Health Talk | Cholera concerns spread as disease incidence doubles in Africa amid vaccine shortfall

While vaccination is an important tool against cholera, safe drinking water and sanitation and hygiene practices are solutions to prevent the disease.

On September 4, the World Health Organisation (WHO) published new data on cholera for 2023, showing an increase in both cases and deaths, which underscores recent concerns raised by international health experts that the disease was increasingly becoming difficult to treat.

(FILES) A worker disinfects a rural isolation centre where patients are being treated for cholera in Wad Al-Hilu in Kassala state, eastern Sudan on August 17, 2024. The number of cholera cases and deaths rose sharply last year, the World Health Organization said on September 4, 2024, calling for more to be done to stem the preventable disease. (Photo by AFP)(AFP)

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It can cause severe acute watery diarrhoea and the severe forms of the disease can kill within hours if left untreated.

The WHO data show, the number of reported deaths from cholera last year increased by 71% compared with 2022, and the number of cases increased by 13%. The disease killed 4000 people last year, a disease that is preventable and has been easily treatable.

Cholera is endemic in many countries.

Like a lot of other problems plaguing the world, climate change, along with unsafe water and sanitation, poverty and displacement, can also be blamed for the rise of cholera outbreaks last year.

The WHO data said that the geographical distribution of cholera has also changed significantly with cases from the Middle East and Asia declining by one-third, and cases from Africa more than doubling.

“Preliminary data show that the global cholera crisis continues into 2024, with 22 countries reporting active outbreaks. So far this year, more than 342,000 cases and 2400 deaths have been reported to WHO from all regions,” said WHO.

The other alarming news is that the global cholera crisis has caused a severe shortage of cholera vaccines. According to WHO data, between 2021 and 2023, more doses were requested for outbreak response than in the entire previous decade. About 36 million doses were produced last year, only half the amount requested by 14 affected countries.

“Since October 2022, the International Coordinating Group, which manages emergency vaccine supplies, has suspended the standard two-dose vaccination regimen, adopting a single-dose approach to reach and protect more people with limited supplies.”

There is data to support that a single dose also is effective. A recent paper in The Lancet examined the effectiveness of a single-dose shot instead of the conventional two-dose regimen after a mass vaccination campaign in the high disease burden setting in 2020 in the Democratic Republic of the Congo.

"A single dose of Euvichol-Plus provided substantial protection against medically attended cholera for at least 36 months after vaccination in this cholera-endemic setting...," were the findings.

While vaccination is an important tool, it cannot be stressed enough that safe drinking water, and following safe sanitation and hygiene practices remain the long-term and sustainable solutions to ending these disease outbreaks and preventing future ones.

Rhythma Kaul, national editor, health, analyses the impact of the most significant piece of news this week in the health sector