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Worldwide cholera outbreaks are ‘unprecedented,’ WHO says

SHARE Worldwide cholera outbreaks are ‘unprecedented,’ WHO says
A youth suffering cholera symptoms is helped upon arrival at a clinic run by Doctors Without Borders in Port-au-Prince, Haiti.

A youth suffering cholera symptoms is helped upon arrival at a clinic run by Doctors Without Borders in Port-au-Prince, Haiti, Thursday, Oct. 27, 2022. For the first time in three years, people in Haiti have been dying of cholera, raising concerns about a potentially fast-spreading scenario and reviving memories of an epidemic that killed nearly 10,000 people a decade ago

Ramon Espinosa, Associated Press

Worldwide, 29 countries are experiencing a cholera outbreak this year, including 13 that didn’t have outbreaks last year.

That’s according to the World Health Organization, which said cholera vaccines are in such short supply that it’s reducing the two-dose recommendation to one dose due to the seriousness of the situation.

As The New York Times put it, “A record number of cholera outbreaks around the globe, driven by droughts, floods and armed conflicts, has sickened hundreds of thousands of people and so severely strained the supply of cholera vaccines that global health agencies are rationing doses.”

Outbreaks are ongoing in the Caribbean, Africa, the Middle East and South Asia, the Times said. The article noted that cholera is more likely “when droughts, floods, famines or the threat of violence force large group of people to move and they lose access to clean water and adequate sanitation facilities.”

Lebanon is an example of the rise of cholera: BBC reported that its last outbreak was 30 years ago. On Oct. 6, cases started appearing and numbers have continued to rise into the hundreds, “but because there aren’t simple diagnostic tests, the true figure could be thousands.”

Reuters puts the case count there as at least 220, with five deaths so far.

The BBC reported that 20 countries per year on average have reported cases, while this year there are at least 29 countries with cholera. And the “World Health Organization has called 2022’s rise in infections ‘unprecedented.’”

“This is a disease that can kill within a day,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus during his opening remarks at a briefing on COVID-19 and other issues last week. “But it is also easily treatable. Rapid access to treatment is critical.”

The way to stop cholera, he said, is with “safe water, and well-maintained sanitation and hygiene.”

About cholera

Cholera spreads through contaminated water, food or sewage.

An estimated 1.3 to 4 million cases are seen worldwide each year, with between 21,000 and 143,000 deaths worldwide, according to the International public health agency. WHO says that severe cases require fast intervention with antibiotics and intravenous fluids.

Cholera can kill within hours. After someone ingests contaminated water or is otherwise exposed, it can take between 12 hours and five days for symptoms to appear. Most will have mild or moderate symptoms, including vomiting and diarrhea that can progress to severe dehydration, which can be lethal as organs can shut down.

Children are especially at risk of death.

Most people will be able to manage the illness by drinking plenty of fluids. It’s crucial that those fluids be sanitary and safe, however.

The toll, miles apart

Reuters has reported that “Syrian refugees in displacement camps are falling victim to a cholera outbreak in Lebanon, already suffering from an economic meltdown that has slashed access to clean water and strained hospitals.”

WHO said the current outbreak began in Afghanistan in June and then spread to Iran, Iraq, Pakistan and Syria, per Reuters. The Syrian office of Doctors Without Borders said the count in Syria includes more than 13,000 suspected cases and at least five dozen deaths.

Haiti also has a new outbreak of its old enemy cholera, this time aided by gang violence, according to The Guardian. At least eight have died so far, and efforts to get clean water and care have been hampered in areas where gangs control the slums and won’t allow water trucks in, the article said.

Haiti was “close to being certified cholera-free — which requires no new confirmed cases in three years,” the article said. But “eradicating cholera this time will be more difficult due to the myriad crises which will enable the illness’ spread,” medical experts in Port-au-Prince told The Guardian.

Gang violence that began with the assassination of president Jovenel Moise in July of last year persists, “exacerbating existing crises, such as malnutrition and a lack of basic supplies,” the article said.

Haiti is especially vulnerable because three-fourths of its hospitals have reduced hours or closed their doors, UNICEF reported in late September.

In Nigeria, flooding has displaced at least a million people and there are 6,000 cases of cholera now, per The New York Times. “The authorities in Kenya are reporting suspected cholera in people fleeing violence in Somalia and arriving at the mammoth Dadaab refugee camp, where tens of thousands of children are at risk.”

Health experts say that providing single-dose vaccine against cholera should slow the outbreak — as long as adequate numbers of people receive those single doses. But the protection won’t last as long as with the prescribed double dose.

WHO said that two-thirds of the 36 million oral doses being produced in 2022 have been or will shortly be shipped, while several countries will receive the rest for an emergency second dose. Those countries are Cameroon, Kenya, Malawi and Pakistan.