Ethiopia: Elevated cholera activity reported in multiple areas, especially in Oromia Region, through June

Event

International health authorities have reported elevated cholera activity in Ethiopia, with more than 11,400 cases reported as of June 20. This represents an 85 percent increase in cases since May 7. The outbreak has spread across four regions in Ethiopia, with Oromia Region (6,560 cases) being the most affected, followed by the Southern Nations, Nationalities, and People's Region (SNNP; 3,105 cases), the Somali Region (1,550 cases), and Sidama Region (192 cases). Health officials have implemented a vaccination campaign in Oromia, SNNP and Somali Regions, which has resulted in over 1.9 million people being vaccinated with one dose only, due to global supply shortage. This represents the most complete data available as of June 26.

Context

On Aug. 27, 2022, the first cholera case was reported in Harena Buluk Woreda, Bale Zone, Oromia Region. Cholera spread to bordering areas of Liban Zone in the Somali Region on Sept. 29, 2022. Health officials stated that the use of unsafe water from contaminated water points is the likely cause of this outbreak, with the majority of the positive cases reporting having collected water from rivers and open wells. Ethiopia reported 674 cases of cholera in 2021, 12,226 in 2020, and 2,615 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.