Cholera in Sekong province

A cholera epidemic has been identified in the Sekong province, southern Laos, since mid-December 2007. Two districts are affected: Thataeng and Lamarm. Sekong is one of the ‘forgotten’ provinces in Laos, inhabited by numerous national minorities.

The Ministry of Health and the World Health Organisation (WHO) officially confirmed this epidemic and the presence of the cholera bacteria, the Ogawa vibrio, on 3 January.

As of January this year, 21363 cases had been reported by the health authorities and four people have so far died.

The evaluation mission, led by Médecins Sans Frontières, went into the area on 14 January and identified the need to quickly improve the conditions for managing the patients in the health facilities. At the Sekong hospital in particular, patients with the disease were not isolated and the hygiene conditions were such that the risk of transmission was significant, even within the hospital facility.

Although it seems that the cholera epidemic is in the process of being eliminated, Médecins Sans Frontières has proposed that it intervene to ensure that the last patients are treated under better conditions and to prepare the province’s health personnel for a possible resurgence of the epidemic. With the arrival of the rains each year in April, the number of cases of acute diarrhoea in the province is likley to increases.

Médecins Sans Frontières have been involved in staff training, including ways to diagnose the disease and procedures for handling patients. Equipment will soon also be provided to isolate patients initially within the hospital and then, if need be, in four health centres.

Médecins Sans Frontières is also prepared to take part in the active surveillance already implemented in several neighbouring districts of the province and in the provinces of Saravane, Attapeu and Champassak.

Previously, Médecins Sans Frontières conducted an intervention in two districts in Sekong province, from 1997 to 2000, and handled two cholera epidemics, in 1998 and 2000, with the provincial health authorities.