By NewsDesk  @bactiman63

The Lebanon Ministry of Health reports in an update today that the cholera outbreak that began in early October has expanded to 2709 total (suspected and confirmed) cholera cases, including 436 confirmed cases.

The cholera death toll now stands at 18.

WHO Regional Director for the Eastern Mediterranean, Dr Ahmed Al Mandhari released a statement on cholera last week:

After decades without a single case of cholera, the outbreaks that have been recently declared in Lebanon and Syria mark an unwelcome comeback in those countries.  In fact, this is part of a worsening pattern across the Region, and the globe, as 8 of the 22 countries in our Region are grappling with outbreaks of cholera and acute watery diarrhoea. 

Moreover, there are now 29 cholera outbreaks worldwide – the highest number on record. We know that cholera can cross borders, placing neighboring countries at increased risk and heightening the need for urgent control. This is a wake-up call for all of us. 

Cholera can spread rapidly in our Region, driven by the multiple complex humanitarian and health emergencies, prolonged conflict, poor water and sanitation infrastructure and deteriorating economic conditions.    

Additionally, climate change has contributed to the resurgence of cholera, and we see this evidence in several countries hit by extreme climate events like floods, droughts and cyclones. Droughts, which are increasingly common across our Region, reduce access to clean water and create the ideal environment for cholera to spread. 

We should not have outbreaks of cholera in our Region in the 21st century, and definitely, people should not be dying from it. Access to clean water and appropriate sanitation facilities should be available to all and is a basic human right. 

Most of the countries affected by the cholera outbreak in the Region are those with poor water and sanitation infrastructure with no major investment in recent years. Water scarcity – again, driven by drought – is another contributing factor. 

A timely and well-coordinated response among all stakeholders is urgently needed to quickly control the outbreaks and curb the further spread of cases and deaths within the affected countries and in neighboring countries.

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This response must be focused on improving access to clean water and appropriate sanitation and hygiene, intensive awareness-raising, community engagement and strengthening early warning surveillance to detect cases quickly and respond effectively. 

Good quality clinical management of patients is essential to minimize mortality – cholera is both a highly preventable and treatable disease. WHO is working with ministries of health and partners in all of these areas.  

The upsurge of cholera outbreaks in the Region and around the globe has led to an acute cholera vaccine shortage. As a result, the International Coordinating Group on Vaccine Provision – which manages the global stockpile of cholera vaccine – is temporarily suspending the standard 2-dose vaccination regimen for cholera outbreak response campaigns, adopting a single-dose approach instead. 

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Using a one-dose strategy allows more people to be vaccinated and provides them protection in the near term.  

Oral cholera vaccination campaigns are planned for both Lebanon and Syria in the coming weeks, while Pakistan has recently undertaken campaigns both prior to, and since, the recent floods.   

While vaccines are a critical tool, they are not the main intervention to control cholera. Cholera is mainly prevented with access to safe water and sanitation and can be treated easily with oral rehydration solution. Most patients do not require hospitalization. Antibiotics are reserved for more severe cases. 

Cholera can kill, but it is preventable. Let us not allow the hard-won public health gains of the last decades vanish due to people lacking access to simple interventions.