This chapter traces the epidemic in africa, describes epidemiologic investigations that determined prevalent modes of transmission, and discusses efforts to control the epidemic and prevent deaths. Aug 12, 2016 the cholera epidemic was declared on august 10, 2016 in djoukou and in zawara, located in the kemo prefecture in the heart of central africa and in bangui. Between 1972 and 1991, cholera spread throughout much of. In subsaharan africa excluding djibouti and eritrea, a mean of 141 918 cholera cases 95% credible interval cri 141 538146 505 were reported per year. More than 40 years after its resurgence in africa in 1970, cholera remains a grave public health problem, characterized by large disease burden, frequent outbreaks, persistent endemicity, and high cfrs, particularly in the region of the central african great lakes which might act as. Water, sanitation and hygiene wash interventions are frequently employed to control outbreaks though evidence regarding their effectiveness is often missing. It is an essential source for uptodate data on cholera in west and central africa. The 20082009 cholera epidemic in zimbabwe resulted in 98,585 reported cases and 4,287 reported deaths. Cholera is an infectious disease that causes severe watery diarrhoea, and can lead to dehydration and kill within hours if left untreated. Environmental determinants of cholera outbreaks in inland.
We included 279 datasets covering 2283 locations in our analyses. In the period between 2000 and 2012, 43,474 cholera cases are reported. The results suggest that cholera outbreaks demonstrate seasonal patterns in higher absolute latitudes, but closer to the equator, cholera. Assessment of the response to cholera outbreaks in two. The cholera library of the humanitarian response west and central africa website publishes weekly reports of cholera incidence and deaths collected from ministries of health and compiled by the west and central africa office of unicef. Latitude and longitude of african locations, geographic coordinates. Cholera outbreak response action plan and all partners are being requested to make their contributions available before christmas. Our efforts gave us a detailed map that showed us where people were most at risk of getting cholera fig. A cholera transmission model incorporating the impact. Identifying environmental risk factors of cholera in a. Understand where care can offer a value add in the response. Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance. The bacteria is typically found in water environments such as freshwater lakes and rivers. Cunningham was recruited to study cholera, with a view to controlling it, following an epidemic in 1867 at a religious fair in hardwar in the state of uttar pradesh, which claimed the lives of over 00 people.
Cholera incidence and mortality in subsaharan african sites. During 20002001 a cholera epidemic spread through the eastern and north eastern parts of south africa. Once common throughout the world, the infection is now largely confined to developing countries in the tropics and subtropics. May 25, 2017 while the cholera epidemic rages in yemen with more than 32,000 cases reported since the beginning of the month, across the gulf of aden, the two largest countries on the horn of africa are also. Worldwide, approximately 35 million cholera cases and 100,000120,000 deaths due to cholera occur annually. Approximately 510% of persons suffer from severe cholera and if. However, in late march, cases sharply increased in bwikhonge subcounty. In august, african health ministers pledged to end cholera on the continent by 2030 by adopting a new who strategic framework. Since the beginning of this millennium, global cholera incidence has increased steadily with 24% more cases reported between 2004 and 2008 compared with 2000 and 2004, reyburn et al. In the twentyfirst century, subsaharan africa bears the brunt of global cholera.
It is the worlds largest humanitarian organization and its millions of volunteers are active in over 183 countries. Nov 01, 20 the present article aims more particularly at exploring the main environmental determinants of cholera epidemics in inland africa. Colwell marine estuarine environmental sciences university of maryland, college park cholera is a serious public health problem because of the high. The first case confirmed in kwazulu natal on 14th august, 2000 and is the most affected province. Cholera caused by vibrio cholera continues to be a global threat to public health and a key indicator of lack of social development. Cholera has been endemic in south asia, central america, and a number of countries in africa, re. The second pandemic lasted from 1826 to 1837 and particularly affected north america and europe due to the result of advancements in transportation and.
