Malawi: Elevated cholera activity reported nationwide through January /update 2

Event

Malawian health authorities have reported an additional 10,363 cases of cholera between Nov. 25, 2022-Jan. 12, 2023, nationwide, bringing the total case count to 23,217 cases since March 3. This outbreak has been the largest reported in Malawi in the past 20 years. Cholera cases are reported in 29 districts. As of Jan. 11, officials have reported 750 cholera-related deaths, leading to a case fatality rate of 3.2 percent. This report reflects the most complete data available as of Jan. 17.

Context

Cholera is endemic to the country's Northern Region (Chitipa and Karonga districts) and Southern Region. Malawi reported two cases of cholera in 2021, three in 2020, 29 in 2019, and 812 in 2018. The Ministry of Health is currently making efforts to curb the spread of the disease, including through vaccination campaigns and contact tracing. Communities that lack access to safe drinking water and proper sanitation are at an increased risk of spreading the disease.

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 two or three days after exposure but can develop up to five 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 regarding cholera vaccination before traveling to the country. Practice strict food and water precautions. Seek immediate medical attention if symptoms develop within a week of being in areas of high cholera transmission.