What is Cholera?
Cholera is an acute diarrheal infection caused by consuming water and/or food that has been contaminated with the bacterium Vibrio cholerae. Originating in India’s Ganges delta in the 19th century, cholera has since become a widespread endemic across the globe most prevalent in Sub-Saharan Africa. According to the World Health Organization (WHO), “Researchers have estimated that each year, there are 1.3 to 4.0 million cases of cholera, and 21,000 to 143,000 deaths worldwide due to cholera.”
Vibrio cholerae infections are often asymptomatic, meaning there can be high contraction rates within the community before any detectable symptoms. Within a span of 1-5 days, the development of cholera will result in acute diarrhea and severe dehydration. Untreated cholera will lead to death, most commonly in children, elders, and immunocompromised individuals.
Cholera is usually predictable and easily preventable. However, without access to basic necessities and adequate healthcare, cholera continues to persist. Educating the public on suitable sanitation and conventional hygiene practices is essential to growth. Furthermore, supplying communities with a clean water reservoir and access to sanitation and medical facilities is pivotal to prevention. Cholera is an enduring issue that continues to globally threaten public health despite being preventable and normally non-fatal. This bacterial disease is a benchmark of global inequity and demonstrates a lack of social development most notably in the realm of healthcare, nutrition, and hygiene.
Newest Cholera Outbreak in 2022. Who’s Affected?
Cholera is an ongoing issue in over 29 countries—some being countries in which cholera was previously eradicated—including Afghanistan, Bangladesh, Burundi, Cameroon, the Democratic Republic of the Congo, the Dominican Republic, Haiti, Iraq, Kenya, Lebanon, Malawi, Mozambique, Nigeria, Pakistan, the Philippines, Somalia, Syria, and Tanzania. In addition, there are countries that are affected but have no updated medical records of an outbreak such as India, South Sudan, Taiwan, Niger, Yemen, Benin, Burkina Faso, Ethiopia, Togo, Uganda, Zambia, and Zimbabwe.
Since 2022, cholera has rapidly increased in Malawi, Somalia, Haiti, the Dominican Republic, Yemen, Syria, Lebanon, and Pakistan. The outbreak has been exacerbated by the pandemic and climate change, which compromised communities and lead to a continued increase in cholera cases and deaths.
Health disparities and a lack of medicinal accessibility intensify the harsh conditions faced by the victims of various diseases such as cholera. Widespread diseases like cholera are primary contributors to an incline in mortality rates at birth and short life expectancy periods.
Leading world organizations such as the World Health Organization (WHO) have attributed the unprecedented rise in cholera cases on "complex humanitarian crises in countries with fragile health systems and aggravated by climate change.” Other authorities such as the UN claim that these unprecedented outbreaks are worsened by climate change. However, while climate change is a factor, the absence of medical support is a major reason why the conditions of the affected populations continue to deteriorate. A combination of sub-par response rates, medical commodities supply chain shortages, limited healthcare resources, climate change/natural disasters, political instability/conflicts, and multiple ongoing crises create barriers between healthcare and the public.
Inadequate access to healthcare, water shortages, droughts, famine, poor hygiene, and community displacement have all become fundamental aspects of diseases in several nations concentrated in Sub-Saharan Africa, the Middle East, the Caribbean, and South/Southeast Asia. The preexisting conditions caused by Cholera, COVID-19, the Ebola virus, and monkeypox further lead to the transmission and spread of other life-threatening diseases such as malaria, pneumonia, severe intestinal infections, HIV, and tuberculosis.
Treatment & Vaccines
The first vaccine for cholera was developed by a Spanish physician Jaume Ferran in 1884, based on the findings of microbiologist/chemist Louis Pasteur in 1877. Ferran’s vaccine was later used to fight the cholera epidemic in the late 19th and 20th centuries. There are currently three FDA-approved cholera vaccines: Dukoral, ShanChol, and Euvichol-Plus/Euvichol. These oral vaccines are quite painful and do not guarantee prevention. On average, their longevity spans anywhere from 3 months to approximately less than 3 years. Vaccines have continually fallen short of showing any effective remedial results without external environmental and social reform. Still, it is vital to continue the implementation of vaccines in regions that cannot receive immediate medical support in order to minimize infection rates.
Cholera vaccines remain inadequate in providing effective long-term prevention, as there is also a continual shortage of production and accessibility. Supply outages and a lack of relevant data collection have diminished progress and medicinal reform in regions with high transmission rates. Additionally, no effective precautionary measures are in place for minimizing secondary infections. Even with the administration of vaccines, reinfection rates remain high, and the availability of vaccines and other resources remain low.
How to Help
Spreading public awareness through social media platforms, city-wide community campaigns, and local student-based clubs is key to prevention and support. It is also important to promote good hygiene and social distancing, and educate people on the significance of clean water sources and proper sanitation within small communities to help reduce the likelihood of infection. If possible, donating essential materials such as cleaning supplies, clean drinking water, non-perishable goods, clothing, etc. can make a great difference. You can also provide monetary support to world relief organizations such as Médecins Sans Frontières, Red Cross/Crescent, Global Task Force on Cholera Control (GTFCC), UNICEF, WHO, and more.
Take Action - Here are some ways you can support those affected by the cholera outbreak.
Donate:
Doctors Without Borders delivers emergency medical aid to people in crisis, and they have responded to the cholera outbreak with a vaccine campaign, cholera kits, treatment facilities, water/sanitation improvements, and community health promotion.
United Nations Children's Fund (UNICEF USA) provides emergency relief for children in need, recently having delivered emergency medical, sanitation, and hygiene supplies in response to the cholera outbreak in Malawi.
The International Federation of Red Cross and Red Crescent Societies (IFRC) aims to launch an emergency appeal to support cholera prevention and control efforts by providing safe water, setting up sanitation facilities, and promoting good hygiene.
United Nations Children's Fund (UNICEF USA) provides safe water/emergency medical supplies and education on hygiene and cholera prevention to Syria, Lebanon and Iraq to save children's lives.
UN Refugee Agency (UNHCR) plans to combat cholera through provision of testing, healthcare, vaccinations, hygiene kits, and improvement of shelter, water, and sanitation services.
Educational Supplements:
"Why Are There So Many Cholera Outbreaks in 2022? (Doctors Without Borders / MSF-USA, 2022)
Centers for Disease Control and Prevention. (2022). Outbreak Response Resources.
Centers for Disease Control and Prevention. (2019). Cholera Vaccine: What You Need to Know.
World Health Organization. (2022). Cholera - Global Situation.
World Health Organization. (2022). Cholera.
Resources:
“A Fire That Is Just Going to Keep Getting Bigger’: What You Need to Know about the Global Cholera Outbreak.” Concern Worldwide, 4 Jan. 2023, https://www.concernusa.org/story/global-cholera-outbreak-explained/.
“Cholera.” World Health Organization, World Health Organization, https://www.who.int/health-topics/cholera#tab=tab_1.
“Cholera Worldwide Overview.” European Centre for Disease Prevention and Control, 23 Jan. 2023, https://www.ecdc.europa.eu/en/all-topics-z/cholera/surveillance-and-disease-data/cholera-monthly.