A total of 69 cases including 5 deaths have been reported so far in the outbreak at Muna Garage, a camp on the outskirts of the state capital Maiduguri which is home to 44 000 people displaced by conflict and famine. The state of Borno is at the heart of a humanitarian crisis in the north-east of the country where almost 7 million people need health assistance and 60% of health facilities are functioning partially or not at all.

Detecting and responding rapidly to suspected cases of cholera is vital to controlling outbreaks, which can spread rapidly in areas where access to safe water is limited, hygiene conditions are poor and populations are weakened by food shortages. Intense efforts by national and partner response teams in Borno State over the last year mean surveillance and monitoring capacity have been greatly strengthened, enabling early detection of this outbreak.

Public health response
The State Ministry of Health is leading partners including WHO, in the response to the outbreak in Muna Garage, which includes the establishment of a cholera treatment centre, increasing risk communications and assessing the need for an oral cholera vaccination campaign in the affected area.

WHO has prepositioned Inter-agency Diarrheal Disease Kits across the state for immediate response to diarrhea and cholera outbreaks and has trained 56 health workers including doctors, nurses, laboratory technicians and pharmacists on cholera case management, and infection prevention and control (IPC). These health workers are boosting capacity to treat people with the disease in the affected camp and surrounding health facilities.

WHO-supported community outreach workers are conducting active case search in the camp to find and refer anyone suffering from the disease that has not been able to seek help at a health facility.

Risk communication
The most effective prevention measures against cholera are basic hygiene practices, including use of clean and safe water and proper sanitation. House to house visits are underway in the camp to sensitize people to the risk of cholera, teach them how to prevent and manage diarrhea at home, and educate them on the use of chloride tablets for household water treatment and safe water storage.

Sample collection, data management and trend analysis are being implemented by WHO surveillance teams to ensure that the response is not just keeping up with cases but is also tailored to prevent further spread.  Partners are also working to improve water and sanitation conditions in the camps.