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Cholera levels in rural Zimbabwe may still rise

The recent outbreak of cholera in Zimbabwe is the worst the country has seen in many years. MSF is responding in a number of areas across the country to save people who have been stricken with the water-borne illness.

The southern town of Beitbridge, on the border with South Africa, has been particularly hard hit. In one week since 14 November, more than 1,500 cases were reported in this town of approximately 50,000 people. The very poor water and sanitation conditions in the town makes it easier for the bacteria to spread.

The focus of Zimbabwe's cholera outbreak is increasingly in the rural areas. Cases are appearing in many places, sometimes just a few here and there, while other areas report a steady and significant increase of cases each week. As is often seen in rural outbreaks, deaths occur more commonly in the community, before interventions can start. The concern is that the peak has not yet been reached in many of these rural districts.

Cases continue to decrease in Harare, but the number of cases occurring there and in Kadoma, another urban area, is still significant. The cases remain a serious concern because they are being found in areas that previously had only very low numbers or no cases of cholera. The lack of sanitation services continues to be a problem in the suburbs and could result in higher case numbers again, such as what was seen in November and December 2008.

Cholera cases are also being found in neighbouring countries and MSF is responding as needed. Apart from the cholera in South Africa, which is clearly linked to the cholera outbreak in Zimbabwe, It is believed that current cholera cases in countries such as Malawi, Mozambique and Zambia are the result of the normal cholera season and are not related to the Zimbabwe cholera outbreak.