Date: Sun 15 Jul 2018 6:49 PM WAT
Source: The Sun Daily [edited]
<http://www.thesundaily.my/news/2018/07/15/cholera-outbreak-kills-6-cameroon>

The health ministry said 6 people have died in Cameroon from a cholera outbreak that has infected 43 people since May 2018. "Cases of cholera were documented since May 2018 in 4 districts in northern regions," health minister Andre Mama Fouda said in a statement sent late [Sat 14 Jul 2018]. He said one case of the disease had been found in the capital Yaounde. "From the moment the 1st cases were documented in the northern region, every measure was taken to contain the epidemic," Fouda said.

Cholera is caused by a bacterium transmitted through contaminated food or drinking water. It causes acute diarrhoea, with children particularly at risk. In 2010, an outbreak of the disease killed more than 750 people across Cameroon.
Date: Sun, 15 Jul 2018 12:20:59 +0200

Douala, July 15, 2018 (AFP) - Six people have died in Cameroon from a cholera outbreak that has infected 43 people since May, the health ministry said.    "Cases of cholera were documented since May 2018 in four districts in northern regions," health minister Andre Mama Fouda said in a statement sent late Saturday.   He said one case of the disease had been found in the capital Yaoundé.   "From the moment the first cases were documented in the northern region, every measure was taken to contain the epidemic," Fouda said.   Cholera is caused by a bacterium transmitted through contaminated food or drinking water. It causes acute diarrhoea, with children particularly at risk.    In 2010, an outbreak of the disease killed more than 750 people across Cameroon.
Date: Fri 1 Jun 2018
Source: Relief Web [edited]
<https://reliefweb.int/sites/reliefweb.int/files/resources/OEW22-260501062018.pdf>

The outbreak of monkeypox in Cameroon continues, with new areas being affected. Since our last report on 18 May 2018 (Weekly Bulletin 20), 9 additional cases have been reported, bringing the cumulative total to 16, including one confirmed case as of 30 May 2018. No deaths have so far been reported. The ages of the affected people range from one month to 58 years, with a median age of 13 years, and the gender distribution is proportionate.

In addition to the 2 initial health districts, 3 others from 3 different regions have been affected, namely: Njikwa (7 cases) in the North-west Region; Akwaya (6) in the South-west Region; Biyem-Assi (1) in the Central Region; Bertoua (1) in the Eastern Region; and Fotokol (1) in the Far-North Region.

The outbreak of monkeypox in Cameroon was confirmed by the Centre Pasteur du Cameroun (CPC) on 14 May 2018 when one of 2 specimens (obtained from the initial cases) tested positive for orthopoxvirus/monkeypox virus by real-time polymerase chain reaction. The confirmed case is a 20 year old male with clinical symptoms of fever, generalized vesiculo-pustular rash and enlarged lymph nodes. Samples from 11 suspected cases have been collected and tested at the CPC. The event was initially reported to the Ministry of Health by Bjikwa health authorities on 30 Apr 2018 when the 1st 2 suspected cases were detected. The Ministry of Health formally notified WHO of the event on 15 May 2018, following laboratory confirmation.

Public health actions
---------------------
On 15 May 2018, the Ministry of Health activated an Incident Management System in response to the outbreak, with support from WHO.
- An action plan has been developed for the interventions, and the needs of the different pillars of the response (coordination, operations, logistics, and communication) have been articulated.
- Active surveillance has been enhanced in the whole country, including case investigation of suspected cases and alerts.
- Training of healthcare workers on using personal protective equipment and advocating proper hand hygiene have been conducted. Information related to isolation of cases, symptomatic case management, and handwashing technique have been shared.
- A communication plan has been developed, and risk communication materials have been disseminated to increase public awareness and precautionary measures to prevent monkeypox transmission.
- On 22 May 2018, the Regional Centre for Epidemics Prevention and Control (CERPLE) organised a coordination meeting attended by the Njikwa Health District team, WHO, UNICEF, and other stakeholders.

Situation interpretation
------------------------
The outbreak of monkeypox continues in Cameroon, with 5 of the 10 regions in the country reporting at least one suspected case. The cases are being reported from remote rural areas where occupational activities such as farming and hunting are increasing animal-human interaction. The detection of additional cases in the other regions could be due to enhanced surveillance following confirmation of the outbreak.

The resurgence of monkeypox in Cameroon underscores the need to maintain a high level of vigilance and raise awareness of the disease among the local population. In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising public awareness of the risk factors, such as close contact with wildlife including rodents, and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical. People infected with monkeypox should be isolated, and infection prevention and control measures should be observed in healthcare facilities caring for infected patients. Close physical contact with persons infected with monkeypox should be limited, and protective equipment such as gloves, face masks and gowns should be worn when taking care of ill people in any setting. Regular hand washing should be carried out after caring for or visiting sick people.
===================
[The previous ProMED-mail post on monkeypox cases in Cameroon did not provide numbers of cases (see ProMED-mail. Monkeypox - Africa (09): Cameroon http://promedmail.org/post/20180519.5805270). Monkeypox virus is widespread in central and west Africa, and sporadic human cases occur there. A report earlier this year [2018] in MMWR stated that: "Since 2016, monkeypox cases have been reported and confirmed from Central African Republic (19 cases), DRC (more than 1000 reported per year), Liberia (2), Nigeria (more than 80), Republic of the Congo (88), and Sierra Leone (1) (table); an outbreak in captive chimpanzees occurred in Cameroon. With 80 confirmed cases, Nigeria is currently experiencing the largest documented outbreak of human monkeypox in West Africa this year (2018). The emergence of cases is a concern for global health security;" (see Monkeypox - Africa (04) http://promedmail.org/post/20180327.5712702). This report does not mention human cases in Cameroon, but the cases in chimpanzees in that country indicate that the virus is present.