Feb 17, 2014 humanitarian situation reports, response plans, news, analyses, evaluations, assessments, maps, infographics and more on namibia. Increase of cholera cases in the horn of africa and the gulf. Cholera epidemic in south sudan and uganda and need for. Local public health authorities implemented initial control measures.
By 2008, 179,323 94% of the reported 190, cholera cases and 5074 99% of 5143 cholera deaths reported to the who occurred in africa 3. Between 1970 and 2011, african countries reported 3,221,050 suspected cholera cases to the world health organization, representing 46 % of all cases reported globally. A cholera outbreak in the southern african country of zambia, centered on the capital lusaka, has led to an indefinite cancellation of some school. Nov 01, 20 in much the same way as occurred when cholera struck the americas in the early 1990s, events in haiti galvanized public and political attention to the problem of epidemic cholera, reenergized the public health sector, and yielded new guidelines and training materials in french and english that can be of immediate benefit in africa 18, 19. In 2009, multiple areas in kenya experienced cholera outbreaks. Cholera is transmitted by drinking water or eating food, which is contaminated with the vibrio cholerae. Outbreaks of infectious diarrhoeal diseases in yemen, somalia, and ethiopia are devastating communities already suffering from conflict. Knowledge of, attitudes toward, and preventive practices. Since the beginning of the cholera outbreak in august 2015, a cumulative 43,073 cases including 1,220 deaths case fatality rate 2. Results predominance of cholera in inland africa according to the yearly cholera global surveillance summaries of the who 11,one third of the 1. Cholera is a severe intestinal disease caused by the bacteria, vibrio cholerae vibreeo collarah. The current wave of cholera outbreaks which had begun several weeks ago in west africa is still ongoing see map below. Epidemiological parameters of cholera outbreaks by main affected state in nigeria, 200420143 note.
Elsewhere in subsaharan africa, cholera occurs mostly in outbreaks of varying size with a constant threat of widespread epidemics. Background and methods cholera remains a significant threat to global public health with an estimated 100,000 deaths per year. This has lowered the case fatality rate in musina and madimbo to 0. Over the course of 2007 to 2011, more than 100,000 cases of cholera were reported to who annually from at least 20 african countries including ghana. Environmental data were taken at the meteorological station of the international airport of lusaka flls676650, whose geographical coordinates are 15. Communitybased research and evaluations are necessary to understand perceptions. November 2011, december 2009, july 2008 cdc at work. Zimbabwe on the border with south africas limpopo province. South africa, for example, also faced a major outbreak, but faced no bans on tourism or trade house 2008.
Preparedness, prevention and control elizabeth lamond and jesee kinyanjui june 2012. Cholera, largely eliminated from industrialized countries by water and sewage treatment over a century ago, still remains a significant cause of illness and death in many african countries. Cholera outbreak in zambia leads to school, church cancellations. The disease dispersed from india to southeast asia, the middle east, europe, and eastern africa through trade routes. People with low immunity such as malnourished children or people living with hiv are at a greater risk of death if infected. Kenya is located in the horn of africa at latitude of 4. Cholera has throughout history wreaked havoc on the worlds people and still remains a global threat, especially in african countries 1 2. The south african red cross society sarcs project personnel received onthejob training on managing cholera situations. The regional cholera platforms aim to improve cholera control and prevention across africa through operationalization of an integrated strategy towards elimination. Cholera is usually transmitted to people or animals through contaminated water sources. Implications of all available evidence cholera remains a substantial threat to human health in subsaharan africa and throughout the world, particularly in.
