NAIROBI, 29 March 2011 (IRIN) - A cholera outbreak in Katanga Province is likely to exacerbate the measles epidemic that for the past six months has been sweeping through the Democratic Republic of Congo (DRC). Aid workers warn it is now likely to get out of control and spread from five provinces to the rest of the country.

"Children who contract cholera and haven't received any inoculations against measles will be more vulnerable to the disease. We need to act quickly to control the epidemic," Ayigan Koffi, health coordinator of the World Health Organization (WHO) in the DRC, told IRIN.

"We are working on ways to increase and better coordinate the response. If nothing is done, the epidemic is likely to spread further," Koffi told IRIN.

Measles is a highly contagious infection of the respiratory system that is only preventable by vaccination and can be fatal in children if not treated. According to Médecins Sans Frontières (MSF) data, measles can kill between one and 15 percent of un-vaccinated children who contract the disease and up to 25 percent of malnourished or vulnerable groups with limited access to healthcare.

WHO says the total number of cases since the beginning of the year has reached 6,524 cases, with 33 deaths.

"The epidemic began in a scattered fashion," says Northan Hurtado, an MSF primary-care physician. "At the start, in mid-October, rural areas were most affected. Then the cases started increasing in urban areas."

According to WHO, because of large population movements, thousands of children missed vaccinations. In addition, insecurity, logistical constraints and limited access hampered vaccination coverage.

Logistical constraints

The strategy aimed at countering the epidemic, involving the DRC Ministry of Health and partners such as WHO, the UN Children's Fund (UNICEF) and MSF, is being rolled out quickly but still faces significant constraints.

"Since September 2010 we have vaccinated more than 1.5 million children in response to the crisis. But the disease is spreading like wildfire. All parties involved in health in the DRC must now make this epidemic a national priority," said Gaël Hankenne, MSF head of mission in the DRC.

According to MSF, the human resources, finance and logistical needs involved require a more concerted response to guarantee the effectiveness of the process.

The organization highlighted logistical problems that hamper delivery and the need to keep better control of the cold chain, critical to preserving the effectiveness of the vaccine.

"We are asking the Ministry of Health to launch a response in any new health zone that is affected and other health organizations to release emergency funding or take hands-on action as part of the epidemic response. If this international response is not rapid, it will be impossible to check the spread of measles in the DRC," said Geza Harzi, MSF head of mission in Katanga, one of the provinces affected.

Since January, MSF has been supporting national health authorities with surveillance, treatment kits, vaccinations (1.5 million doses of measles vaccine are being mobilized), and immunization coverage surveys.

MSF has provided emergency response (treatment, inoculations and epidemiology) in Katanga, Kasaï Occidental and South Kivu but new outbreaks have flared up in Bandundu, Kasaï Oriental and Maniema provinces. The epidemic is moving north fast.

Source: The Integrated Regional Information Networks (http://www.irinnews.org )