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On 7 September 2018 the World Health Organisation 
reported continuing transmission of cholera in African countries.
Algeria: an outbreak of cholera was announced on 23 August 2018. There have been 173 suspected cases with two deaths up to 30 August in six provinces, with confirmed cases from Blida (39 cases, 2 deaths), Tipaza (15 cases), Alger (15 cases), Bouira (3 cases), Medea (1 case) and Ain Defla (1 case)
Angola: from 21 December 2017 to 18 May 2018, a total of 895 cases were reported from two districts in Uíge province. From 22 May to 29 July 2018, 95 cases with 7 deaths have been reported from 14 districts in Luanda Province. The most affected district is Talatona having reported a total of 26 cases with five deaths.
Cameroon: a cholera outbreak continues, with active transmission mainly in the North Region. Since 10 August 2018, 90 suspected cholera cases and 9 deaths have been reported. No new cases have been reported in the Central Region since 27 August 2018. From the beginning of the outbreak on 18 May 2018 to 3 September 2018 there have been 251 suspected cases, including 20 deaths .
Democratic Republic of the Congo: from the beginning of the year to 19 August of 2018, 17 069 cases of cholera including 566 deaths have been reported. Six hundred ninety-eight cases including 35 deaths were reported in week ending 19 August from 13 out of 26 provinces. Five provinces (Kivu Oriental, South Kivu, Sankuru, Tanganyika and Kasai), reported 90.0% of cases.
Kenya: from 1 January to 27 August 2018, a total of 5 756 cases including 78 deaths have been reported. Since week 23, the number of cases reported has decreased. Nineteen of 47 counties in Kenya have been affected,with the outbreak currently active in Garissa county.
Niger: since the beginning of the outbreak on 5 July 2018, a total of 2638 suspected cholera cases, including 51 deaths . The affected health districts are Damagaram Takaya, Madarounfa, Gaya, Guidan Roumdji and Maradi.
Nigeria: from the beginning of the year to 26 August 2018, 23 893 suspected cases including 434 deaths have been reported from 18 States. There is an increasing trend in the number of cases reported with Zamfara and Kano States but no new cases were reported in the last three weeks from Adamawa, Anambra, Ebonyi, Niger, Plateau, Nasarawa, Gombe, Kogi, and Jigawa States.
Tanzania: from the beginning of the year to 2 September 2018, 3 670 cases with 68 deaths were reported from Tanzania Mainland since the beginning of 2018. Most recently 54 new cases (no deaths) were reported from Ngorongoro DC in Arusha Region.
Zimbabwe: on 6 September 2018, a cholera outbreak was declared in Harare. About 695 suspected cases were screened, with 46 confirmed cases and 5 deaths by 8 september 2018. Affected areas are Budiriro, Glenview 1, Glenview 3, Glenview 4, Glenview 8, , Mbare and Southdowns.
Cholera is rare in travellers. Mild cases may present as travellers' diarrhoea.
All travellers should be given advice on maintaining good food, water and hand hygiene, see traveller's diarrhoea, safe eating and drinking and water purification.
Travellers should be advised on basic steps in self - treating diarrhoea, particularly maintaining hydration.
Vaccination should be considered under the following circumstances and is dependant on the individual risk assessment:
Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks likely.
Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks (see current notes on the country concerned).
For further information see Cholera.
