Following years of decline, cholera cases are rising worldwide, says WHO

By Peter Kenny

GENEVA (AA) – After years of a decline in numbers, the world has seen a worrying upsurge in cholera outbreaks over the past year, the World Health Organization said on Friday.

"Not only do we have more outbreaks, but the outbreaks themselves are larger and more deadly," Philippe Barboza, who heads the WHO's Cholera and Epidemic Diarrheal Diseases section, said at a UN news conference in Geneva.

In the first nine months of 2022 alone, 26 countries have reported cholera outbreaks.

He said there are rising concerns about southern Africa, the Indian subcontinent with India, Afghanistan, Bangladesh, Pakistan, and Nepal, as well as neighboring countries, and the situation could spread to other affected countries such as Lebanon.

Between 2017 and 2021, fewer than 20 countries reported cholera outbreaks each year.

"The average case fatality rate reported in 2021 has almost tripled compared to the five previous years," said the WHO doctor.

"In Africa, where we have more data available, the case fatality rate was as high as 3%."

- Climate change is growing threat for ancient disease, warns UN health agency

Barboza explained that cholera is an ancient disease, but the WHO is speaking about it today because of concerning changes that need the world's attention.

Although cholera can kill within hours, its treatment is simple.

"It requires rehydration, including simple oral rehydration and a course of antibiotics for more severe cases," said Barboza.

"But the hard reality is that many people don't have timely access to those."

He said that the triggers for cholera outbreaks like poverty and conflict are enduring, but today climate change imposes a growing threat.

"Extreme climate events like floods, cyclones, and droughts further reduce the access to clean water and create an ideal environment for cholera to thrive," said the WHO doctor.

"As the impacts of climate change intensify, we can expect the situation to worsen unless we act now to boost cholera prevention."

The WHO advises that cholera outbreaks can be prevented by ensuring access to clean water and basic sanitation and hygiene.

Also needed are stepped-up surveillance, access to health care, and the effective engagement of communities.

He said countering the disease can look more straightforward than it is to achieve.

"Although many cholera-affected countries are actively engaged in these efforts, they are facing multiple crises including conflict and poverty, and this is why international action is so important," said Barboza.

For example, as of Sept. 28, in Syria, health authorities reported cholera outbreaks in 10 governorates (Aleppo, Al Hasakah, Deir Ez-Zor, Raqqa, Latakia, Homs, Sweida, Daraa, Quneitra, and Damascus) with a total of 33 deaths and 426 confirmed cases.

"The situation is evolving alarmingly in affected governorates and expanding to new ones," said Barboza.

The WHO is following up closely with all health partners to contain the outbreak and prevent further spread of infection through enhancing cholera surveillance in high-risk areas and providing resources to fight the disease.