Absence of cholera reporting is not equivalent to reported absence. Astoundingly, when the epidemic struck New York City it prompted as many as 100,000 people, nearly half the city's population, to flee to the countryside. To give the vaccine to children aged 2–6 years: Vaxchora (lyophilized CVD 103-HgR) is a single-dose, oral vaccine FDA- approved in the United States for use in people aged 2–64 who are traveling to an area of active cholera transmission. Oxfam will truck in water and repair wells to improve the. Since 1817, seven cholera pandemics have spread from Asia to much of the world. Eleven countries in the region are currently battling one of the worst cholera outbreaks to hit the region in years. One name that is closely tied to our understanding of cholera transmission is Dr. (@wera. With proper treatment, even severely ill patients can be saved. I'm Joe Palca. Cholera is an acute bacterial intestinal infection caused by toxigenic Vibrio cholerae O-group 1 (O1) or O-group 139 (O139). Overview: Cholera is an acute diarrhoeal infection caused by ingestion of contaminated water or food. 0 comments. Rehydration. Over the past 200 years, there have been seven cholera pandemics, and today’s surge is the largest in a decade. Diagnosis and treatment of cholera. Protective immunity in cholera. cholerae O1, is the only cholera vaccine licensed for use in the United States. With the Global Cholera SPRRP, and the coordination with key partners. Author Summary The global burden of cholera is largely unknown because the majority of cases are not reported. 14, 2021. Vibrio cholerae is a major cause of severe dehydrating diarrheal disease and remains a major public health problem in low- and middle-income countries (LMICs) where water, sanitation, and hygiene (WaSH) are inadequate (). S. 中文. Now, scientists have used DNA from historical samples to figure out how the modern strain—responsible for 1304 deaths last year alone—morphed from a harmless microbe centuries ago into a deadly. Most people respond well to oral rehydration salts, which are easy to administer. Results. We divided the study region into 20 km × 20 km grid cells and modelled annual cholera incidence in. Cholera is a diarrhoeal disease caused by the bacterium Vibrio cholerae. Since the start of the latest outbreak, Zimbabwe’s Health Ministry has recorded 8,087 suspected cholera cases and 1,241 laboratory confirmed cases. 2022 saw a surge in cholera. S. Improving sanitation and hygiene behaviors. cholerae harbor a bacteriophage, cholera toxin phage, integrated in their genome. Abstract. The Yemen cholera outbreak has been driven by years of conflict and has now become the largest in epidemiologically recorded history with more than 1. 2 million cases, including over 5,600 deaths, to the World Health. Cholera is a nationally reportable disease in the U. Since the middle of March, both the numbers of cases and deaths continue to decline. It causes acute mortality and chronic suppurative necrosis. The potential drivers of the outbreaks and challenges impacting response activities were highlighted in the last Disease. This activates protein kinase A, and in turn, the. An outbreak of cholera began in Yemen in October 2016. The cholera vaccine can be given at the same time as other injected vaccines. To identify risk factors associated with death from cholera, a case-control mortality study was conducted during January 12–March 26,. That’s why rehydration is the most important treatment for cholera. Cholera is an acute diarrheal infection characterized, in its severe form, by extreme watery diarrhea and potentially fatal dehydration. 04 May 2023. [3] The. After years of steady decline, cholera has made a devastating comeback. An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. Whole. Message: All people (visitors or residents) in areas where cholera is occurring or has occurred should be aware of the basic cholera facts and follow these five basic cholera. The first cholera outbreak in Haiti was reported in October 2010, 10 months after the catastrophic earthquake that killed >200,000 persons and displaced >1 million. [9] For the first six months after vaccination it provides about 85 percent protection, which decreases to 50 percent or 62 percent during the first year. It’s an old disease which has mostly affected developing countries, many of which are in Africa. In 2018, the country declared a state of emergency after 20 deaths and more than 2,000 cases related to typhoid and cholera were reported. The infection causes an acute diarrhoeal illness, which is usually mild but can develop into life-threatening symptoms. That. Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. The surveillance system in India does not adequately capture the. Prompt rehydration therapy is the cornerstone of. The first cholera pandemic (1817–1824), also known as the first Asiatic cholera pandemic or Asiatic cholera, began near the city of Calcutta and spread throughout South Asia and Southeast Asia to the Middle East, Eastern Africa and the Mediterranean coast. Example of data collection form for cholera investigation:How to prevent cholera. Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium, Vibrio cholera. Vibrio cholerae is a species of Gram-negative, facultative anaerobe and comma-shaped bacteria. Over 600 people died of cholera in London during the outbreak of 1854. People contract cholera when they ingest an infective dose of V. Cholera toxin mechanism of action. Three countries, this week alone, have reported outbreaks, WHO cholera team leader Philippe Barboza told reporters at a press conference on Friday. The Global Cholera SPRRP proposes key actions to address the current resurgence, outlined within 10 pillars. Cholera. While most people infected with V. Tell your vaccine provider if the person getting the vaccine: Has had an allergic reaction after a previous dose of cholera vaccine, or has any severe, life-threatening allergies. Booster doses are not recommended at this time. Cholera is endemic in nearly 70 countries, most of them in Africa, South East Asia and South America. More than ever the world must invest in water and sanitation systems and prepare communities before outbreaks occur. A young child is vaccinated against cholera in Haiti. The cholera outbreak in Eastern and Southern Africa isn’t just an outbreak, it’s an emergency for children. Use toilets or sanitation facilities that are safely managed to get rid of faeces (poop). Fowl cholera is a bacterial disease of chickens, turkeys, and other birds. People can get sick when they swallow food or water contaminated with the cholera bacteria. cholerae are pathogenic to humans and cause a deadly disease called. Despite centuries of effort, cholera (an acute diarrheal disease caused by Vibrio cholerae O1 or O139) remains a high-volume health issue, especially in Africa and the Indian subcontinents []. When this happens, some signs of dehydration will start to appear, such as: Thirst. Cholera is an acute bacterial intestinal infection caused by toxigenic Vibrio cholerae O-group 1 (O1) or O-group 139 (O139). eating food that's been handled by an infected person. Cholera was recognized by Dr. 0 million cases, and 21,000 and 143,000 deaths worldwide every year. Cholera infection may cause a variety of symptoms, including: profuse but painless watery diarrhea (rice watery stools) vomiting of clear fluid. The arrival of the disease prompted widespread. 1. In fact, it was Koch’s work on cholera the led the way to firmly establishing the germ theory of disease, and helped convince the medical community as to the microbial nature of this. Cholera remains a global public health threat, causing between 1. The World Health Organization documents over 150,000 cases each year. In this Review article, Andrew Camilli and colleagues discuss the. The incubation period is between 12 hours and 5 days after ingestion of contaminated food or water. 中文. Cholera is closely linked to poor environmental conditions. Cholera is a disease that is caught from contaminated food or drink and causes severe diarrhoea. 4. ; Has a weakened immune system or has close contacts (e. [6] Treatment. The Yemen cholera outbreak has been driven by years of conflict and has now become the largest in epidemiologically recorded history with more than 1. ; Global efforts which primarily focus on outbreak response are shifting. Treatment. For six decades, resource-limited regions in Asia, Africa, and Latin America have faced an ongoing cholera pandemic. The infection is often mild or without symptoms, but can sometimes be severe and life-threatening. According to the World Health Organization, up to 80 percent of cholera patients can successfully be treated by ORT. Preventing cholera in children involves: Ensuring access to clean drinking water. 4%) were reported from 4 January 2021 to 14 November 2021 in seven countries. A physician checking a patient for dehydration. Overview. Cholera is endemic in at least 47 countries 2, 3 but this number is dynamic as affected countries, as listed on the Centers for Disease Control and Prevention (CDC) website, frequently change. Some of. 2 million cases since the beginning of the outbreak in April, 2017. leg. As of 26 April, 78 cholera cases and four deaths have been reported, of which 97% (76 cases) have been reported from Nsanje district. Cholera infections are often mild, but about 1 in 10 people will develop life-threatening. In addition to the restrictions, the government is also monitoring burials in all affected areas. ) late 14c. 