Geneva, 22 May 2023 – Gavi, the Vaccine Alliance today published a roadmap* outlining critical actions needed to ensure supply of oral cholera vaccine (OCV) is able to meet growing demand from countries. Released against a backdrop of a recent wave of cholera outbreaks around the world, the roadma...p forecasts the short-, mid- and long-term outlook for global cholera vaccine supply. Developed in consultation with a range of key Alliance partners, including WHO, UNICEF, the Global Taskforce for Cholera Control (GTFCC), and the Bill and Melinda Gates Foundation (BMGF), it describes how these organizations, manufacturers and countries can work together towards ensuring global OCV supply can support largescale preventive vaccination by 2026.
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The identification of Priority Areas for Multisectoral Interventions (PAMIs, sometimes referred to as ‘hotspots’) for cholera control is among the first steps for a cholera-affected country to develop or revise a National Cholera Plan (NCP) for cholera control. PAMI identification is critical to... maximize the potential impact of NCP implementation on cholera control.
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The CDC document outlines five essential steps for preventing cholera. It emphasizes the importance of using treated water for drinking and food preparation, washing hands thoroughly with soap and safe water, cooking food thoroughly and consuming it while hot, using latrines or properly burying fec...es to avoid open defecation, and cleaning and disinfecting areas contaminated with feces using a solution of one part household bleach to nine parts water. These measures are critical to controlling and preventing the spread of cholera, especially in areas affected by outbreaks.
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The CDC document titled "KOLERA: Senk (5) Etap Debaz Yo Pou Prevansyon" outlines five essential steps for preventing cholera. It emphasizes the importance of using treated water for drinking and food preparation, washing hands thoroughly with soap and safe water, cooking food thoroughly and consumin...g it while hot, using latrines or properly burying feces to avoid open defecation, and cleaning and disinfecting areas contaminated with feces using a solution of one part household bleach to nine parts water. These measures are critical to controlling and preventing the spread of cholera, especially in areas affected by outbreaks.
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Cholera remains a significant public health threat in many countries worldwide. In resource-constrained settings, it disproportionately affects thousands of poor and vulnerable population
Cholera is a major health risk in many parts of the world, affecting millions of people every year. Since mid-2021, the world has been facing an acute upsurge of the 7th cholera pandemic, which is characterized by the number, size and concurrence of multiple outbreaks, the spread to areas that had b...een free of cholera for decades and alarmingly high mortality rates. The mortality associated with these outbreaks is of particular concern as many countries have reported higher case fatality ratios (CFR) than in previous years
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Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
The main goal of IPC in the cholera response is to
• To reduce transmission of health care-as...sociated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
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Response to the Periodic Epidemic
What you should do as head of school or child centre to prevent cholera:
Educate all staff and pupils on the common cholera transmission routes and how to prevent it.
Educate all kitchen staff on how to handle food and cooking utensils. Emphasis the key points below:
o All kitchen staff MUST wa...sh their hands with soap and chlorine solution before cooking or handling food.
o All food should be properly stored to prevent contamination from insects etc.
o Wash all food in safe water.
o All food served should be properly cooked, and served hot.
o Only allow kitchen staff to enter the kitchen and to serve food.
o Wash dishes with soap or chlorine solution and rinse under safe water. Dry dishes on a rack well above the ground and in the direct sunlight (sunlight will help to disinfect).
All students should wash their hands with soap and safe water or chlorine solution before eating
Avoid washing your hands in a bowl of standing water, always use safe, running water!
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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To better adapt current case management practices and address excess mortality in otherwise treatable
cases will require better knowledge of the demographic characteristics of the patients and comorbidities
which can make severe dehydration harder to tolerate physiologically. With this in mind, a ...scoping review
was undertaken, to explore the literature and summarise the existing evidence on cholera mortality and
reported risk factors.
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Cholera is an acute diarrhoeal infection caused by ingesting contaminated food or water. It can
spread rapidly in areas with inadequate access to safe water, sanitation and health care.
The Global Task Force on Cholera Control (GTFCC) launched Ending Cholera: A Global
Roadmap to 2030 (Global Roadmap) (1), a strategy that aims to reduce global cholera
deaths by 90% and eliminate the disease in at least 20 countries by 2030. It is
organized according to three main axes:
• E...nsuring early detection and response to contain outbreaks; (2)
• Adopting a multisectoral approach to prevent and control cholera in hotspots; and
• Establishing an effective coordination mechanism for technical support, resource
mobilization and partnership at local and global levels.
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Le Groupe spécial mondial de lutte contre le choléra (GTFCC) a lancé Mettre fin au choléra :
Une feuille de route mondiale pour 2030 (la Feuille de route mondiale) (1). Cette stratégie vise
à réduire de 90 % le nombre de décès dus au choléra dans le monde et à mettre fin à la
malad...ie dans au moins 20 pays d’ici 2030. Elle est organisée selon trois axes principaux :
• assurer une détection et une réponse précoces pour contenir les épidémies(2) ;
• adopter une approche multisectorielle pour prévenir et contrôler le choléra dans les
points chauds ; et
• mettre en place un mécanisme de coordination efficace de l’appui technique, la
mobilisation des ressources et des partenariats aux niveaux local et mondial.
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BMC Health Services Research (2019) 19:458 https://doi.org/10.1186/s12913-019-4315-7
Multi-sectoral Cholera Elimination Plan
This document aims to provide guidance to countries in the identification of priority areas
for intervention as part of the Situational Analysis of their National Cholera Control or
Elimination Plans (NCPs).
Le présent document vise à fournir des indications aux pays pour identifier les zones
d’intervention prioritaires dans le cadre de l’analyse de la situation prévue dans leur plan
national de contrôle et d’élimination du choléra (PNC).
N Engl J Med 2018; 378:577-579; DOI: 10.1056/NEJMc1711583
A dose of oral vaccine provides effective short-term protection against cholera during an outbreak, a study in Zambia shows.
According to researchers, a shortage in the global stockpile of cholera vaccines meant that single-dose oral vacc...ination was necessary to tackle an outbreak in Lusaka, Zambia, in February 2016. The emergency vaccination campaign was implemented in April 2016, targeting more than 500,000 people in Lusaka’s overcrowded township areas.
The 2016 outbreak happened when Zambia had not reported a case of cholera in four years.
To determine the effectiveness of the single-dose cholera vaccine, the researchers enrolled 66 patients with confirmed cholera and 330 people without the disease who were neighbours of the patients.
According to the study the effectiveness of the single dose vaccination was about 90 per cent.
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