Cholera


Cholera outbreak in Yemen

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Every year, there are an estimated 3–5 million cholera cases and 100 000 to 120 000 deaths due to cholera. The short incubation period of 2 hours to 5 days, enhances the potentially explosive pattern of outbreaks.

Cholera is an extremely virulent disease. It affects both children and adults and can kill within hours. About 75% of people infected with Vibrio cholerae do not develop any symptoms although the bacteria are present in their faeces for 7–14 days after infection and are shed back into the environment, potentially infecting other people.

Cholera remains a major public health risk in the WHO Eastern Mediterranean Region. There has been a resurgence of cholera in the Region in the past few years, and the leading attributing factors are poor environmental infrastructure, such as lack of safe drinking water and lack of access to safe sanitation, and increased population movement. 

Countries in the Region facing complex emergencies are particularly at risk as they lack safe drinking water and sanitation resources. The full extent of the burden of cholera in the Region is difficult to estimate due to weak surveillance systems in some endemic countries in addition to underreporting of cases. It is estimated that the number of cholera cases may be around 188 000 per annum. During the past decade, at least 9 out of 22 countries in the Region have reported cholera cases, often in epidemic proportions. Explosive outbreaks have been reported from Afghanistan, Djibouti, Iraq, Pakistan, Somalia, Sudan, Syria and Yemen. 

Effective and proven prevention and control measure for cholera are dependent on the provision of adequate environmental infrastructure and health services and healthy hygiene measures. The availability of oral cholera vaccines is offering hope for cholera prevention and control, particularly in situations where other conventional public health measures, such as improving access to safe water and sanitation, cannot be scaled up rapidly due to conflict or other environmental factors. Four cholera-endemic countries in the Region (Iraq, Somalia, Sudan and Yemen) have introduced oral cholera vaccines to supplement the existing preventive measures. 

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