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Cholera in Africa (Update 4)

28 March 2018

The World Health Organisation (WHO) reports that cholera continues to be transmitted in Africa, with the following reported up to 16 March 2018.

Angola has reported 794 cases (5 deaths) from 21 December 2017 to 11 March 2018. The outbreak began Uige Province: affected neighborhoods of Uige have been previously reported as Orlando Fonseca, Gai and Candombe Novo. Between 5 and 11 February 2018, 12 cases (1 death), were reported from Cabinde Province.

Democratic Republic of the Congo has reported 6 080 cases (140 deaths) from 1 January to 4 March 2018. In week ending 24 February 2018, 571 new cases with 22 deaths were reported, including 37 cases in Kinshasa, the capital. Half the cases reported in week 8 were from North Kivu, South Kivu and Tanganyika. A total of 60 492 cases (1 288 deaths) have been reported since January 2017.

Kenya has reported a total of 1 476 cases (29 deaths) from 1 January to 26 February 2018. The outbreak is active in 6 counties: Garissa, Siaya, Tharaka Nithi, Meru, Tana River, and Turkana counties. The outbreak is controlled in Mombasa, Kirinyaga, and Siaya counties.

Mozambique has reported 2 147 cases (5 deaths) from 12 August 2017 to 15 March 2018. Cases have been reported from Nampula and Cabo Delgado Provinces.

Nigeria reported an outbreak of cholera in Kukawa Local Government Area (LGA) of Borno State on 8 March 2018. From 13 February 2018 to 16 March 2018, a cumulative total of 608 suspected cases (3 deaths) have been reported. In addition to this, throughout Nigeria, from 1 January to 31 December 2017, 4 221 suspected cholera cases (107 deaths) were reported in 20 States. In the first five weeks of 2018, 172 suspected cases(13 deaths) have been reported in 7 States.

South Africa reported a single case pf cholera in the border district of Umkhanyakude, in KwaZulu-Natal on 7 February 2018.

Tanzania reported 1 440 cases (27 deaths) from 1 January to 11 March 2018. All of these were reported from the mainland. None were reported from Zanzibar.

Uganda reported 1 695 cases (36 deaths) from 12 Feb to 15 March 2918. The outbreak is located in Hoima District where Kabwoya, Buseruka and Kyangwali sub-counties are affected. Most cases are newly-arrived refugees from DRC.

Zambia has reported 4 876 cases (97 deaths) from 4 October 2017 to 15 March 2018. Since the start of the outbreak, Lusaka has reported 4 483 cases (83 deaths). The cumulative number of cases from other districts is 393 (14 deaths).

Zimbabwe has reported 111 cases (4 deaths) from 8 January 13 March 2018. A cholera outbreak was declared in Chegutu Municipality in Mashonaland West Province in the first week of March 2018. Five cases have also been confirmed in Harare since 8 March 2018.

Advice for Travellers

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.

When to consider vaccination

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.