Cholera worldwide overview

Geographical distribution of new cholera cases reported worldwide

Americas 

Haiti: In 2020 and as June, no confirmed cholera cases have been reported in Haiti. In 2019, Haiti reported 684 suspected cases including three deaths (CFR: 0.4%). According to a Unicef report, the last confirmed cholera cases in Haiti were reported in February 2019. Since the beginning of the outbreak in 2010 and as of 25 January 2020, Haiti has reported 820 461 suspected cholera cases including 9 792 deaths (CFR: 1.2%).

Dominican Republic: In 2020, and as of 23 May, no cholera cases have been reported in the Dominican Republic.

Africa

Burundi: A new cholera outbreak was declared in March 2020 in Burundi. As of 7 June, 70 cases with no associated deaths have been reported in six districts.

Cameroon: Since January 2019 and as of 10 June 2020, Cameroon reported 1 773 cholera cases including 91 associated deaths (CFR: 5.1%). This represents an increase of 409 cases and 29 deaths since the previous update. The outbreak is ongoing in the North, far North, South-West and central regions.

DR Congo: In 2020 and as of 31 May, 10 533 cases including 147 deaths (CFR: 1.4%) were reported in the country. For the whole of 2019, DR Congo reported 30 304 suspected cholera cases, including 514 deaths (CFR: 1.7%). This represents an increase of 7 882 cases and 104 deaths since the previous update. The majority of the recent cases reported in the country were notified in North and South Kivu, Haut Katanga, and Lualaba regions.

Ethiopia: In 2020 and as of 10 May, 8 191 cases including 112 associated deaths (CFR: 1.4%) have been reported in Ethiopia. These numbers represent an increase of 5 642 cases and 91 deaths since the previous update.

Kenya: In 2020 and as of 14 June, 642 cases including 13 deaths (CFR: 2.1%) were reported in the country. This represents an increase of 389 cases and 12 deaths since the previous update. The outbreak continues to be active in the Marsabit counties. In 2019, 5 150 cases including 39 associated deaths (CFR: 0.8%) were reported.

Mozambique: Since the beginning of the outbreak in January 2020 and as of 12 June, 2 625 cases and 21 associated deaths (CFR: 0.8%) have been reported in Nampula and Cabo Delgado provinces.

Nigeria: In 2020 and as of 31 May, 1 003 suspected cases and no deaths associated have been reported. Among these cases, 12 were confirmed. For the same period in 2019, 1 196 cases including two deaths were reported.

Somalia: As of 30 May 2020, WHO reported 13 528 suspected cholera cases including 67 associated deaths (CFR: 0.5%) since December 2017.
According to WHO, in 2020, cholera cases have been reported from the regions of Banadir, Hiran, Lower Shabelle and Middle Shabelle. This represents an increase of 2 877 cases and 12 deaths since the previous update.

Uganda: In May 2020, a new cholera outbreak was reported in Moroto district, in Uganda. As of 12 June, 682 cases including six associated deaths (CFR: 0.9%) were reported.

Asia

Bangladesh: In 2020 and as of 14 June, 59 076 AWD cases have been reported in the Cox’s Bazar. This represents an increase of 42 040 AWD cases since the previous update. For the whole of 2019, 191 057 AWD cases were reported in the Cox’s Bazar.
According to WHO, between 5 September and 29 December 2019, 239 cases of acute watery diarrhoea (AWD) tested positive with a cholera rapid diagnostic test or culture in Cox’s Bazar, Bangladesh.

India: In 2020 and as of 8 March, according to the Indian National Centre for Disease Control, cholera cases have been reported in Kerala (1), Assam (1) and Karnataka (1). In addition, media sources quoting health authorities are reporting a cholera outbreak in Bengaluru, with 25 cases reported, including seven confirmed cases, in March 2020.

Yemen: Since the beginning of the outbreak in 2017 and as of 19 February 2020, Yemen has reported 2 309 859 suspected cholera cases and 3 786 deaths (CFR: 0.2%). In 2020 and as of 19 February, 56 220 cases have been reported, including 20 associated deaths. As of May 2020, cholera cases have begun to be reported in Yemen.
 

ECDC assessment

Cholera cases continue to be reported in eastern Africa, the Horn of Africa and Gulf of Aden over the past few months. Cholera outbreaks have also been notified in the western and southern part of Africa and in some areas of Asia. Despite the high number of cholera outbreaks reported worldwide, few cases are reported each year among returning EU/EEA travellers. The risk of cholera infection in travellers visiting countries with ongoing outbreaks remains low, even though sporadic infections among EU/EEA travellers are possible. In 2018, 26 cases were reported in the EU/EEA Member States, while 17 and 23 cases were reported in 2017 and 2016 respectively. All cases had travel history to cholera-affected areas. The risk of further transmission of Vibrio cholerae within the EU/EEA is very low. 

According to WHO, vaccination should be considered for travellers at higher risk, such as emergency and relief workers who are likely to be directly exposed. Vaccination is generally not recommended for other travellers.

Travellers to cholera-endemic areas should seek advice from travel health clinics to assess their personal risk and apply precautionary sanitary and hygiene measures to prevent infection. These can include drinking bottled water or water treated with chlorine, carefully washing fruit and vegetables with bottled or chlorinated water before consumption, regularly washing hands with soap, eating thoroughly cooked food and avoiding the consumption of raw seafood products.

Disclaimer: Data presented in this report originate from several sources, both official public health authorities and non-official, such as media. Data completeness depends on the availability of reports from surveillance systems and their accuracy, which varies between countries. All data should be interpreted with caution as there may be areas of under-reporting and figures may not reflect the actual epidemiological situation.