1. Situation on October 12th 1 |1 | Cholera update - Guinea Bissau Summary of data from May to October 12 th 2008 Prepared by WHO Country Office, Guinea-Bissau

2. Situation on October 12th 2 |2 | Overview of the epidemic 10,866 cumulative cases and 184 deaths in all 11 regions (case- fatality rate = 1.7% or 17 deaths per 1000 infected persons) 69% of all cases and 34% of all deaths are registered in Bissau, the capital. The highest attack rates (number of cases / population) seen in Biombo, Bissau, Bijagos and Sao Domingos ranks respectively (2.18%, 1.85%, 1.82% and 1.50 – see and map). Case management is worse in São Domingos amongst the 4 regions above, however, Quinara and Bafata are leading negatively as far as most of deaths occurs outside treatment centres (see slide 7) The number of cases and deaths for the last week is apparently lower. Four regions with minor scale epidemic still have to notify cases for the weekend. As far Bissau and Biombo dictates the trend of the epidemic and we have 100% data completeness in these regions, we may hope that we are in plato or a curve starting to decline.

3. Situation on October 12th 3 |3 | Total number of cholera cases and deaths by week – Guinea Bissau 2008

4. Situation on October 12th 4 |4 | Weekly lethality and incidence of new cases – Guinea Bissau 2008 1% cutt-off

5. Situation on October 12th 5 |5 | Total cholera cases and deaths by region – 2008, n=8.439

6. Situation on October 12th 6 |6 | 40 – 60 cases / 10 000 population 60 – 100 cases / 10 000 population 100 + cases / 10 000 population Number of cholera cases / 10.000 population by region, Guinea-Bissau 2008 20 – 40 cases / 10 000 population 1 – 20 cases / 10 000 population

7. Situation on October 12th 7 |7 | Cholera case-fatality rate by region in Guinea-Bissau – 2008 cut-off