Yemen's cholera epidemic called 'worst ever' by Oxfam

In just over 3 months, Yemen has reported more than 368,000 cholera cases, the most recorded in a single year, according to the nongovernmental organization Oxfam.

"It is quite frankly staggering that in just 3 months, more people in Yemen have contracted cholera than any country has suffered in a single year since modern records began," Nigel Timmins, Oxfam's humanitarian director, said in a statement.

The crisis, which began in October of 2016, picked up speed in April. Since then, there have been approximately 5,000 new cases suspected every day. The World Health Organization (WHO) said there were 368,207 suspected cases reported from Apr 27 to Jul 19, and 1,828 deaths, resulting in a case-fatality rate of 0.5%.

Almost all (21 out of 23) of Yemen's governorates have reported cholera cases. The Al Hali district (Al Hudaydah governorate) has the most cases, with 14,229 suspected cases and 23 deaths in the last 3 months.

Yemen's cholera outbreak is worsened by a collapsing public health infrastructure, where healthcare workers haven’t been paid by the government in more than 10 months, and clinics, water treatment centers, and plumbing have suffered because of conflict and internal displacement of thousands of people.

The WHO estimates that more than half of all Yemeni health facilities are closed, and 14.8 million people don't have access to healthcare in that country.

New totals surpass Haiti's

Oxfam said Yemen could report as many as 600,000 cases by the end of the year, making it the largest outbreak since records started in 1949. The previous annual record was in Haiti in 2011, when 340,311 cases were recorded, the group said.

Speaking today at a press briefing in Geneva, WHO officials said that malnutrition among Yemen's displaced people creates a vicious cycle for cholera.

"We need to break the vicious cycle of malnutrition and diarrhea," Fadela Chaib, a spokesperson with the WHO, said, according to notes from the briefing. "17 million people in Yemen are currently food insecure. Malnutrition exacerbates diarrhea, and diarrhea leads to malnutrition."

Children under the age of 15 account for 41% of suspected cases, and people over 60 account for one third of all deaths. 

The WHO had planned for a one-dose vaccination campaign this month, but has now tabled that plan in favor of a two-dose campaign slated for next year. Officials said the situation has moved so quickly, vaccines are not a priority tool. Instead, diarrhea treatment centers, oral rehydration corners, and healthcare workers are the main focus of WHO's efforts to stop the outbreak. The WHO said $64 million, in addition to the $10.2 million already spent, is needed in Yemen.

Kenya outbreak grows

In other cholera news, Kenya is reporting growing numbers in its cholera outbreak, which is active in Garissa and Nairobi. As of Jul 17, a total of 1,216 suspected cases including 14 deaths (case-fatality rate of 1.2%) have been reported since the first of the year.

Kenya has been battling cholera since January, and like Yemen, has seen an uptick in cases since April. Outbreaks are occurring in the general population and in refugee camps.

The country has also reported two point-source outbreaks in Nairobi County, one involving conference participants at a hotel and the other in people who attended a trade fair.

See also:

Jul 20 WHO update

Jul 19 WHO report

Jul 21 Oxfam statement

Jul 21 WHO Kenya update

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