At least 22 people have been killed from cholera outbreak in South Sudan representing a case fatality rate of (CFR) of 2.49 percent, the UN humanitarian agency said on Tuesday.

The UN Office for Coordination of Humanitarian Affairs (OCHA) said cholera has now been confirmed in three locations in South Sudan: Juba and Terekeka in Central Equatoria and the Duk Islands in Jonglei.

"As of Aug. 6, 883 cholera cases and 22 deaths had been reported, representing a CFR of 2.49 percent," OCHA said in its report.

According to the UN, Juba has recorded 808 cholera cases and nine deaths (CFR 1.11 per cent), while Tereke­ka has reported 14 cases and five deaths (CFR 35.71 percent).

In Duk, the outbreak is affecting five islands - Atuek, Atul, Koyom, Moldova and Watkuac - where there have been 61 suspected cases and eight deaths, representing a CFR of 13.11 percent. Moldova is the most affected island, with 26 cases.

Cholera is caused by acute intestinal infection from contaminated food or water. The current outbreak has been attributed to use of untreated water from the River Nile and water tankers, lack of household chlorination of drinking water, eating food from roadside food vendors or makeshift markets and open defecation/poor latrine use.

In Juba, cases spread rapidly following the eruption of fighting in July and access to clean water and safe food has become increasingly difficult as a result of rising costs due to continued devaluation of the South Sudanese Pound (SSP).

"While the CFR for Juba is deemed within the acceptable range, the CFR for the outbreaks in Duk and Terekeka is well above the cholera threshold of one per cent," the UN said.

It said that partners are ramping up their response and an integrated response strategy that includes surveillance, hygiene promotion, health education and provision of water, sanitation and hygiene has been rolled out in areas with a high number of cases. Active case search and referrals are ongoing.

"Cholera messages are being disseminated through radio, churches, mosques, bulk mobile phone messages and publicity materials, while alerts are being received through the toll-free cholera hotline," it said.

According to OCHA, South Sudan's cholera preparedness plan has been updated to guide the response, under the leadership of the country's Ministry of Health.

Source : XINHUA