18. Although the results of OCV effectiveness studies. Despite suboptimal surveillance and reporting, it is estimated that globally 2–3 million people have cholera each year, and more than 100,000 die from this infection annually [1,2]. Five Basic Cholera Prevention Steps. Cholera remains a global threat to. Across the continent, cases in January were 30 per cent higher than for the whole of last year. Introduction. ; Most of those infected will have no or mild symptoms, and can be successfully treated with oral. The third cholera pandemic (1846–1860) was the third major outbreak of cholera originating in India in the 19th century that reached far beyond its borders, which researchers at University of California, Los Angeles (UCLA) believe may have started as early as 1837 and lasted until 1863. one death from severe acute watery diarrhoea in a person. Currently, only a few cases are recognized in the United States each year. They need 75 mL cholera vaccine for each dose. Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae O1 or O139. Malawi is experiencing a widespread cholera outbreak, with 36 943 cases and 1210 associated deaths reported from all 29 districts since 3 March 2022. The number of cholera cases decreased globally by 60% in 2018, the World Health Organization (WHO) announced in a report that points to an encouraging trend in cholera prevention and control in the world’s major cholera hotspots, including Haiti, Somalia and the Democratic Republic of the Congo. How to prevent cholera. Cholera. cholerae from contaminated water or food. Cholera is now in all of the country’s 10 provinces, Health Minister Douglas Mombeshora said at a clinic in the hotspot township of Kuwadzana in Harare this weekend. Wash hands with soap and safe water after going to the bathroom. 1 billion people are at risk, with children under 5 especially vulnerable. Overview: Cholera is transmitted by ingesting faecally contaminated water or food. 3 and 4. 2 million cases since the beginning of the outbreak in April, 2017. 0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to cholera 1. The African continent. Introduction. Use bottled water to brush your teeth, wash and prepare food, and make ice or. The. Children aged 2–6 years. Left untreated, cholera can be fatal within hours, even in previously healthy people. Overall funding gap. Background. [4] [3] Symptoms may range from none, to mild, to severe. The first cholera outbreak was reported in Haiti in October 2010. Gastrointestinal diseases and respiratory and skin infections are rising amid Israel war,. Over 600 million people throughout the globe are at risk of contracting cholera. Moderators. Typhoid fever (TF) and cholera are potentially life-threatening infectious diseases, and are mainly transmitted through the consumption of food, drink or water that have been contaminated by the feces or urine of subjects excreting the. Cholera is endemic in Malawi with seasonal outbreaks occurring during the wet season. Members. Most people exposed to the cholera bacteria will not develop any symptoms. Cholera is caused by the bacteria V. In this report we review and discuss the cholera management strategies applied by the major international. 3 million cases with about 21,000–143,000 deaths per year. Boosters are given after two years for people over 6 years old, and after six months for children 2-6 years old. There were 42,071 suspected and confirmed cholera cases from 2008 to 2013 from PIDSR, ESR and ProMED, among which 5,006 (12%) were confirmed cholera cases. However, cholera remains under active surveillance in South Africa. Cholera is an infectious disease caused by the bacterium Vibrio cholerae. 2. It is caused by a gram-negative, toxigenic organism, Vibrio cholerae, which is found in aquatic environments. , widespread, localized, or presumed). 7 to 5 billion cases per year worldwide. The most important way to prevent cholera is to practice safe food and water precautions and frequent handwashing, as described on our Five Basic Cholera Prevention Steps page. Cholera. Cholera tracks with areas of high poverty and low access to safe drinking water, sanitation and hygiene - like Africa and Asia. 28 million people are in need in Malawi, Mozambique, Somalia, Kenya, Ethiopia, Zambia, South Sudan, Burundi, Tanzania. Three countries, this week alone, have reported outbreaks, WHO cholera team leader Philippe Barboza told reporters at a press. one death from severe acute watery diarrhoea in a person. Cholera patients should be evaluated and treated quickly. Cholera is a severe form of watery diarrhea caused by Vibrio cholerae toxigenic strains. CDC recommends CVD 103-HgR (Vaxchora) for travelers ages 2–64 years old going to areas of active toxigenic Vibrio cholerae O1 transmission (i. What the