Two stories from this week that update, most recently, "Guinea-Bissau cholera death toll nears 300, cases top 15,000":
Deaths in the cholera epidemic raging in tiny Guinea-Bissau have passed the 300 mark, prompting authorities to ban the sale of drinks and food by street vendors as well as forbid all traditional ceremonies.
The health ministry said on Wednesday that the epidemic has claimed 305 lives and stricken 19,054 people in four months. Sources in the ministry said that despite measures to halt the spread, the four-month-old epidemic was gaining ground.
Cholera is a water-borne disease that surfaces in parts of West Africa at each rainy season when wells and sewage spill over. The intestinal infection, caused by contaminated food or water, can kill within 24 hours by inducing severe vomiting and diarrhoea.
The Guinea-Bissau government late last week imposed a ban on all traditional rites and ceremonies for at least 30 days, as large gatherings are a major conduit for the highly contagious disease.
More than half the cases have occurred in the capital, Bissau, a city of 300,000 built on low-lying land on the banks of a muddy estuary.
Endemic in some countries in the region, cholera hit the capital of neighbouring Senegal in late 2004 for the first time in eight years and has remained entrenched. With unusually heavy rains in Dakar this year, the Senegalese health ministry by 2 October had reported 25,573 cases, including 352 deaths over the year.
And with 60,000 people made homeless by flooding in August and September and the rain continuing, Senegal in just the first three days of this week registered 433 cases and 12 deaths, the ministry reported.
The mortality rate is higher still in impoverished Guinea-Bissau, where a poor infrastructure - stemming from the 1998-1999 civil war and subsequent instability - makes treatment difficult.
“The epidemic has not abated yet,” said Claire-Lise Chaignat, the leading cholera expert at the UN World Health Organisation. “With the rains continuing it could get worse.”
Chaignat said improved public health and hygiene measures were vital to combat the disease across the region where several countries have been hit.
“We must prepare for next year,” she told IRIN by telephone from Geneva. “We need to train health workers and inform the public about the basic hygiene needed to combat cholera.”
With Muslims currently observing the holy month of Ramadan, extra care must be taken around communal meals, she said. “We must be vigilant during the month of Ramadan or there could be a resurgence."
Health officials in Guinea-Bissau are struggling to contain what has become a nationwide epidemic of cholera. About 16,000 cases of the water borne disease have been recorded in the tiny West African nation, since outbreaks first appeared earlier this year.
In the main marketplace in Guinea-Bissau's capital city, Bissau, a water seller calls to potential customers as they pass in front of her stand.
The tiny former Portuguese colony is in the middle of an epidemic of cholera that has now affected all of its regions.
The disease has killed about 300 people since instances of the disease appeared in Guinea-Bissau in July. More than 4,000 new cases were reported in the past month.
Health authorities are blaming polluted wells and rivers for the spread of cholera in the countryside. In Bissau, the health ministry says raw sewage may have seeped into the public water supply through the city's cracked and aging pipes.
Nurse Mime Gomes, who is helping with efforts to educate the public on how to prevent the spread of cholera, also blames the city's water sellers.
"People should not buy this water, because the person who sells this water, she does not know the procedure to take care of water," says Ms. Gomes. "This water is not clean."
But water seller Maria Diata says the authorities are simply paranoid.
Many of the women who support their families by selling water in Bissau's main market say they are being made scapegoats by the government, which, they say, has failed to contain the outbreak.
Ms. Diata says her water is safe. She says, though she takes water from the tap and resells it, she adds lemon juice to kill any bacteria.
Health officials say this is not enough. They say all water meant for drinking must be boiled first. And people should take extra care to wash their hands with soap before eating.
Former colonial power Portugal is also helping combat the disease. It has sent tons of drugs and medical equipment and its Foreign Minister, Diogo Freitas do Amaral, says medical expertise is also being made available to Guinea-Bissau.
"We have some experience in these tropical diseases," said Mr. Amaral. "We have a very good research institute in tropical diseases in Lisbon,and we will give all the support we can."
Cases of cholera have appeared in eight West African countries this year. More than 100,000 cases of the disease, which is characterized by diarrhea and profuse vomiting, were reported last year. Most of those occurred in poor countries in the developing world.
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