Ongoing Multi Country Cholera Outbreak in Africa

The World Health Organization (WHO) reports that since the beginning of 2023, a cumulative total of 825,000 cases and 5900 deaths from cholera were reported from 31 countries across the globe. Cholera is a bacterial infection acquired from contaminated food and water, prevalent in areas with poor sanitation and lack of clean drinking water, or that have experienced recent flooding. It affects the gut and can quickly lead to death from dehydration as a result of massive watery diarrhea.

The highest number of cases have been in the East Mediterranean region (including Afghanistan, Somalia and Syrian Arab Republic), but now 18 countries in Africa are reporting higher than average incidence, with the outbreak yet to peak in some of these regions. Currently, the highest number of cases are being reported in Zimbabwe, Democratic Republic of the Congo, Ethiopia, Somalia and Tanzania.

The huge need for immunization has reduced the world’s reserve of cholera vaccine to critically low levels. Generally, risk to travelers is minimal, but cholera vaccination should be considered for aid and refugee workers and medically vulnerable persons going to affected areas and for travelers visiting friends and relatives in these areas. Travelers, regardless of vaccination status, should observe strict food and beverage precautions and hand hygiene and carry empiric antibiotic therapy (Azithromycin).