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Global cholera outbreak: WHO warns of ‘very high’ risk


The UN agency has called for adequate surveillance, vaccination, and infection prevention as important parts of the response efforts

As cholera spreads to formerly cholera-free areas, causing high fatality rates, the World Health Organisation (WHO) has warned that the worldwide risk is very high.

The UN agency described the current situation, including the increasing number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources as alarming.

“Since mid-2021, the world is facing an acute upsurge of the seventh cholera pandemic characterized by the number, size and concurrence of multiple outbreaks, the spread to areas free of cholera for decades and alarmingly high mortality rates,” WHO said.

As of March 20, 2023, at least 24 countries continue to report cholera cases.

“The mortality associated with the outbreaks is of particular concern as many countries reported higher case-fatality ratios (CFR) than in previous years,” WHO pointed out. “The average cholera CFR reported globally in 2021 was 1.9 percent (2.9 percent in Africa), a significant increase above the accepted targeted rate.” 

Since the last disease outbreak news on the global cholera situation was published on February 11, 2023, the global situation has further deteriorated with four new countries reporting outbreaks.

Since the beginning of 2023, outbreaks have spread further in south-east Africa. The widespread and extended outbreaks in Malawi and Mozambique remain active, and the risk for further deterioration after the impact of cyclone Freddy in March is very concerning.

Additional outbreaks have been reported in Tanzania, South Africa, Zimbabwe and Zambia since the start of the year.

In the greater Horn of Africa, outbreaks continue in Somalia, Ethiopia and Kenya. In March, South Sudan reported a new outbreak in the region.

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, as well as overstretched public health and medical personnel, who are dealing with multiple disease outbreaks and other health emergencies at the same time.

WHO has called for adequate surveillance, vaccination, and infection prevention as important parts of the response efforts.

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