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Rains may spread cholera in Africa

Rainy season floods could make it even harder to stop Zimbabwe's cholera epidemic, which appears to be spreading across southern Africa, the World Health Organisation said yesterday.

Some 73,385 Zimbabweans have been infected with the water-borne diarrheal disease since last August and 3,524 have died in Africa's deadliest cholera outbreak in 15 years.

WHO spokeswoman Fadela Chaib said that the countries sharing borders with Zimbabwe have all reported cholera infections that could be related to the ongoing epidemic.

"There is believed to be a link between the Zimbabwe outbreak and South Africa, and possibly with Mozambique, Botswana and Zambia," she told a news briefing in Geneva. "Movements of population are likely the source of infection and spread."

The wet season stands to spread Zimbabwe's cholera-contaminated water, and floods may keep aid workers from distributing water-purification tablets, rehydration salts and soap in rural areas, according to the WHO spokeswoman.

"Cholera is not yet under control, far from it," she said. In normal conditions, cholera is preventable and treatable.

The outbreak in Zimbabwe is tied to an economic crisis that has left eight in 10 people out of work and caused the health system to collapse, with unpaid doctors and nurses among those reliant on food aid and struggling with an inflation rate estimated at more than 231 million percent.

To tackle Zimbabwe's cholera crisis and other looming health risks, Harare's new unity government must work to fix critical shortages of health workers, and improve disease monitoring and immunization coverage rates across the country, Chaib said. "The challenges ahead are enormous," she said.

Outside Zimbabwe, the largest cholera outbreak in the region is in South Africa, which has reported 4,859 cases and 34 deaths from mid-November to end-January, Chaib said. Mozambique has reported 3,592 cases and 25 deaths, Zambia has reported 3,035 cases and 43 deaths, and Angola has had 273 cases and one death.

Chaib said cholera is endemic in those countries, which have never fully stopped the disease, so "it is hard to say if all cases are linked to the Zimbabwe outbreak."

"Botswana is not endemic for cholera and it has only had a small number of cases, eight cases that were clearly linked to Zimbabwe," she said.

The WHO is not recommending travel restrictions in the area. Zimbabwe's neighbors have stronger and more functional health systems, so they are expected to be able to prevent and treat cholera much more effectively.


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