Approximately 510% of persons suffer from severe cholera and if untreated, 50% of severe cases are fatal. During 2007 and 2011, annual casefatality ratios cfrs for cholera within this region ranged from 2. Cholera affects both children and adults and can kill within hours if untreated. Over the course of 2007 to 2011, more than 100,000 cases of cholera were reported to who annually from at least 20 african countries including ghana with case fatality rates reaching about 3 % 5. However, there is a high risk that travellers from the outbreakaffected areas may present with cholera in south africa. Cholera caused by serogroup 09 emerged in 1992, in geographic distribution cholera is endemic in the middle east, africa, central and south america, parts of asia and the gulf coast of the united states but outbreaks can occur in any country. Comparison of incidence from endemic areas in asia and africa cdc pdf pdf 5 pages external. Cholera vaccines not only provide health benefits to susceptible populations but also have effects on the earning capabilities and financial stability of the family. Tanzania mainland has reported 86% of the total cases in this outbreak. The sixth cholera pandemic 18991923 largely didnt affect western europe and north america due to advances in public health and sanitation. Africa latitude and longitude and relative locations. Cholera is a diarrhoeal disease caused by a bacterial infection of the intestine. This study reveals the environmental factors associated with cholera in zhejiang.
During the 20th century, cases of cholera were mostly limited to areas in asia and the indian subcontinent where cholera is endemic. The case fatality for cholera in africa is approximately 2% compared to the global average of 1. Over the course of 2007 to 2011, more than 100,000 cases of cholera were. Phylogenomic and structural analyses of vibrio cholerae populations and endemic cholera younggun zo, doctor of philosophy, 2005 dissertation directed by. Lines of latitude are often referred to as parallels.
Introduction crossborder cholera outbreaks are a major public health problem in subsaharan africa contributing to the high annual reported cholera cases and deaths. Materials and methods a systematic pubmed query was conducted using the terms cholera or vibrio cholerae and africa or the current or past names of all subsaharan african countries between 1970 and. Prioritize scaling up ongoing interventions rather than starting new interventions from scratch. In much the same way as occurred when cholera struck the americas in the early 1990s, events in haiti galvanized public and political attention to the problem of epidemic cholera, reenergized the public health sector, and yielded new guidelines and training materials in french and english that can be of immediate benefit in africa 18, 19. Although cholera has disappeared as a publichealth problem in developed countries, it remains a major concern in subsahara africa 1,2.
Welcome on the regional cholera platforms in africa. From 2007 to 2012, at least 20 african countries reported more than 100,000 cases of cholera world health organization who weekly epidemiological records, 20072012. A cholera outbreak started on 29 february in bwikhonge subcounty, bulambuli district in eastern uganda. In 2005, there were 31,719 cholera cases, with 458 deaths in the republic of senegal. The patient that was visited by the medical advisor at tshwane district hospital, who was sleeping in the street, before hospitalization and was critically ill, has died on 21 december. A lion in our village the unconscionable tragedy of cholera in africa. Cunningham was a prominent worker on cholera for many.
Cholera outbreak in the horn of africa cholera is spreading at an alarming rate in the horn of africa, worsening dire situations in countries facing humanitarian crises. Wang, stability analysis and application of a mathematical cholera model, mathematical biosciences and engineering 83 2011, pp. Declared in june 2014, the west and central african cholera outbreak as of january 25, 2015 claimed 1,683 registered deaths and over 91,361 reported cases with a reported case fatality rate cfr of 2% in 11 countries, which is 3 times more than in 20. Review of cholera epidemic in south africa, with focus on. Outbreaks of cholera are associated with inadequate sanitation and lack of safe drinking water. Republic of kenya multisectoral cholera prevention and. Cholera is extremely rare in the united states and is almost always related to travel to areas of the world where cholera is common, such as africa, asia, and latin america. We found that over 140,000 cholera cases per year were reported in subsaharan africa during our 6year study period. It is endemic in africa, parts of asia, the middle east, and south and central america. During the current seventh cholera pandemic, africa bore the major brunt of global disease burden.
