"Although the situation seems under control, we should remain alert especially in the most remote areas," said Dr. Morote. "According to the experience of other outbreaks, we expect that the outbreak will last more or less two months.
Since October 18, when the MSF team received the first cases of cholera in the health zones of Pweto and Kabalo, MSF has attended more than 500 cases in Pweto, where the majority of cases have occurred.
The outbreak is in the province of Katanga, in south-east of the Democratic Republic of Congo (DRC),
To date there have been 12 deaths. On October 23 MSF received 62 cases - the highest number of new cases in one day. Since then the levels have decreased to between 17 to 20 new cases a day at the beginning of November.
This outbreak has affected mainly people over the age of five, although on October 27 MSF received 15 new cases of children less than five years old. In the Kabalo health zone, the number of cases is considerably smaller. There, MSF has attended to 60 patients and, at this time, there have not been any deaths.
"The fast response of teams in situ has been crucial for the quite low mortality rate in the outbreak (in our health structures). I think this has been possible thanks to the Emergency Preparedness Plan and to the staff of the mission with outbreak experience," said Dr. Silvia Morote, a medical coordinator for MSF programs in the DRC.
In the Pweto health zone, MSF has installed two Cholera Treatment Centres (CTC) in the Boma health centre and in ChamfubÃ?º Hospital respectively, and also two Cholera Treatment Units (CTU) in the Kakonona and Kapulo health centres. Nine oral re-hydration posts in several communities complete the structures that MSF have installed in the Pweto health zone, where the outbreak is hitting hardest.
In Kabala, MSF has opened a CTC in the hospital and a CTU in Kitule, located 50 kms from Kabalo, where 12 cases have been treatned since October 27.
MSF has sent 10,000 litres of intravenous solution, over 3,500 doses of saline solution for oral re-hydration, and has purified tens of thousands of litres of water. In addition Unicef has donated medical and logistical material to the MSF team working in the outbreak.
Some 60 local people are collaborating with MSF in the coping with sanitation issues and information within local communities in the affected health areas to develop prevention measures in order to avoid the extension of the outbreak. At the same time, Ministry of Health has hired 25 sanitary workers who will receive a bonus from MSF whilst the outbreak continues.
MSF has hired one national doctor and seven nurses with outbreak experience and has sent a medical and logistical team of six expats who have joined the Pweto project team.
"Although the situation seems under control, we should remain alert especially in the most remote areas," said Dr. Morote. "According to the experience of other outbreaks, we expect that the outbreak will last more or less two months. This kind of outbreaks happen cyclically each four or five years. The last outbreaks happened here exactly five years ago. At the time, there were 1,500 cases and 93 dead. The duration of the outbreaks is more or less the same as the rain station which begins around October and finishes in February."
MSF has been working in Pweto since 2001 and in Kabalo since 2002 providing primary and hospital health care, with special attention to internal displaced people.