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Cholera in Africa (Update 3)

29 Jan 2018

The World Health Organisation (WHO)  reports that cholera continues to be transmitted in Africa, with the reported up to 19 January 2018. 

Angola reports that the cholera outbreak that began in Uige Province last month continues, with 411 cases and nine deaths as of 17 January 2018. The affected neighborhoods of Uige have been previously reported as Orlando Fonseca, Gai and Candombe Novo.

Burundi reported 167 cases (no deaths)  from 6 districts; DS Nyanzalac (30 cases), DS Mpanda (31 cases), DS Cibitoke (35 cases), DS Isare (33 cases), DS Bubanza (31 cases) and DS B M Nord (6 cases) from 15 August to 6 December 2017.

Chad reported 817 cases (including 29 deaths) were reported in the Salamat region from 11 September 2017 to 10 December 2017. No new cases have been reported in Sila Region since 22 October 2017. The case incidence has been decreasing since the end of October. No new cases were reported in the week ending 9 December 2017. 

Democratic Republic of the Congo reports a declining national trend of new cases.In the final week of 2017, 888 cases (including 19 deaths) were reported, compared to 939 cases (including 16 deaths) in the week ending 16 December 2017. However, an increase in case numbers  was seen in the last week of 2017 in the provinces of South Kivu (23.8%), Tanganyika (26.0%) and Kinshasa (310%), compared to the previous week. From 4-7 January 2018, flooding affected areas of Kinshasa that are reporting cholera cases. In 2018, 697 cholera cases (including 53 deaths) have been reported across 21 health zones up to 11 January.

Kenya reports ongoing transmission of cholera with 7 counties reporting cases: Nairobi, Garissa, Mombasa, Wajir, Kwale, Embu, and Kirinyaga. Around 60% of the cases are in Nairobi county. Since the start of 2017, 4 079 cases (including 76 deaths) have been reported across the country.

Malawi reported 68 new cases of cholera in the second week of 2018. From 20 November 2017 to 14th January 2018, 261 cases including 4 deaths had been reported from 6 districts: Karonga (194 cases, 4 deaths); Nkhatabay  (18 cases, no deaths); Kasungu (1 case, no death), Dowa ( 4 cases, no deaths), Salima (9 cases, no death) and Lilongwe (35 cases, no deaths). No cases have been reported from the other districts in Malawi.

Mozambique has reported cholera from three districts (Memba, Erati, and Nacaroa) in Namapula province. The outbreak started in mid-August 2017 in Memba district. The national total to 15 December 2017 is 1 255 cases (including 1 deaths). The outbreak continues.

Nigeria reported 3 714 cases in 20 states from 1 January to 9 December 2018. This compared to 727 cases (including 32 deaths) from 14 states during the same period in 2016.

South Sudan reports that cholera transmission is declining nationally. Since the week ending 25 November 2017, cases were reported only in Juba and Budi counties. No new cases were reported during the last week of 2017. The national total number of cases is 20 438 from June 2017 to the end of 2017.

Tanzania reported a total of 176 cases with 5 deaths (CFR: 2.8%) were reported in the first 2 weeks of 2018. In week 2, cases have been reported from three regions: Rukwa (35 cases), Songwe (3 cases), Ruvuma (11 cases).  A total of 4 803 cases has been reported since the start of 2017.

Uganda reports that 12 sub-counties in Kasese District are now affected with Nyakiyumbu Sub County the most affected in the district. Another outbreak involving 3 cases has been identified in Kisoro district. The total to 29 November 2017 is 225 cases and 4 deaths.

Zambia reported 43 new cases (no deaths) in Lusaka district on 20 January 2018. Since the beginning of the outbreak reporting period on 4 October 2017, Lusaka district reported a total of 3 334 cases (including  70 deaths). The number of cases from other districts is 200 (including 7 deaths).

Advice to Travellers

Prevention is focused on ensuring safe water and food, particularly in countries where cholera is more common or where outbreaks occur (see individual country record). Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables.

Good personal hygiene is essential. Individuals should ensure that they wash their hands frequently, prior to eating and after visiting the bathroom.

A vaccine is available to protect against cholera but as the risk to most travellers is very low, it is only recommended in the following circumstances:

  • Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks likely.
  • Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible.

For further information see Cholera