Ebola distracts from worsening Cameroon cholera outbreak

A cholera epidemic in northern Cameroon has killed at least 65 people and probably infected about 1,300 people in two months, as international attention has been diverted to fighting Ebola in West Africa, health experts said on Saturday.

They said the insurgency by Islamist sect Boko Haram was also hampering efforts to control the outbreak.


Some 185 suspected cholera cases were recorded last week alone in the outbreak focused on the Mogode, Hina and Bourha districts on the turbulent Nigerian border. The death toll is expected to climb as more cases are confirmed by laboratory testing.


Atilio Rivera-Vasquez, public health adviser in the region for International Medical Corps, said Cameroonian health authorities were diverting resources to impose checks at border crossing and airports for Ebola, after it killed more than 700 people in Guinea, Sierra Leone and Liberia.


"This is distracting from an appropriate and fast response to this cholera epidemic," Rivera-Vasquez said.


He added that the violent activities of Boko Haram in neighbouring northern Nigeria partly explained why the outbreak was not being brought under control.

Cameroon has some 100,000 double-doses of an oral cholera vaccine that showed high efficacy in a 2012 trial in Guinea. However, insecurity in the north has deterred the government from immunizing.


The cholera outbreak has shown a worrying increase in mortality in the last few months, he said, rising to 4.8 percent or more than double the 2 percent maximum cited in World Health Organisation (WHO) guidelines.


Julian Schlubach, from the European Union's aid agency, ECHO, said the situation was alarming because the rainy season - the worst time for cholera - still lay ahead.


ARRIVED FROM NIGERIA


Cholera is an acute intestinal illness that brings severe stomach aches, diarrhoea and vomiting, causing severe dehydration and even death if untreated. It is commonly contracted by drinking water or consuming foods contaminated with cholera bacteria.

The first three cases in Cameroon were reported in late April in the Far North region after a Nigerian family crossed the border to receive treatment.


The United Nations refugee agency (UNHCR) said some 60,000 refugees have fled into Cameroon, Niger and Chad from northern Nigeria, where fighting between the government and Boko Haram has killed thousands in the last six months. Some of them are carrying the disease.


"People in northern Nigeria cannot get to health clinics in time due to the awful security situation and that's one reason why they come across the very porous border where they have family or tribal ties," said Rivera-Vasquez.


Some 24,683 cholera cases have been reported in Nigeria since the beginning of the year, according to the Assessment Capacities Project, a consortium of international NGOs which check humanitarian needs in emergencies and crises.


In Cameroon, a country of 22 million people, outbreaks of the disease cause alarm because of poor sanitary conditions, particularly in rural areas.

According to a 2011 government survey, 54 percent of rural households have only cesspools or open holes, whilst 50 percent use drinking water from unprotected wells or surface water.


The mortality rate for those infected ranges between one and 50 percent, depending on access to treatment. A similar outbreak in Cameroon killed more than 4000 people in 2011/12.


The current outbreak is the first major epidemic since then.