Cholera Outbreaks

Cholera Outbreaks 2024

The World Health Organization (WHO) has recorded seven cholera pandemics over the past two centuries. The current (7th) cholera epidemic is considered to have started in 1961 and continues in forty-five countries in 2024, with a case fatality rate of 0.6%. The WHO classified the global resurgence of cholera as a grade 3 emergency in January 2023. The WHO published External Situation Report #19 on October 19, 2024, confirming a cumulative total of 439,724 cholera cases and 3432 deaths were reported globally across five WHO regions. The WHO's Global Cholera and Acute Watery Diarrhoea Dashboard was updated in October 2024. Data show cholera cases increased by 13% and deaths by 71% in 2023 compared to 2022. There were 472,697 cholera cases reported to the WHO in 2022, up from 223,370 in 2021.

The U.S. Centers for Disease Control and Prevention (CDC) has identified an unprecedented global increase in cholera outbreaks in 2022 and 2023. In addition, the Pan American Health Organization (PAHO) and the European CDC have reported active cholera transmissions in Benin, Cameroon, the Democratic Republic of the Congo, Eswatini, Ethiopia, Kenya, Malawi, Mozambique, Niger, Nigeria, Somalia, South Africa, South Sudan, Tanzania, Uganda, and Zambia, Haiti, Syria, and India.

Cholera Cases in the U.S.

Nearly all cholera cases reported in the U.S. are acquired during international travel. As of August 17, 2024, week #33, six cholera cases were reported to the CDC this year. In 2023, there were 10 cases, and in 2022, the CDC confirmed (8) travelers infected with cholera arrived from Pakistan, Iraq, and Bangladesh. In addition, the CDC's Clinician Outreach and Communication alert in 2023 identified an unprecedented global increase in cholera infections.

Cholera Outbreaks Africa

The cholera outbreak has affected 18 countries in the WHO African Region as of 2024. In April 2024, the WHO announced a global program that will see more than 1.2 million rapid diagnostic test kits for cholera would be distributed to 14 African countries at high risk for cholera.

Zambia's oral cholera vaccination campaign reached 1.84 million eligible people in 2024. Zambia's cholera outbreak began in October 2024, and 412 people have died, and 10,413 cases have been recorded, according to the Zambia Public Health Institute in 2024. The Republic of Kenya vaccinated about 1.59 million people in eight high-risk counties during a 10-day OCV campaign in early August 2023. Since January 2022, a cumulative number of 223,951 cholera cases has been reported in Africa, including 4,125 deaths, with a case-fatality ratio (CFR) of 1.8%. Cameroon, the Democratic Republic of the Congo, Malawi, Mozambique, and Nigeria account for 83.4% of the cases. The WHO says (Feb. 2023) Malawi has been experiencing a widespread cholera outbreak since March 2022. Malawi had among the highest total cases and the most deaths, 54,841 and 1,684, respectively, as of March 20, 2023. Cholera has been endemic in Malawi since 1998. In Mozambique, the first cholera case in the city of Beira was reported in January 1998, and an outbreak has been growing exponentially since December 2022, according to the WHO.

The Republic of Zimbabwe recently recorded 100 suspected cholera deaths from cholera and more than 5,000 possible cases in August 2023, prompting the government to impose restrictions.

The first cholera cases in this outbreak in South Africa were imported or import-related cases following travel to Malawi. All subsequent cases acquired infection locally and are classified as indigenous cases. As of May 22, 2023, a cholera outbreak has killed at least ten people near Pretoria. As a result, the city of Pretoria urged residents of Hammanskraal and surrounding areas not to drink from the tap. Sudan recently declared a cholera outbreak in Gedaref State, where 16 associated deaths had been reported in 2023.

Cholera Outbreaks Region of the Americas

The PAHO reported in April 2024, the Brazil IHR National Focal Point (NFP) reported a case of autochthonous
cholera in the municipality of Salvador, Bahia State.

Cholera Outbreaks Caribbean

In the Dominican Republic, the Ministry of Public Health confirmed that 113 suspected cholera cases, including one deceased case, were reported as of EW 14 in 2024. Haitian national authorities reported confirmed cholera outbreaks in the greater Port-au-Prince area began in 2022. In 2023, over 40,000 cholera cases, including 253 deaths, were reported in Hati.

Cholera Cases Europe

In Europe, 51 cases, mostly infected abroad, were reported in 2022 vs only five cases in 2021. Most of these isolates belonged to a strain that emerged recently and has caused cholera outbreaks in Asia and Africa.

Cholera Outbreaks Syria

Since a cholera outbreak was first declared in Syria in September 2022, over 50 thousand suspected cases have been reported in both Idlib and Aleppo governorates. On March 8, 2023, the WHO, UNICEF, the Syria Immunization Group, and the Global Alliance for Vaccines announced a cholera vaccination campaign would focus on northwest Syria. During the campaign, 1.7 million doses of a cholera vaccine will be offered to Syrians above one year of age. The U.S. CDC says (January 31, 2023) that active cholera transmission is widespread in Syria. However, cholera is rare among travelers.