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The Federated States of Micronesia reported an outbreak of Cholera (serotype Ogawa), which was confirmed by the Public Health Laboratory on Guam on 8 May 2000. The primary symptom was an acute onset of watery diarrhoea with intermittent vomiting and dehydration. The outbreak was exacerbated by the death of the high-ranking traditional chief of Kitti on 27 April 2000. The funeral was followed by several days of feasting and drinking sakau (kava).
The majority of cases were from Kitti or were connected to the funeral. They either attended the funeral or ate food taken from the feast. There have been no fatalities.
As of 11 May 2000, 36 cases were admitted to the Pohnpei State Hospital. The first two cases were admitted on 17 and 19 April. Five cases were admitted on 1 May and since then, the daily admissions fluctuated between one to six cases.
The outbreak was limited to the island of Pohnpei with a strong focus in Kitti Municipality. The preponderance of cases resided in Kitti Municipality and attended the funeral. The rural dispensaries in the other municipalities did not experience an increase in diarrhoea despite increased surveillance activities.
The 36 patients admitted to the hospital were aged from 2 to 81 years with only three under the age of 15 years.
The public health response included closure of all schools and sakau bars, and curtailing of all travel to the outer islands. The hospital established a separated ward for cholera patients with limited family access and with no food allowed in or out of the cholera wards. The Division of Primary Health Care conducted follow-up visits to the homes of all admitted patients. Household members were provided with antibiotics and printed health education materials on water disinfection and safe disposal of faeces. In addition, community leaders were being contacted and their assistance requested. Radio announcements on preventative health measures were broadcast throughout the day.
* Prepared by JP Chaine, PIHOA Regional Epidemiologist
Thanks also to the Pohnpei and Federated States of Micronesia health authorities for sharing this information
This article was published in Communicable Diseases Intelligence Volume 24, No 5, May 2000.