-Caveat Lector- Southern Africa Fights Widespread Cholera Outbreak Reuters Jan 9 2001 10:24AM JOHANNESBURG (Reuters) - Southern African and international health authorities said on Tuesday they were battling cholera outbreaks that have killed dozens of people and infected thousands more since the start of summer rains. Cholera has been reported in South Africa, Swaziland, Mozambique, Malawi, Zambia and Zimbabwe. Despite efforts by health officials and the World Health Organization, it appears to be spreading among communities with no access to clean water. South Africa has called in the WHO for advice and funding to combat the epidemic in its eastern province of KwaZulu-Natal. Latest figures show 63 people have died since August and 475 new cases have been reported in the past 24 hours, bringing the total number of cases to 16,569. "This is the season when we expect cholera outbreaks in the sub-region and we have not been surprised," said Paul Lusamba, regional adviser at the WHO's regional office in Harare. "But what has happened in South Africa has been out of proportion, so that is why so much effort is being put in to stop it," Lusamba told Reuters in a telephone interview. Cholera is a bacteria spread through water and unsanitary conditions. It causes severe diarrhea and its victims die from the shock of dehydration. COUNTER-MEASURES TAKEN Despite initial concerns as the number of cholera cases escalated rapidly, the South African health ministry believed that its counter-measures were bearing fruit. "The reported deaths to date are...by far the lowest in the history of cholera epidemics in South Africa," it said. In a statement, the ministry said South Africa had surpassed first world expectations in containing the disease and had kept the fatality rate below 0.5 percent of reported cases. Economic analysts have warned of a detrimental impact on production if cholera breaks out in the slums of the industrial heartland of Gauteng province where a high percentage of the province's labor force lives. It has been difficult to curb the disease in KwaZulu-Natal because of the remoteness of rural communities, a lack of health care facilities and the dependence of villagers on polluted streams as their only source of water. The disease has crept across the border and infected villagers in neighboring Swaziland, where seven people have died in the eastern region of Lubombo bordering KwaZulu-Natal. Two people have died in the southern Zimbabwe border town of Beitbridge and five others are infected. The disease killed 88 people and affected almost 700 in Zimbabwe in 1999. Local media said the recent outbreak probably came from South Africa. SPREADING IN THE REGION Cholera has also hit the Mozambique capital Maputo, where some 85 people have been hospitalized since mid-December. One person has died in Manica province in central Mozambique out of 40 reported cases. Zambian authorities said cholera had been reported in its farming central region but the situation was under control. "We are watching the situation in South Africa very closely and it is a threat to us mainly because of mobility of people," said Dr. Gavin Silwamba, director-general of the Central Board of Health. Silwamba said there was one cholera death seven days ago. Zambia had 25 cases of cholera reported in December. "Notably, there have been no cholera cases in Lusaka, the Copperbelt or southern provinces and these are the nerve centers of the Zambian economy," Silwamba told Reuters. "We believe the infections in Zambia originated from refugees fleeing the Congo war, but a huge campaign over time has raised awareness about the disease and we are on top of the situation at the moment." Silwamba said medical equipment worth $15,000 and reinforcements of doctors had been sent to northern Zambia in case a crisis emerged, especially among refugees. Health authorities in Malawi said 39 cholera cases had been reported since November, but so far there had been no deaths. Malawi reported a total of 122 cases of cholera in 1999, with five deaths, according to data from the health ministry. "Because of a massive awareness campaign launched three years ago, very few and often isolated cases of cholera have been reported across the country's 26 districts," said a spokesman for the health ministry in the commercial city Blantyre. Copyright © 2000 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similiar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. 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