Mozambique: Elevated cholera activity reported nationwide through April /update 2

Event

International health authorities have reported elevated cholera activity in Mozambique, with 14,965 additional suspected cases reported from March 5-April 4, bringing the total to 22,482 suspected cases. Tete (10,376 cases) is the most affected province, followed by Inhambane (4,976 cases), Cabo Delgado (4,075 cases), Gaza (3,053 cases), Nampula (1,712 cases), and Zambezia (1,215 cases). Mozambican health authorities have implemented enhanced surveillance, laboratory testing, case management, and water and sanitation services to prevent and control the spread of cholera. This represents the most complete data available as of April 12.

Context

The current cholera outbreak in Mozambique has been ongoing since Sept. 14, 2022, when one case was reported from Lago district, Niassa Province. Cholera outbreaks have been reported annually since 2017 in Mozambique during the hot and rainy season, which runs Oct.-April. Mozambique reported 3,930 cases of cholera in 2022, 3,787 in 2020, and 7,010 in 2019.

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.