Rapid risk assessment - Outbreak of cholera in Cuba, potential risk for European travellers - 1st update - 18 January 2013

Risk assessment

This updated rapid risk assessment assesses the potential risk for European travellers to Cuba after an outbreak of cholera in the Cuban province of Granma expanded to the provinces of Santiago de Cuba, Camagüey and Guantanamo. By the end of 2012, the cumulative number of cases reported in Cuba had reached 500. The report of 51 confirmed cases in Havana, Cuba, raises the risk for European travellers for contracting the disease when compared to the previous rapid risk assessment (July 2012). However, the overall risk for travellers is still considered low.

Executive summary

In 2012, Cuba faced – for the first time in almost 150 years – an outbreak of cholera. In July 2012, ECDC assessed that the risk of infection for European travellers was low.

As of 14 January 2013, 51 cases of cholera have been confirmed in Havana and were subtyped to be Vibrio cholerae toxigenic serogroup O1, serotype Ogawa, biotype El Tor.

The report of 51 cases in Havana raises the risk for European travellers for contracting the disease when compared to the previous risk assessment. The overall risk of cholera infection in travellers visiting Cuba should still be considered low. However, the risk has increased because of the high proportion of tourists visiting Havana and the fact that the affected geographical area is expanding.

The Cuban authorities are taking measures to raise awareness among the population, improve sanitary and food hygiene, including water treatment and supply, and provide clinical care.

Travellers to Cuba, Haiti and the Dominican Republic should be aware of preventive hygiene measures and seek advice from travel medicine clinics to assess their personal risk.

Furthermore, physicians in the EU should consider the diagnosis of cholera in returning travellers from these countries, presenting with compatible symptoms. Upon diagnosis, notification to the relevant public health authorities is essential.