Outbreak of Cholera, East-Akim Municipality, Ghana, November, 2010

Background: Cholera is an acute infectious illness with profuse watery diarrhea caused by toxigenic Vibrio cholerae serogroup O1 or O139. World–wide, an estimated 3–5 million cholera cases with 100,000–120,000 deaths occur annually. In Ghana, over 9000 cholera-cases with 250 deaths were recorded in 1999. Provision of safe water and sanitation prevents cholera outbreaks. On October 29th 2010, the East-Akim Municipality (EAM) received a report of suspected cholera outbreak. We investigated to characterize 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 diarrhea, with or without vomiting in EAM from 1st October to 20th November, 2010. We analyzed data by person, place and time. Risk factors were identified using Chi-Square 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%) November 2nd. Attack rate was 2/1000 population; no fatality. Ages ranged from 1-84 years; mean of 34±18. Age-group 20-29 (30.1%) was mostly affected with Tafo Sub-Municipality having most case-patients (19.9%). Vibrio 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: 2.45-13.74].

Conclusion: Vibrio 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.

Key words: case control studies, cholera, outbreaks, serotype-ogawa, East-Akim 

Author (s): 

Joseph Opare 1, 2, Der1, 2, K .Afakye1, G. Bonsu2 C. Ohuabunwo1, E. Afari1, S. Sackey1, F. Wurapa1, J.

Presenter (s): 
Add files
Your rating: None