Hundreds of additional cholera cases have been reported in past week in South Sudan bringing the total cases in this outbreak to 1,244, up from 984 on July 14.

Vibrio cholerae/CDC
Vibrio cholerae/CDC

The Government of South Sudan adds that the dearth toll in the outbreak is now 39, up 5 since the last update. Juba County accounts for the bulk of the cases and fatalities with 1,138 cases and 38 deaths.

Two weeks ago, UNICEF reported that 20 percent of the fatalities were in children 5 years of age and younger.

The World Health Organization says the initial cases in Juba were traced back to 18 May 2015 in UN House PoC where the first cholera case was confirmed on 1 June 2015.

The probable risk factors fueling transmission include: residing in a crowded internally displaced persons (IDP) camp with poor sanitation and hygiene; using untreated water from the Water tankers; lack of household chlorination of drinking water; eating food from unregulated roadside food vendors or makeshift markets; open defecation/poor latrine use; and attending/eating food at a funeral.

Cholera, caused by  the bacterium Vibrio cholerae, is an acute bacterial intestinal disease characterized by sudden onset, profuse watery stools (given the appearance as rice water stools because of flecks of mucus in water) due to a very potent enterotoxin. The enterotoxin leads to an extreme loss of fluid and electrolytes in the production of diarrhea. It has been noted that an untreated patient can lose his bodyweight in fluids in hours resulting in shock and death.

The bacteria are acquired through ingestion of contaminated water or food through a number ofmechanisms. Water is usually contaminated by the feces of infected individuals. Drinking water can be contaminated at the source, during transport or during storage at home. Food can get contaminated by soiled hands, during preparation or while eating.

Beverages and ice prepared with contaminated water and fruits and vegetables washed with this water are other examples. Some outbreaks are linked to raw or undercooked seafood.