WHO confirms cholera outbreak in 23 countries, says over 1bn people at risk

World Health Organisation (WHO), Friday, announced the outbreak of cholera in 23 countries, warning that 20 more countries sharing land borders with the affected countries are at risk.

The Nigeria Centre for Disease Control and Prevention (NCDC), had in January, this year, reported 23,550 suspected cases of cholera nationwide, with six states in the country accounting for 84 per cent of all cases of the disease in 2022.

Making the fresh disclosure, WHO Director-General, Dr Tedros Ghebreyesus, who confirmed this during the bloc’s online media conference, said more than one billion people globally, were now at the risk of cholera.

“Cholera spreads through contaminated water, so clean water is needed urgently wherever there is an acute outbreak, to prevent transmission,” he said. According to him, WHO also strongly recommends countries at risk of cholera outbreaks to scale up surveillance so cases can be identified and managed as quickly as possible.

The WHO boss noted that though there were effective vaccines for cholera, supply however, was very limited.

According to Ghebreyesus, the International Coordinating Group that manages the global cholera vaccine stockpile in 2022 suspended the standard two-dose regimen, recommending instead a single-dose approach to extend supply.

He, however, said in the medium-to long-term, it remained important that global vaccine production was increased.

“In the meantime, we must rely on other measures to stop outbreaks and save lives,” he said.

Last Thursday, the global body reported an ‘exponential rise’ in cholera cases across Africa, with Nigeria and nine other countries on the continent topping the list of worst-hit nations, as, according to it, as of January 29, this year, an estimated 26,000 cases and 660 deaths have been reported in the 10 countries.

WHO also warned that if the current trend continues, reported cases could surpass the number recorded in 2021, which was the worst year for the disease in the continent in nearly a decade.

In Nigeria, 583 people died from cholera in the country in 2022, according to the Nigeria Centre for Disease Control and Prevention (NCDC), which also added that 23,550 suspected cases of the disease were reported nationwide during the same year under review.

The agency further disclosed that Borno State topped reported figures with 12,459 cases in 2022.

Director-General of the NCDC, Dr Ifedayo Adetifa, who disclosed this, in January, this year, also informed that Yobe State placed second in reported cases with 1,888 cases, while Katsina State followed with 1,632 cases. Taraba had 1,142 cases; Gombe State had 1,407 cases, while Kano State recorded 1,131 cases.

According to the NCDC boss, ‘these six states accounted for 84 percent of all cases of cholera in Nigeria in 2022,’ adding also that 52 per cent of cholera victims in 2022 were female while males accounted for the balance of 48 per cent, as he put the fatality rate at 2.5 per cent of cases reported in 33 states of the federation.

According to WHO, reported cases of the disease in these 10 African countries in January were 30 per cent higher than for the whole of last year, with most new infections and deaths occurring in Malawi, which is facing its worst outbreak in 20 years.

“Overall, 10 African countries are affected by cholera.  The waterborne disease causes acute watery diarrhoea and can kill within hours but is easily treatable.

“Besides Malawi, cases have been reported in neighbouring Mozambique and Zambia, as well as in Burundi, Cameroon, the Democratic Republic of the Congo (DRC) and Nigeria.

“Ethiopia, Kenya and Somalia are also responding to outbreaks amid the historic drought in the Horn of Africa which has left millions in dire need of humanitarian assistance. 

“We are witnessing a worrying scenario where conflict and extreme climatic events are worsening the triggers of cholera and increasing its toll on lives,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa. 

The average case fatality ratio is almost at three per cent, which is above the 2.3 per cent reached in 2022 and far exceeds the acceptable level of below one.

“It’s critical for African countries to scale up readiness to quickly detect cases and mount comprehensive and timely response,” said Dr. Moeti.

The NCDC in Nigeria lamented that cholera is largely associated with rural communities and among the poor with poor nutrition, poor water quality, and poor sanitation and had not gotten the desired attention from governments.