Cholera: resurgence of fatal yet preventable disease

Cholera is highly predictable, with flare-ups in endemic areas at specific times of the year in densely populated areas and driven by natural disasters, conflict, forced migration, poverty, urbanisation, population growth, and climate change. If left untreated, shock from severe acute diarrhoea after ingesting contaminated water or food is often fatal.1

Cholera is also highly preventable, by improving access to clean water and sanitation and good hygiene (WASH) and access to oral vaccines. Yet since 2021, globally reported cases have been rising after years of decline.2 The latest data show a doubling in case fatality rate over a decade to about 1.9%.3 Accurate global case and death data are lacking, but in 2021, 35 countries reported 223 370 cases and 4159 deaths to WHO,4 compared with 323 320 cases and 857 deaths in 27 countries in 2020.5 Active epidemics and outbreaks have become more frequent. Since the beginning of 2023, outbreaks have extended further in Malawi, Mozambique, Tanzania, South Africa, Zimbabwe, Zambia, Somalia, Ethiopia, Kenya, South Sudan, Haiti, India, Pakistan, the Philippines, Syria, and Lebanon. …