MEDBOX Issue Brief 26. Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the bacterium Vibrio cholerae. ...ht medbox">Cholera remains a global threat to public health and is an indicator of inequity and lack of social development. Researchers have estimated that every year, there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to the infection. However, cholera remains a neglected and underreported disease. Many cases are not recorded due to limitations in surveillance systems and fears of potential impact on trade or tourism. Today cholera affects 47 countries across the globe. Almost every developing country faces cholera outbreaks or the threat of cholera. Major ongoing outbreaks are being reported from Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia and Nigeria. Major outbreaks are currently in Syria and Haiti. Therefore, MEDBOX decided to produce issue briefs on cholera and available resources in Arabic, English and French. more

Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygi...ene. It adversely affects mostly the poor and vulnerable populations in countries, which are already deprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades, Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country. more

The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, wat...er, sanitation and hygiene, logistics, community engagement and risk communication. All efforts must be well coordinated to ensure a rapid and effective response across sectors. This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities. more

Since the last situation report on the multi-country outbreak of cholera was published on 1 June 2023 (covering data reported until 15 of May), no ...new country reported a cholera outbreak. In total, 24 countries have reported cases since the beginning of 2023. The WHO African Region remains the most affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high. more

Since the last situation report on the multi-country outbreak of cholera was published on 6 July 2023 (covering data reported until 15 of June), an...d as of 15 July 2023, one new outbreak of cholera was reported from India on 15 May 2023. In total, 25 countries have reported cases since the beginning of 2023. The WHO African Region remains the most affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high. more

The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings. In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive ...medbox">cholera outbreak followed, leading to 1 million suspected cases in 2 waves from September 2016-July 2018. “We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states. While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou more

The cholera outbreak has affected 14 countries in the WHO African Region. The climate-induced natural disasters such as cyclone and flooding in the southern African region and drought in the Horn of Africa led to increase in cases of ...tribute-to-highlight medbox">cholera in many of the affected countries. With the rainy season commencement in the west African region there is risk of more cholera outbreaks on the horizon. The trend across the region is being closely monitored and this highlights the need for Member States to enhance readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border infection. Since 1 January 2022, a cumulative number of 213 443 cholera cases has been reported to the WHO Regional Office for Africa (AFRO), including 3 951 deaths with a case fatality ratio (CFR) of 1.9% as of 16 July 2023 (Table 1). Malawi accounts for 28% (58 941) of the total cases and 45% (1 766) of all deaths reported, and together with Cameroon, Democratic Republic of the Congo, Mozambique, and Nigeria contribute to 85% (181 300) of the overall caseload and 88% (3 464) of cumulative deaths. In Epidemiologic week 28, six countries Burundi, Cameroon, Ethiopia, Kenya, Malawi and Mozambique reported a total of 667 new cases. more

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 c...haracterized by the number, size and concurrence of multiple outbreaks, the spread to areas that had been 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 more

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 diarrheal disease caused by the bacterium Vibrio cholera. The infection primarily spreads through contaminated water and food. Symptoms include the onset of acute diarrhea and/or vomiti...ng, muscle cramps, and body weakness. If untreated, the infection can result in rapid dehydration and death within hours. more

This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 l...ow- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services. more

Cholera which disproportionally impacts poor countries and the most vulnerable continues to affect at least 47 countries across the globe, resulting in an estimated 1.3 – 4 million cases, and 21,000 - 143,000 deaths per year worldwide. In Ethiopia..., despite major improvements seen in the increasing access to healthcare, clean water, and improvement in maternal and child health, the country continues to be significantly affected by cholera outbreaks. From 2015 – 2021 for example, several outbreaks of cholera have occurred in multiple parts of the country resulting in over 105,000 cases and thousands of deaths. Some of the risk factors associated with cholera in Ethiopia include inadequate access to clean water, practice of open defecation, poor household and environmental sanitation, unhygienic latrine and weak sanitation practise among communities. more

Multi-sectoral Cholera Elimination Plan

Weekly Epidemiological Record (WER), 17 September 2021, Vol. 96, No. 37 (pp. 445-460)