Floods increase cholera risk even as number of cases declines in Africa

As the number of cholera cases decreases each week in affected African countries, heavy flooding caused by seasonal rains and tropical cyclones in southern Africa increases the risk of the disease spreading and threatens to undermine control efforts against epidemics.

The number of new cholera cases fell to 2,880 in the week ending February 26, a 37 percent drop from the previous week, when 4,584 cases were recorded. The number of deaths has hardly changed, going marginally from 82 to 81 over the same period. Twelve African countries are currently reporting cases, with South Africa, Tanzania and Zimbabwe being the latest countries to report a cholera outbreak.

In southern Africa, cholera epidemics occur in a context marked by seasonal rains and tropical storms that have caused heavy flooding. In Malawi, the country experiencing the worst cholera outbreak in its history, increased rainfall is slowing efforts to control the outbreak. In some localities, response teams are struggling to reach people in need due to impassable roads and damaged infrastructure. Some cholera treatment units were affected by the floods and the number of notified cases increased in some places in the days following the heavy rains.

In Mozambique, tropical storm Freddy which made landfall on February 24 caused major damage to infrastructure. According to preliminary assessments, more than 44,000 people have been affected, 55 health facilities damaged or destroyed and nearly 3,500 kilometers of roads damaged. Mozambique is facing a cholera epidemic which has affected six of its 11 provinces. The number of cases has risen sharply in the country since December 2022 amid the ongoing rainy season. Vaccination activities against cholera are currently continuing. Neighboring South Africa and Zimbabwe also reported flooding.

“Countries have stepped up their cholera control measures and early indications are promising. However, heavy flooding and cyclone phenomena in parts of southern Africa are likely to accelerate the spread of the disease,” said Dr Matshidiso Moeti, Regional Director of the World Health Organization (WHO) for Africa. “We are strengthening our support to countries to increase their capacity to detect diseases, by providing medical equipment and improving their preparedness in localities at risk of flooding. »

In Madagascar, where cholera was last reported in 2000, recent cyclones, particularly Cyclone Cheneso which hit the country in January, caused extensive flooding, some of which is slowly disappearing. The floods have led to an increase in malaria cases and increased the risk of a cholera outbreak. More than 470,000 people have no access to health services after Cheneso destroyed at least 77 health facilities. In the aftermath of Tropical Cyclone Freddy which swept across the island on February 21, more than 116,000 people were affected and nearly 29,000 homes were flooded or damaged in seven of the country’s 23 regions. Preparedness capacities are strengthened based on identified gaps.

As part of the cholera response, WHO has deployed 80 experts to affected countries. Over the past two months, the Organization has also sent 455 tons of essential supplies for cholera treatment to Malawi and Mozambique and to support preparedness in Burundi, Democratic Republic of Congo, Ghana, Kenya and Zambia .

Cholera is acute and extremely virulent, but easy to treat. Most people can be successfully cured by the rapid administration of oral rehydration salts or intravenous solutions. A sustainable and effective fight against cholera requires comprehensive measures such as improved detection and response, access to treatment and vaccination, as well as access to drinking water and sanitation. .

The ongoing cholera epidemics in Africa are exacerbated by extreme weather events and conflicts that have made populations more vulnerable. Thus, people who have been forced to flee their homes because of conflicts or who have been impoverished by climatic phenomena have to face precarious living conditions.

Dr. Moeti spoke today at a press conference. She was accompanied by Professor Zely Arivelo Randriamanantany, Minister of Public Health of Madagascar. Also present, to answer questions, were the following experts from the WHO Regional Office for Africa: Dr Thierno Baldé, Head of COVID-19 Response Operations and Dr Patrick Otim, Head of Health Emergencies at the serious event management unit.

Source: World Health Organization