risks are and who is most at risk. Cholera ( / ˈkɒlərə /) is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Introduction. cholerae. Davis died at 5:00 p. Nausea and vomiting. A medical personnel stands in front of a ward of a Cholera Treatment Center, funded by the Unicef, Malawi Red Cross and UK Aid, at Bwaila Hospital in the capital Lilongwe, Malawi, January 25, 2018. Diarrhea and vomiting may be mild to severe. A cholera pit was a burial place used in a time of emergency when the disease was prevalent. Cholera is an acute, diarrheal illness caused by infection of the intestine with the toxigenic bacterium Vibrio cholerae serogroup O1 or O139. The disease dispersed from India to Southeast Asia, the Middle East, Europe, and Eastern Africa through trade routes. cholerae. 5 percent [. nausea. CVD 103-HgR, a single-dose, live attenuated oral cholera vaccine derived from V. Nearly 12 years after the outbreak began, Haiti was declared cholera-free on February 4, 2022. Vaccination against cholera is not routinely recommended because cholera is rare in travelers and most travelers do not visit areas. Many developing countries still endure frequent outbreaks due to the lack of basic sanitation. [1] [2] CTX is responsible for the massive, watery diarrhea characteristic of cholera infection. leg. Lab Cultures. The main symptom of cholera is severe watery diarrhea, which can lead to dehydration and death if untreated. Despite being preventable and easily treatable, children continue to suffer from the potentially fatal disease. Cholera is a deadly, diarrheal disease that has been recognized for millennia. These reported cases are from regions of Hiran, Lower Shabelle, Middle Shabelle and Banadir. New cholera cases in the southern African country trebled from 437 to 1,259 this week, the biggest jump since the latest outbreak of the water-borne disease started in February. The Cholera is intensifying in the middle of Kenton and is starting to spread out. Children aged 2–6 years are recommended to receive 3 doses of cholera vaccine. Cholera was common domestically in the 1800s but water-related spread has been eliminated by modern water and sewage treatment systems. Vibrio cholerae is the causative agent of the disease. The incubation period for cholera is short (a few hours–5 days for most subtypes) []. Cholera is a major cause of epidemic diarrhea in some parts of the world. The etiologic agents of cholera is Vibrio cholerae, either serotype O1 or serotype O139. He noticed that the cases were primarily found in areas. 1. Death or flight took all but five of the 75 families from the town. 1 This was followed by major outbreaks in 1993 and 1999. The slots were an excellent depiction of the Cholera spread. 2,505 Followers, 247 Following, 77 Posts - See Instagram photos and videos from Wera_cholera😛😈 (@w_e_r_r_k_a)Overview Cholera is a bacterial disease usually spread through contaminated water. Cholera is rare in the U. The cholera history can be traced through many centuries. There are many types (strains) of the Vibrio cholera bacteria. Summary. On the Contents (dark) toolbar, click Share map. Between 2014 and 2021 Africa accounted for 21% of cholera cases and 80% of deaths. The oral cholera vaccine can be given to children over one year and adults. People usually contract the disease by. Cholera ( / ˈkɒlərə /) is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Symptoms of cholera infection can include: Diarrhea. Cholera is caused by the bacteria Vibrio cholerae. 16 December 2022 Health. Vibrio cholerae was first isolated in pure culture by Robert Koch in 1883, although it had been seen by other investigators, including. e. Introduction. Cholera is an intestinal infection caused by Vibrio cholerae (see the images below). , cases are usually traced to people traveling to cholera-risk areas or to people who have eaten food brought over from cholera-risk areas. Study Design: VAXCHORA was studied in a randomized, double-blind, saline placebo–controlled V. The disease is characterized by watery diarrhea that is so voluminous that daily fluid. Welcome to PolskieOnlyfans. For adults and children aged 6 years or above, two oral doses are administered 7–14 days apart as part of primary immunization against cholera. Cholera is a deadly disease that can cause severe dehydration and diarrhoea in a short time. Cholera is an indicator of inequity and lack of social development. cholerae can be found in contam. This study guide will enable you to learn more about cholera, its risk factors, clinical manifestation, treatment, nursing diagnosis, nursing interventions, and nursing management. It's a severe gastrointestinal disease, transmitted by a bacterium called Vibrio cholerae. The recent outbreaks have also been more deadly, with case fatality