The main reservoirs of monkeypox virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp; an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_. Halting the bushmeat trade and consumption of wild animals in order to halt MPX virus exposure will be culturally and economically difficult, so continued occasional occurrence of cases can be expected.

Reference:
Durski KN, McCollum AM, Nakazawa Y, et al. Emergence of monkeypox -- West and Central Africa, 1970-2017. MMWR Morb Mortal Wkly Rep 2018; 67(10):306-10. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Cameroon:
<http://healthmap.org/promed/p/65>.]
Date: Fri 18 May 2018 10h35
Source: Journal du Cameroun [edited]
<https://www.journalducameroun.com/en/monkey-pox-hits-english-speaking-cameroopn/>

The dreaded but rare viral zoonotic disease (from animal to man) caused by monkeypox virus has hit English speaking Cameroon, Andre Mama Fouda, Cameroon's Public Health Minister said on [Thu 17 May 2018].

Going by a press release issued by the Minister, monkeypox was detected in Njikwa, Momo Division, in the North West Region and Akwaya, Manyu, in the South West Region. The release states that the epidemiology surveilance system had recorded cases of human monkeypox in late April 2018. The few cases, the release went on was later confirmed in May with high suspicions of the virus circulating across several health districts.

Studies reveal monkeypox is a viral illness caused by a group of viruses that include chicken pox and smallpox [chickenpox is not in the group. - ProMED Mod.TY]. The virus has 2 types, the Central African and the West African types with the West African type being milder and having no records of mortality.

Given the serious consequences of the disease, Minister Mama Fouda urged Cameroonians to take adequate measures in order to reduce the risk of contracting the diseases. In his press statement, the Minister exhorted the population of the North West and South West regions to collaborate with health officials by staying away from sick animals. Persons with fever and rashes were equally urged to rush to the nearest health facility.  [Byline: Marriane Enow Tabi]
====================
[The report does not indicate how many monkeypox (MPX) cases have occurred this year (2018) in Cameroun nor the source of the infections. Apparently, these cases occurred in 3 different areas. Report earlier this year in WMMR stated that, "since 2016, monkeypox cases have been reported and confirmed from Central African Republic (19 cases), DRC (more than 1000 reported per year), Liberia (2), Nigeria (more than 80), Republic of the Congo (88), and Sierra Leone (1) (Table); an outbreak in captive chimpanzees occurred in Cameroon. With 80 confirmed cases, Nigeria is currently experiencing the largest documented outbreak of human monkeypox in West Africa. The emergence of cases is a concern for global health security" (see Monkeypox - Africa (04) http://promedmail.org/post/20180327.5712702). This report does not mention human cases in Cameroun, but the cases in chimpanzees in that country indicate that the virus is present.

The main reservoirs of monkeypox virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp; an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_). Halting the bushmeat trade and consumption of wild animals in order to halt MPX virus exposure will be culturally and economically difficult, so continued occasional occurrence of cases can be expected. - ProMED Mod.TY]

[Reference
Durski KN, McCollum AM, Nakazawa Y, et al. Emergence of monkeypox -- West and Central Africa, 1970-2017. MMWR Morb Mortal Wkly Rep 2018; 67(10):306-10

A map of Cameroon: <http://healthmap.org/promed/p/65>]
Date: Fri, 20 Apr 2018 20:55:16 +0200

Yaoundé, April 20, 2018 (AFP) - Two Cameroonian soldiers died and four were seriously injured on Friday after a mine exploded in an anglophone region hit by violence between separatists and the government.   "A Cameroonian army vehicle went over a mine" in Eyumedjock, a town in an English-speaking part of the southwest, a security source told AFP on condition of anonymity.   The source said the blast close to the Nigerian border caused "two deaths and four serious injuries".   Eyumedjock lies between Mamfe, the main town of the Manyu, and Ekok "in an epicentre of violence in the southwestern Anglophone region," the source added.

Since late 2017, anglophone separatists have killed 30 members of the security forces, according to an AFP count based on official statements and including the two deaths on Friday. Other observers in Yaounde believe the toll is higher.   Northwest and southwest Cameroon are home to the English-speaking inhabitants of Cameroon, who make up 20 percent of the population.    Separatist ambitions have long simmered in the two minority anglophone regions in the west of the country, where people complain of being marginalised by the French-speaking elite.   The deep socio-political crisis has gradually turned into a low-intensity armed conflict in recent months.

The separatists, who are fighting for independence, have asked Yaounde and military personnel to leave their territory, calling them "occupation forces".   For three months, armed separatist groups have ramped up violence against the police, kidnapped civil servants and clashed with the army.   As the crisis grows, new separatist groups have appeared, posing on social networks with weapons and a flag of "Ambazonia", the name of the state they want to create.   Cameroonians swept up in the conflict are facing a humanitarian crisis, according to aid groups, as they struggle to reach people in remote areas that have become virtually off-limits.
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