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 to accelerate in 2024. The current cholera case fatality rate is 0.6%. The WHO published External Situation Report #13 in April 2024, confirming that 31 countries have reported 824,479 cholera cases and 5,900 deaths since 2023. The WHO assesses the risk of global cholera outbreaks in 2024 as very high. Previous WHO data show 472,697 cholera cases were 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 Outbreak in the U.S.

Nearly all cholera cases reported in the U.S. are acquired during international travel. For example, in December 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 Outbreak Africa

In April 2024, the WHO announced a global program that will see more than 1.2 million rapid diagnostic tests (RDT) kits for cholera would be distributed to 14 African countries at high risk for cholera. The cholera outbreak has affected 18 countries in the WHO African Region as of 2024. Zambia's oral cholera vaccination campaign reached 1.84 million eligible people 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.

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 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 Caribbean

In the Dominican Republic, the Ministry of Public Health confirmed 88 cholera cases, 71 of which were imported from Haiti as of late February 2023. Over three years, Haitian national authorities reported confirmed cholera cases in the greater Port-au-Prince area. Since January 2023 and as of August 2023, over 40,000 cholera cases, including 253 deaths, have been reported in Hati. 

Cholera 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. 

Cholera Taiwan

The Taiwan Centers for Disease Control and Prevention (TCDC) reported the first locally confirmed case of cholera in July 2023.

Cholera Vaccines

As of April 2024, various cholera vaccines have been WHO-approved but remain in limited availability. In October 2022, the WHO issued recommendations suggesting people receive only one dose of the two-dose cholera vaccine.