rates being the highest recorded in over a decade. It generally occurs in regions of the. Cholera remains a significant public health threat in many countries worldwide. Cholera causes severe diarrhea and dehydration. Fowl cholera is a bacterial disease of chickens, turkeys, and other birds. cholerae O1, is the only cholera vaccine licensed for use in the United States. In 2018, the country declared a state of emergency after 20 deaths and more than 2,000 cases related to typhoid and cholera were reported. Find specific details on this topic and related topics from the Merck Vet Manual. When this happens, some signs of dehydration will start to appear, such as: Thirst. [4] [3] Symptoms may range from none, to mild, to severe. It can cause very rapid dehydration of the body, which can be fatal. A global surge of cholera cases has put one billion people in 43 countries at risk, the World Health Organization (WHO) cautioned this week. e. Left untreated, cholera can be fatal in a matter of hours, even in previously healthy people. Please use one of the following formats to cite this article in your essay, paper or report: APA. (See bacterial disease. Be sure you drink and use safe water. Cholera, largely eliminated from industrialized countries by water and sewage treatment over a century ago, still remains a significant cause of illness and death in many African countries. The burden of diarrheal diseases is very high, accounting for 1. It focuses on the epidemiology of cholera and the laboratory methods to isolate and identify Vibrio cholerae serogroups O1 and O139 and how to test their susceptibility to antimicrobial agents in the epidemic setting. The obstructive sleep apnea (ORS) solution is available as a powder that can be made with boiled or bottled. Surveillance. 1 billion people are at risk, with children under 5 especially vulnerable. Cholera is a major public health problem, primarily in countries with poor sanitary conditions and regions affected by natural disasters, where access to safe drinking water is limited. Vibrio cholerae is unusual in that it competes in the natural environmental community of bacteria in estuarine and brackish waters worldwide. From the late 1990’s through the. ; Is pregnant or breastfeeding, or thinks she might be pregnant. The interval between each dose is 1–6 weeks. Authorities last week declared a state of. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed. (1) Upon ingestion, Vibrio cholerae colonises the intestine and produces cholera toxin, consisting of the toxic A subunit and five B subunits, which are responsible for receptor binding. Although it was suspected that tuberculosis was caused by an infectious agent, the organism had not yet been isolated and identified. Prevention. Created Apr 23, 2023. Global Cholera. Dry mouth and eyes. Situation at a glance. A Cholera Expert Group in the country was established to gather evidence and to prepare a road map for control of cholera in India. The Cameroon Ministry of Public Health (MoPH) invited CDC and the World Health. Vaxchora should be taken at least 10 days before travel to an area of active cholera transmission. Cholera is an acute, secretory diarrhea caused by infection with Vibrio cholerae of the O1 and O139 serogroups. Cholera. The Global Cholera SPRRP does not replace the GTFCC Ending Cholera Roadmap, and in fact it is critical that countries commit more than ever to the Roadmap. 8. The infection is often mild or without symptoms, but can sometimes be severe. Over 600 million people throughout the globe are at risk of contracting cholera. Such mass graves were often unmarked and were placed in remote or specially selected locations. Abstract. The world is facing an upsurge in cholera, even touching countries that have not had the disease in decades. 7 million. Cholera is endemic in Malawi with seasonal outbreaks occurring during the wet season. Restlessness or irritability. In 2017 and 2019, war-torn Yemen accounted for 84% and 93% of all cholera cases in the world, with children constituting the majority of reported cases. The cholera outbreak extended as far as China, Indonesia (where more than 100,000 people succumbed on the island of Java. The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). The current cholera outbreak is taking place in the context of other ongoing. Cholera is an acute dehydrating diarrheal disease caused by the Gram-negative bacterium Vibrio cholerae. Cholera is an infectious disease in DayZ. When deployed in settings where cholera is endemic, the current vaccine reduces incidence of severe cholera by 37–65% over the ensuing 2–3 years [9], [10]. Although significant advances have been made in our knowledge of cholera transmission and its control, the seventh cholera pandemic. The incubation