WHO concerned that cholera will spread to neighbouring countries

The World Health Organisation (WHO) has expressed concern that the cholera epidemic in Senegal could spread to neighbouring countries. There has been a massive upsurge in the number of new cases following a pilgrimage by more than one million Muslims to Touba, a town at the epicentre of the epidemic, at the end of March. According to the Health Ministry, 4,838 new cholera cases and 64 deaths were reported nationwide between 28 March and 6 April. "The epidemic constitutes a threat for the whole region … Cases have already been reported in Gambia, and one cannot rule out cases in Mali, Guinea-Conakry, Guinea-Bissau or Mauritania," Doctor Malang Coly, the head of Disease Prevention Control at the WHO office in Dakar, told IRIN on Thursday. His Geneva-based colleague, Claire-Lise Chaignat, the coordinator of the WHO's cholera control division, agreed. She told IRIN that the measures undertaken so far by the Senegalese authorities had been insufficient. "Sensitization messages, emergency measures, epidemiological surveillance and preventive measures should be put in place in Senegal as well as in neighbouring countries," Chaignat told IRIN on Thursday. Earlier this week, Health Ministry officials reported a drop in the number of new cases being reported each day. But doctors say the cholera outbreak is not yet under control. "We cannot say that we have brought the cholera outbreak under control. The epidemic is soaring, new cholera cases are coming every day," Dr Pape Salif Sow, the Head of the Dakar Fann Hospital department of infectious diseases told IRIN. With two weeks to go before huge crowds flock to large mosques throughout the country to celebrate the birth of the prophet Mohamed, the Senegalese government announced a new package of cholera control measures on Wednesday night. These included a ban on the sale of water in plastic bags in the street and a bigger public awareness campaign. Messages have already been broadcast on radio stations urging people to wash their hands before eating and boil drinking water and the government is now trying to involve Islamic religious leaders in the campaign against cholera. About 95 percent of Senegal's 10 million population is Muslim. "Religious gatherings cannot be prevented, thus a whole lot of measures were taken to improve prevention and care, such as water chlorination, improved waste disposal and the deployment of public health officials," said Doctor Bernard Marcel Diop, of the infectious diseases department of Fann hospital. The epidemic began in the Diourbel region of central Senegal in early January. Touba lies 200 km east of Dakar, in the heart of the affected area. Just over 2,000 cases of the disease had been recorded in central Senegal before the Touba pilgrimage got under way during the last week of March. But since then the number of new cases has tripled and the epidemic has spread nationwide as infected pilgrims took the disease home with them. The annual pilgrimage to Touba is organized by the influential Mouride brotherhood, to commemorate the departure into exile to Gabon of Cheikh Ahmadou Bamba, the founder of the Mourides and a hero of Senegalese nationalism, in 1895. The Muslim cleric, who preached the virtues of self discipline and hard work, was eventually allowed to return to Senegal by the French colonial authorities and he was buried at Touba following his death in 1927. In Gambia, which sent hundreds of pilgrims to Touba, the authorities reported on Thursday that a cholera-related death had been recorded in a village near the Senegalese border. Three cases of cholera had previously been reported at the main hospital in the capital Banjul. In Senegal, the celebrations on 20 April to mark Mohamed's birth, are expected to attract huge crowds to the large mosque at Tivouane, a town 100 km northeast of Dakar. People are also expected to flock in large numbers to several other provincial centres, including Kaolack and Touba. The Gambian government has urged people not to panic over the cholera outbreak. "All the health facilities in the country are well equipped to cope with any rise in cholera cases," Health Minister Malick Mbowe told reporters. "We have sent health teams to the border with Senegal to ensure that suspected cases are quarantined before being let in the country,” he added. Mauritania, Senegal's neighbour to the north, is also screening returning people crossing the border. Doctor Mohamed Idoumou Ould Mohamed Vall, the government's director of sanitary protection, said the authorities had established mobile clinics at Rosso, the main crossing point, to screen all pilgrims returning from Senegal.