WHO tracks evolving cholera picture

Jul 29, 2011 (CIDRAP News) – Global cholera incidence has increased since 2000, with Haiti's large outbreak tipping the largest burden away from Africa for the first time since 1995, the World Health Organization (WHO) said today.

Currently, a cholera outbreak is spreading along the Congo River in the Democratic Republic of Congo and has already sickened nearly 4,000 and caused almost 300 deaths in four provinces. The rainy season and flooding on the island of Hispaniola renewed previous outbreak activity in Haiti and the Dominican Republic.

The widening distribution of cholera's biggest hot spots prompted the World Health Assembly in May to adopt a resolution to implement a global approach to cholera control. The WHO said factors driving the global increase in cholera infections include the emergence of new strains of Vibrio cholerae that cause more severe illnesses (such as El Tor variants detected in Bangladesh), microbial resistance, and climate change.

The disease has been most deadly in countries where populations have limited access to healthcare and disease surveillance gaps, the WHO said today in an overview of 2010 cholera activity, which appears in Weekly Epidemiological Record. In 2010, 48 countries reported cholera cases. Outbreaks in three areas—the Lake Chad basin in central Africa, Hispaniola, and Papua New Guinea—accounted for 79% of cases last year, along with 89% of deaths from the disease.

Development of new and safe oral cholera vaccines is ushering in a new phase of cholera control, the WHO said, urging their use in endemic areas, high-risk populations, and large-scale epidemics, especially in areas where other interventions can't be administered effectively.

More financial commitments are needed to help developing countries improve water supplies, increase access to hygiene and sanitation, and develop new strategies for prevention and control.

Earlier this week, the Pan American Health Organization (PAHO) issued a monthly update on cholera activity in Haiti and the Dominican Republic. Overall disease activity is starting to drop off in both countries, following a surge in new cases over the past few months. However, some areas are still seeing increasing numbers of cases—North and North West departments in Haiti and Distrito Nacional in the Dominican Republic.

Since the start of the outbreak, Haiti's health ministry has recorded 388,958 cases of cholera and 5,899 deaths. The Dominican Republic's public health ministry has reported 13,200 suspected cases, along with 87 confirmed deaths from the disease.

See also:

Jul 26 PAHO epidemiological alert

Jul 29 Wkly Epidemiol Rec report

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