Lebanon: Nationwide cholera outbreak ongoing as of late November /update 2

Event

Health authorities have reported 1,628 additional suspected and confirmed cholera cases Nov. 7-26. This brings the case total to 4,337 suspected cases (595 confirmed) since Oct. 6, when the first cases were reported. Disease activity is reported across all eight governorates, with the highest activity reported in Akkar Governorate in the north of the country. As of Nov. 26, only 20 cholera-associated deaths have been reported, leading to a case fatality rate of 0.46 percent. This represents the most complete data available as of Dec. 1.

Context

The last cholera outbreak in Lebanon was in 1993 when 344 cases were reported. Cholera is transmitted directly through food or water contaminated with fecal material from an infected person. Most infected people develop no symptoms or only mild diarrhea. However, approximately one in 10 infected people develop severe cholera, which causes symptoms including profuse, watery diarrhea, vomiting, rapid heart rate, low blood pressure, muscle cramps, restlessness, or irritability. Symptoms typically appear 2-3 days after exposure but can develop up to 5 days after exposure. Individuals with severe cholera can develop acute renal failure, severe electrolyte imbalances, and coma. If left untreated, these can lead to shock and rapid death.

Advice

Consult a travel medicine provider before departure regarding cholera vaccination. Practice strict food and water precautions. Seek immediate medical attention if symptoms develop within a week of being in affected areas.