The First Use of the Global Oral Cholera Vaccine Emergency Stockpile: Lessons from South Sudan

Abstract

Andrew Azman and colleagues describe their experience of deploying >250,000 doses of oral cholera vaccine in South Sudan in 2014

Cholera Epidemic in South Sudan and Uganda and Need for International Collaboration in Cholera Control

“…Within days, the first reported cholera outbreak in South Sudan since 2009 began, resulting in 6,269 suspected cases, including 105 deaths in health facilities and 51 community deaths (case-fatality ratio 2.4%) by the end of October 2014 ( 7 ). Transmission continued in Juba throughout the epidemic, and outbreaks occurred throughout the country, including large outbreaks in the north.…”

Perceptions of oral cholera vaccine and reasons for full, partial and non-acceptance during a humanitarian crisis in South Sudan

“…Paper cards documenting the date and dose of the vaccination were provided to all recipients. WHO estimates that 85-96% of the target population in each PoC received one or two doses of OCV as based on self-reporting or evidence from vaccination cards [3,8]. Complaints concerning the taste of the vaccine and physical symptoms such as nausea, diarrhoea and stomach pains were reported [3].…”

Population-Level Effect of Cholera Vaccine on Displaced Populations, South Sudan, 2014

“…By the end of 2014, one in five persons within the country had been displaced, and many sought refuge in protection of civilians (PoC) sites inside United Nations (UN) Mission bases and in spontaneous internally displaced persons (IDP) settlements. Within 6 weeks of the start of the violence, South Sudan Ministry of Health requested vaccine from the global oral cholera vaccine stockpile to target 163,000 IDPs in 6 camps throughout the country, but not persons in the broader host communities ( 1 ). …”