period rages form 18 hours to 5 days. cholerae is reviewed here. Many other serogroups of V. Outbreak at a glance. The vaccine manufacturer reports Vaxchora reduces the. thirst. Children aged 2–6 years. When cholera symptoms occur, they begin 1 to 3 days after exposure, usually with sudden, painless, watery diarrhea and vomiting. The largest active cholera outbreak on the continent was in Malawi: 54,841 cases and 1,684 deaths reported during February 28, 2022–March 20, 2023 . Philippe Barboza, from the World Health Organization, speaking in Geneva, via Zoom. You can catch cholera from: drinking unclean water. It is safe for you to receive the oral cholera vaccine if you are pregnant. Since ESR only started in 2010, data from 2010 to 2013 was used to calculate the average. 4 billion people are at risk from cholera in endemic countries, with an estimated 1. [1][2][3] The infection is transmitted via the fecal-oral route and can. Dry mouth and eyes. In this webpage, you can find the latest information on the cholera outbreak in the Democratic Republic of the Congo, where more than 31,000 cases and 1,000 deaths have been reported in 2020. It is a virulent infection associated with extreme poverty, closely linked to poorLove in the Time of Cholera is a 2007 American romantic drama film directed by Mike Newell. If you are an adult 18 through 64 years old traveling to an area where people are getting infected with cholera,Causes and Symptoms of Cholera. Natural and man-made disasters which produce overcrowding, a scarcity of safe drinking water, improper elimination of human waste, and the contamination of food during or after its preparation are risk factors for the. And it. 04 May 2023. vomiting. The case-fatality ratio is up to half in vulnerable groups during outbreaks but can be under 1% if properly. 0%) have been reported from all 29 districts of the country, making it the biggest active cholera outbreak in Africa. He made a map, and determined that it was polluted water being supplied by the pump on Broad Street that. Cholera reached the Americas in 1991, affecting at least a million people. Preliminary data suggests similar trend for 2022 and 2023. A global surge of cholera cases has put one billion people in 43 countries at risk, the World Health Organization (WHO) cautioned this week. 3. Eighty-six percent (n=11 751) of all reported cases have been hospitalized. If you don’t have access to a toilet: Poop at least 30 meters (98 feet) away from any body of water (including wells) and then bury your poop. Early Research Led to Today’s Most Important Treatment. Table 1 shows the annual distribution of suspected and confirmed cholera cases. Cholera affects both children and adults and can be fatal if untreated. 628 Followers, 497 Following, 64 Posts - See Instagram photos and videos from Wera Cholera (@weracholera)1,082 Likes, 7 Comments - Wera_cholera😛😈 (@w_e_r_r_k_a) on Instagram: “🤙#happynewyear #polskakobieta #polishgirl #instagood #instagram #instalike #instgirl #instamoda…”Bahir Dar – The Amhara region is the 2nd most populated region in Ethiopia. A child infected with cholera may experience severe diarrhea, vomiting, and abdominal pain. Immune protection after infection or oral immunization is mediated mainly, if not exclusively, by locally produced SIgA antibodies that are directed against the cell surface LPS O antigen (predominantly against the A epitope defining the O1 serogroup, but also against the serotype-specific epitopes B (Ogawa). 9% (2. In June. hog cholera, serious and often fatal viral disease of swine. A second case was detected in on 7 March. Diagnosis is by culture or serology. Or, as a group of eminent cholera scientists declared in 1994, “Cholera can be a net benefit to humanity by calling attention to deficiencies in basic systems and. Abstract. It spreads through the ingestion of contaminated food and water, and can quickly lead to severe dehydration from the rapid loss of fluid. Cholera outbreaks were described throughout history and as far back as the ancient Greeks by Hippocrates in 400 BCE. Online. Failure to do this will result in central Government moving in to institute relevant corrective measures, as President Mnangagwa’s administration continues to. 9% in Africa), a significant increase above acceptable (<1%) and the highest recorded in over a decade. CDC recommends that adults traveling to areas with active cholera transmission get vaccinated with a newly licensed cholera vaccine (Vaxchora ®, PaxVax Corporation). Introduction. Figure-2: Cholera cases* reported to WHO by year and continent, global CFR, 1989-2021** The average cholera CFR reported globally in 2021 was 1. Cholera cases are often under reported. Cholera is still a major cause of disease epidemics in sub-Saharan Africa (SSA).