Multi-country outbreak of cholera, External situation report #20 - 20 November 2024

Overview

From 1 January to 27 October 2024, a cumulative total of 486 760 cholera and acute watery diarrhoea cases and 4018 deaths were reported from 33 countries across five WHO regions.  While the number of cases reported in October 2024 is 42% lower than the same period in 2023, the number of deaths has increased by 54% – reflecting severe response challenges in outbreak settings. Factors such as conflict, mass displacement, natural disasters, and climate change have intensified outbreaks, particularly in rural and flood-affected areas, where poor infrastructure and limited healthcare access delay treatment. These cross-border dynamics have made cholera outbreaks increasingly complex and harder to control.

Since the last report, new cholera outbreaks have been reported in Iraq (571 cases and one death), Lebanon (one case with no death) and South Sudan (49 cases and one death), bringing the total number of affected countries in 2024 to 33.

In November, record production of Oral Cholera Vaccines (OCV) was achieved, the highest since 2013, driven by new formulations and production methods introduced and prequalified this year. Despite this progress, the OCV emergency stockpile averaged less than 600 000 doses in October – far below the target of five million doses needed for emergency stockpile at all times for effective outbreak response. This persistent shortage continues to hinder efforts to control cholera outbreaks and respond promptly to the spread of the disease.