  4. G Bonsu1,2,
  5. C Ohuabunwo1,
  6. E Afari1,
  7. F Wurapa1,
  8. S Sackey1
  1. 1Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, Legon, Accra, Greater Accra Region, Ghana
  2. 2Ghana Health Service, Ghana, Accra, Greater Accra Region, Ghana

Abstract

Background Cholera is an acute infectious illness with profuse watery diarrhoea caused by toxigenic Vibrio cholerae serogroup O1 or O139. In Ghana, over 9000 cholera-cases with 250 deaths were recorded in 1999. On 29 October 2010, the East-Akim Municipality (EAM) received a report of suspected cholera outbreak. We investigated to characterise the outbreak, and implement control and preventive measures.

Methods We interviewed health workers, reviewed medical records, conducted environmental assessment and obtained water and stool samples for laboratory test. A descriptive study followed by unmatched case-control study was conducted. A suspected cholera-case was a person with acute watery diarrhoea, with or without vomiting in EAM from 1 October to 20 November 2010. We analysed data descriptively and risk factors were identified using χ2 test at 95% confidence level.

Results Of 136 case-patients, 77 (56.6%) were males. Index-case occurred on October 13th, and case-patients peaked (18.4%) 2 November. Attack rate was 2/1000 population; no death. Ages ranged from 1 to 84 years; mean of 34±18. Age-group 20–29 (30.1%) was mostly affected with Tafo Sub-Municipality having most case-patients (19.9%). V cholerae serotype ogawa was isolated from stool samples. We observed pollution of River-A with sand-washings by small-scale miners. Compared to controls, case-patients were more likely to have drunk from River-A. [OR 5.80, 95% CI 2.45 to 13.74].

Conclusion V cholerae serotype ogawa caused the EAM cholera-outbreak affecting mostly young adult-males. Drinking water from contaminated River-A was the major risk-factor. Boiling or chlorination of water was initiated based on our recommendations and this controlled the outbreak.

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