Cholera Outbreak Reaches New Heights in Africa and the Middle East

New numbers in a report from the World Health Organization (WHO) show cholera cases are rising in at least 18 countries as of February 1.

WHO General Director, Tedros Adhanom Ghebreyesus, addressed the cholera crisis in his opening remarks at a press briefing on Wednesday. The WHO says the world is currently facing an uptick in cholera cases since mid-2001.

According to the WHO, a major concern with cholera is its high rate of fatalities. The average case fatality ratio for cholera is 1.9%, and a worrying 2.9% in Africa. Cholera currently threatens one-billion people worldwide.

In his remarks, Ghebreyesus emphasized the severity of cholera in Syria due to the ongoing conflict and its rise in many countries.

Since late August, about 85,000 cholera cases have been reported from the Syrian Arab Republic. But it’s just one of 30 countries that reported cholera outbreaks last year. Around the world, we estimate that more people died from cholera last year than in the previous five years put together. Currently, 23 countries are experiencing cholera outbreaks, and a further 20 countries that share land borders with affected countries are at risk.

— WHO General Director, Tedros Adhanom Ghebreyesus

Cholera cases increase

A WHO report released on Saturday provides more insight into the rising cholera situation. It says inefficient health systems, climate change, and humanitarian conflicts have led to cholera’s rise.

The war in the province of North Kivu in the Democratic Republic of the Congo has left many without homes and moved to camps near Goma. Little access to water and sanitation within the camp has increased cholera cases, and the country’s rainy season may contribute to more cases of the infection.

Early this year in Malawi, over 600 cholera cases were reported per day. It is the most costly cholera outbreak in Malawi’s history, with the case fatality ratio near 3%. Other African countries dealing with cholera outbreaks include Mozambique, Tanzania, Zimbabwe, Ethiopia, Kenya, and Somalia.

In the Caribbean, Haiti is currently stabilizing a cholera outbreak after a peak in the fall months of October and November in 2022. However, Santo Domingo in the Dominican Republic is currently battling some imported cases from their neighbor.

Increase for Cholera following earthquake

The WHO is warning of cholera outbreaks in the border area of Turkey and Syria following an earthquake that has led to over 25,000 deaths. The 7.8-magnitude earthquake that struck on Feb. 6 affected 310 miles that contain 13.5 million Turkish residents.

Over 80,000 injuries have been reported from what Turkish President Recep Tayyip Erdoğan is calling the "disaster of the century."

What is cholera?

Consuming food or water that contains the bacterium vibrio cholera which can lead to the acute diarrheal infection known as cholera. It is classified as a global threat to the public by the WHO.

Symptoms of cholera occur between 12 hours and five days after having contaminated food or water. The WHO says cholera can affect children and adults, and even kill within hours if untreated.

Cholera is not a difficult infection to treat. The WHO recommends oral rehydration solution. Adults may need 6 L of oral rehydration solution on the first day to recover sufficiently. The WHO suggests vaccines for those in areas subject to a higher risk of cholera.

Cholera in the U.S.

Cholera is not a major threat in the U.S. according to the CDC. Occasionally, raw or undercooked shellfish from the Gulf of Mexico has contributed to cholera cases.

If traveling to countries where cholera cases are present, exposure to the infection is possible and symptoms may arise upon returning home. A health guide for travelers visiting countries threatened by cholera is available on the CDC’s website.

Vaxchora is a single-dose oral cholera vaccine that has been approved by the FDA, but it is currently unavailable. The CDC recommends a visit to a doctor or clinic for questions revolving around vaccination before traveling to an affected country.