November 29, 2019 – Weekly Epidemiological Record
An excerpt – While the true global disease burden is not entirely captured by annual reporting of cholera epidemiological indicators by Member States to WHO, the overall number of cholera cases was 60% lower in 2018 than in 2017.
The decrease in the global cholera burden is attributable to a large reduction in the number of cases in Yemen and significant decreases in other countries, such as the Democratic Republic of Congo (DRC), Somalia and South Sudan.
Overall, in 2018, 34 countries reported 499 447 cholera cases and 2990 cholera deaths to WHO, with a case-fatality rate (CFR) of 0.6% (Figure 1, Map 1 and Table 1).
Africa – Overall, in 2018, 34 countries reported 499 447 cholera cases and 2990 cholera deaths to WHO, with a case-fatality rate (CFR) of 0.6% (Figure 1, Map 1 and Table 1). After exclusion of cases reported in Yemen (where reporting is imprecise), the total numbers of cases and deaths reported globally in 2018 were 128 121 and 2485, respectively, a 34% decrease in the number of cases and a 27% decrease in that of deaths from 2017. The case load represents the fewest cases reported worldwide since 2004, when there were 101 383 cases (with 2345 deaths).
The epidemiology of cholera on the African continent showed the typical regional tendency. In West Africa, cholera transmission was high in Nigeria (with 45 000 cases in 2018 and only 12 000 in 2017), with subsequent spill-over into Cameroon and Chad. Other countries in the West African region saw no cholera cases, and only 2 cases were reported in Liberia.
Middle East and Asia – As in 2017, Yemen reported by far the most cholera cases in a single country in 2018, with 371 326 cases and 505 deaths (Figure 2). This nevertheless represented a great improvement over the previous year, with a 64% decrease in the number of cases and a 78% decrease in the number of deaths. While the way in which cholera cases were reported changed during the year, the decreases in numbers of cases and deaths represented greater mobilization by the Government and partners in improving water, sanitation and hygiene and in providing adequate medical care of cases.
The Americas – In Haiti, a strategy for an integrated rapid response to outbreaks resulted in 2018 in the fewest cases since the start of the cholera epidemic in 2010 (Figure 2). The Dominican Republic continues to report relatively few cases, and the number is decreasing over time, in parallel with the numbers in Haiti.