Cholera Outbreaks Continue in 2023

Over the past month, the multi-country cholera outbreak has reached India, which has reported over 600 cases, says the World Health Organization (WHO).

In total, 25 countries have reported cases since the beginning of 2023, and the WHO assesses the risk at the global level as very high. 

For example, the Republic of Haiti has reported over 40,000 cholera cases, including 253 deaths, this year.

In the U.S., nearly all cholera cases reported are acquired during international travel. 

As of August 4, 2023, the WHO African Region remains the most affected region, with 14 countries reporting cholera cases since the beginning of the year.

According to the WHO's Edition #5, seven cholera pandemics have occurred over the past two centuries. The seventh pandemic, which remains active today, is considered to have started in 1961.

However, cholera's global burden is unknown because most cases are unreported. Furthermore, while cholera can cause a simple case of diarrhea, it can also be deadly.

The WHO reported the average cholera fatality rate in 2021 was 1.9%, but 2.9% in Africa. 

Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from feces. With safe water and sanitation, cholera can be prevented. It can kill within hours when not treated, but immediate access to treatment saves lives, says the WHO.

The overall capacity to respond to these 25 outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV), says the WHO.

As of late July 2023, about 50 million OCV doses were requested, of which 39% were approved for 11 countries.

As of August 6, 2023, three WHO pre-qualified OCVs: Dukoral®, Shanchol™, and Euvichol®, which are in limited supply.