Cholera is a water-borne, acute gastrointestinal infection caused by the Vibrio cholerae bacterium. It is transmitted by contaminated water or food, or direct contact with contaminated surfaces. In non-endemic areas, large outbreaks can occur suddenly and the infection can spread rapidly.
Researchers estimate that roughly 1.4 to 4.3 million cases of cholera occur annually and that 28,000 to 142,000 people die from the disease each year.
Cholera is most common in densely populated settings where sanitation is poor and water supplies are not safe. Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced persons or refugees, where minimum requirements of clean water and sanitation are not met.
For more information: WHO cholera fact sheet
- Transmission: A person becomes infected by ingesting the bacteria. If food or water supplies are contaminated, outbreaks can spread very rapidly.
- Signs and symptoms: Cholera causes profuse, watery diarrhoea and vomiting. Most people suffer only a mild infection, but serious cases can lead to severe dehydration and, without rapid treatment, death.
- Diagnosis: A rapid diagnostic test is available, but confirmation from a laboratory is still required, especially in declaring an outbreak.
- Treatment: Most patients can be treated using oral rehydration solution (ORS) – a mixture of water, glucose and electrolytes (sodium and potassium). In more serious cases, fluids and electrolytes are administered by intravenous infusion.
- Prevention and control: Three WHO pre-qualified oral cholera vaccines are available. All three require two doses for full protection. For two of the vaccines, a minimum two-week delay is required between doses. Ensuring safe water and effective sanitation are essential during all outbreaks.
MSF has developed cholera treatment kits in order to provide rapid assistance in epidemics.
When an epidemic seems imminent, MSF will begin setting up dedicated cholera treatment centres and oral rehydration points as close as possible to the population at risk. As specialised isolation wards designed to prevent the spread of the disease, cholera treatment centres are vital in managing and treating severely sick cholera patients. The onset of cholera is abrupt and cases must be detected and treated as early as possible.
Patients in a more serious condition are transferred to the treatment centres, while more moderate cases are treated at the rehydration points. MSF staff work to raise communities’ awareness of the disease and how it is spread, and promote hygiene messages. Water and sanitation staff will ensure there are sufficient latrines available, adequate quantities of safe water, and soap.
MSF staff first introduced the use of the two-dose oral cholera vaccine in 2012 as part of its response to an outbreak in Guinea. The vaccine has since been used as important tool in MSF responses to outbreaks in countries such as the Democratic Republic of Congo, Ethiopia, South Sudan and Tanzania.
A new cholera control strategy using a single-dose of oral vaccine instead of two is sufficient to protect against the deadly disease during an outbreak, according to a study published by MSF in the Lancet Global Health that evaluated the effectiveness of the new strategy, first used in Juba, South Sudan in July 2015. The study found that the single-dose vaccine was 87.3 per cent effective in reducing cholera for up to two months among the nearly 900 people who took part in the study. In April 2016, MSF also vaccinated 423,000 people in Lusaka, Zambia, in the largest ever single-dose oral cholera vaccination campaign to take place during an outbreak.
MSF treated 20,600 people for cholera in 2016.
- Access to essential medicineApply Access to essential medicine filter (21)
- Access to healthcareApply Access to healthcare filter (21)
- Child healthApply Child health filter (21)
- Maternal healthApply Maternal health filter (6)
- Mediterranean MigrationApply Mediterranean Migration filter (2)
- Mental healthApply Mental health filter (6)
- MigrantApply Migrant filter (66)
- Mobile clinicApply Mobile clinic filter (14)
- Neglected diseasesApply Neglected diseases filter (4)
- Refugees and internally displaced peopleApply Refugees and internally displaced people filter (66)
- Sexual violenceApply Sexual violence filter (11)
- VaccinationApply Vaccination filter (45)
- Water and sanitationApply Water and sanitation filter (46)
- ChikungunyaApply Chikungunya filter (2)
- Dengue feverApply Dengue fever filter (2)
- EbolaApply Ebola filter (7)
- HIV/AIDSApply HIV/AIDS filter (15)
- Infectious diseasesApply Infectious diseases filter (29)
- Kala azar (visceral leishmaniasis)Apply Kala azar (visceral leishmaniasis) filter (3)
- LeishmaniasisApply Leishmaniasis filter (3)
- MalariaApply Malaria filter (33)
- MalnutritionApply Malnutrition filter (19)
- MeaslesApply Measles filter (27)
- Parasitic diseasesApply Parasitic diseases filter (36)
- Pneumococcal diseaseApply Pneumococcal disease filter (6)
- Sleeping sickness (human African trypanosomiasis)Apply Sleeping sickness (human African trypanosomiasis) filter (3)
- TuberculosisApply Tuberculosis filter (11)
- 2017Apply 2017 filter (28)
- 2016Apply 2016 filter (34)
- 2015Apply 2015 filter (26)
- 2014Apply 2014 filter (30)
- 2013Apply 2013 filter (11)
- 2012Apply 2012 filter (7)
- 2011Apply 2011 filter (21)
- 2010Apply 2010 filter (30)
- 2009Apply 2009 filter (15)
- 2008Apply 2008 filter (21)
- 2007Apply 2007 filter (10)
- 2006Apply 2006 filter (18)
- 2005Apply 2005 filter (5)
- 2004Apply 2004 filter (26)
- 2003Apply 2003 filter (3)
- 2002Apply 2002 filter (4)
- 2001Apply 2001 filter (1)
- 2000Apply 2000 filter (1)
- 1998Apply 1998 filter (3)