Glass, viral gastroenteritis unit g04, centers for disease control, 1600 clifton road, n. Cholera is an important public health problem, causing substantial morbidity and mortality especially in the developing countries. There is a vaccine against cholera, but it only works for a limited amount of time, and there is not enough of it to vaccinate everyone who is at risk. Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea. This article describes lessons learnt during the crossborder cholera outbreak control in eastern and southern africa subregions using. The reemergence of cholera is presenting unprecedented challenges 1,2. Cholera is most common in south asia, particularly in the indian subcontinent, and is endemoepidemic in several countries in africa. The impact of water, sanitation and hygiene interventions. Primarily linked to insufficient access to safe water and proper sanitation, its impact can be even more dramatic in areas where basic environmental infrastructures. The classic symptom is large amounts of watery diarrhea that lasts a few days. It is an indicator of socioeconomic problems and is a global threat to public health. Cholera 6 june 2006 the federations mission is to improve the lives of vulnerable people by mobilizing the power of humanity.
Pierce md prof d a viral gastroenteritis unit, centers for disease. Seasonal factors, with a particularly heavy rainy season, along with increased population movements in the area contribute to this unusually high incidence of cholera. More than 40 years after its resurgence in africa in 1970, cholera remains a grave public health. Comparison of incidence from endemic areas in asia and africa cdcpdf pdf 5 pages external. Crossborder cholera outbreaks in subsaharan africa, the. In endemic countries such as bangladesh, consequences of cholera place an enormous financial and social burden on patients and their families. Cholera, a manual for the medical profession in china, shanghai. These outbreaks affect all categories of people and are challenging to prevent and control. Cholera is an acute enteric infection caused by the ingestion of bacterium vibrio cholerae present in faecally contaminated water or food. Over the course of 2007 to 2011, more than 100,000 cases of cholera.
Cholera has become endemic in africa with large epidemics occurring in different parts of the continent 3, 4. Search latitude 5290 documentation find articles, manuals and more to help support your product. The region is broadly affected by many cholera cases and outbreaks that. Cholera is transmitted by drinking water or eating food, which is. Responding to the cholera outbreak, the deployment of the regional disaster response team rdrt to this project proved to be very successful and costeffective. The kenya ministry of public health and sanitationdivision of disease surveillance and response mophs ddsr requested cdc technical assistance a to provide assistance with describing the epidemiology of cholera outbreaks in kenya. Mapping the burden of cholera in subsaharan africa and. Cholera epidemiology, prevention and control intechopen. One 1 suspected case on 19th dec in the coj area, charlotte maxeke hospital. The first cholera pandemic occurred in the bengal region of india, near calcutta starting in 1817 through 1824. In africa in the time of cholera, echenberg chronicles how, within a century, cholera has been transformed from an imported scourge to an african disease. Cholera yearly incidence rates in inland and coastal africa. As of 23 november 2016, there are no confirmed or suspected cases of cholera in south africa.
Cholera is an infection of the small intestine by some strains of the bacterium vibrio cholerae. Increase of cholera cases in the horn of africa and the. Between 1970 and 2011, african countries reported 3,221,050 suspected cholera cases to the world health organization, representing. Cholera tends to be reported at the national or subnational level with few attempts to understand how it may simultaneously affect multiple countries in the same region 35. West africa ebola outbreak from 20142015, and the haiti cholera outbreak in 2011 to inform covid19 response. Most countries in subsaharan africa are affected by cholera epidemics ranging from annually to every 35 years or more 1,2. Regarding the americas, cholera outbreaks and sporadic cases have been reported in mexico, haiti, the. Since 1970, cholera has become endemic in many countries of subsaharan africa and remains a recurring problem. Humanitarian situation reports, response plans, news, analyses, evaluations, assessments, maps, infographics and more on zimbabwe. What other factors can contribute to people getting cholera. A cholera outbreak caused by drinking contaminated river.
1274 730 417 607 1058 443 1240 1325 995 764 36 231 626 1125 766 736 829 646 643 721 1437 848 1385 972 306 1078 1284 51 313 540 1091 26 513 37 1322