As severely as cholera can hit a person, it is, in principle, so easy to avoid. Diarrheal disease could long be a thing of the past, and yet it is currently flaring up in more regions of the world than ever before. “There are currently 29 cholera outbreaks worldwide – the highest number ever recorded,” Ahmed Al Mandhari, head of the WHO regional office for the Middle East, said at a news conference on Wednesday. Haiti, Nigeria, Somalia and eight countries in the Middle East are affected. The infections are currently raging particularly hard in Syria and Lebanon.
The comma-shaped cholera bacteria are transmitted through polluted drinking water or contaminated food. The disease can occur wherever there is a lack of clean water: in very poor countries, in regions whose water supply has collapsed as a result of crises, wars and catastrophes, in overcrowded refugee camps without adequate sanitary facilities. And recently also in countries that are severely affected by global warming.
“Climate change has contributed to the resurgence of cholera,” says Ahmed Al Mandhari. “We see evidence of this in countries that have been hit by extreme weather events such as storms, floods and droughts.” In particular, the increasingly frequent droughts in the Middle East made access to clean water more difficult, creating an ideal environment for the spread of Vibrio cholerae.
The outbreak in Syria probably has its origins in the water shortage. In desperation, people have dug their own wells without the necessary control of the water quality. In the meantime, cholera bacteria have been detected in these unofficial water points, says Iman Shankiti, who works for the WHO in Syria. Almost 25,000 suspected cases have been reported there since the end of August, and 81 people have died.
Lebanon has not experienced a cholera outbreak for almost 30 years
The infections probably came to Lebanon in early October from Syria. The first cases were registered among Syrian refugees in the camps in the north of the country. They have now spread to other parts of the state.
It’s the first eruption in the country in almost 30 years, and it’s still expanding. About 400 cases of cholera have been confirmed so far, plus 1,850 suspected cases. 18 people died. “The situation in Lebanon is fragile, the country is already having difficulties fighting other crises – exacerbated by ongoing political and economic problems,” the WHO comments on the situation. Hospitals and other healthcare facilities have been weakened as staff have migrated to other countries and there are problems with the delivery of essential medical supplies. The houses are having increasing difficulties in caring for the increasing number of patients.
Depending on general health, cholera can be asymptomatic, mild, or cause diarrhea and vomiting so severe that people die from dehydration within hours. The most important measure is therefore the administration of liquids, in severe cases in the form of infusions.
Vaccines are available to prevent further cases. But according to the WHO, their stocks are currently scarce. In the regions currently affected, only one of the two doses actually required is therefore administered initially.
Travelers are not generally endangered as they usually stay in areas with good water supplies. According to the Robert Koch Institute, only 28 cases of cholera have been registered in Germany since 2001. Vaccination is therefore generally not recommended for travelers. Exceptions are, for example, disaster workers or employees in the health sector, who will stay longer in areas with cholera diseases.