WHO warns of intensifying cholera outbreak in Malawi

News brief

Malawi is experiencing its deadliest cholera outbreak ever, and a sharp increase in cases over the past month signals that the situation will worsen without strong interventions, the World Health Organization (WHO) said today in an update.

Though cholera is endemic in Malawi, the current outbreak began in March 2022 and has extended through the dry season. So far, nearly 37,000 cases have been reported, with about 1,200 deaths, for a case-fatality rate (CFR) above 3%. The WHO said the outbreak has been marked by a consistently high CFR and large geographic spread. Cases have been reported from all 29 of the country's districts.

High CFRs have been recorded from three districts where sick people presented too late to healthcare facilities.

Stretching response capabilities

Malawi's government declared a public health emergency on Dec 5, but the pace and scope of the outbreak is stretching its ability to respond. The WHO said Malawi's outbreak is one of several cholera outbreaks that have put pressure on the supply of vaccines and treatments.

Adolescents, teens, and young adults are among the hardest-hit groups, with males making up 57% of cases. However, most deaths have occurred in people ages 60 and older.

So far, two oral cholera vaccination campaigns have been conducted across 21 districts.

The WHO said Malawi's rainy season is under way and typically runs from November through May, and cases are likely to increase further, along with the risk of international spread.

The WHO put the risk to both Malawi and the region as high. Cases have already been confirmed in bordering Mozambique. In January, the WHO said the global risk from cholera is very high due to ongoing multiple outbreaks across multiple regions.

Another Wisconsin county reports first CWD in wild deer

News brief

Lisa Schnirring

The Wisconsin Department of Natural Resources (WDNR) yesterday reported the first chronic wasting disease (CWD) detection in a wild deer in Langlade County in the town of Wolf River, which is located in the north central part of the state.

In a press release, the WDNR said the animal was a 1-year-old hunter-harvested buck. Based on state law, the detection triggers the renewal of a 3-year baiting and feeding ban in the county and a 2-year ban in border counties within 10 miles of a CWD detection. Langlade County borders the Menominee Reservation in Menominee County and Octonto County.

The Menominee tribal government has imposed its own baiting ban for the reservation's exterior boundaries, and the WDNR said it is working with tribal officials regarding the baiting and feeding bans, which are steps taken to prevent deer from congregating in areas that may be contaminated by sick animals.

Officials noted that Oconto County is already under a ban due to detections in that county.

The WDNR asked local hunters and landowners to help assess the extent of spread in the southeastern part of the county by applying for surveillance permits, which allow the harvesting of adult deer, which must be tested for CWD.

Expanded spread in Wisconsin

Earlier this month, the WDNR reported CWD in a wild deer harvested from Sheboygan County, a 4- to 5-year-old doe taken during the 2022 gun deer season. And in January, it reported CWD for the first time in a wild deer from Waupaca County, which came just a month after the first detection in a Buffalo County wild deer.

CWD, a fatal prion disease, can spread among cervids like deer, elk, and moose. The disease spreads through contaminated environments, antler velvet, and body fluids and tissues.

Though CWD isn't known to infect humans, health officials warn against eating the meat of infected animals due to concerns that it could cause an illness similar to another prion disease, bovine spongiform encephalitis ("mad cow" disease).