Cholera outbreaks rise globally as vaccine supplies run out

Record number of epidemics reported after droughts, floods and wars forced large numbers of people to live in unsanitary conditions .

A record number of cholera outbreaks around the world, caused by droughts, floods and armed conflicts, have sickened hundreds of thousands of people and has so strained the supply of cholera vaccines that global health agencies are rationing doses.

Outbreaks have been reported in the Caribbean, Africa, in the Middle East and South Asia, endangering the health of millions of people and overwhelming fragile health systems. Untreated, the disease, which is usually spread through contaminated water, can lead to death from dehydration in just a day as the body attempts to expel virulent bacteria in streams of vomiting and watery diarrhea.

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Cholera is usually fatal in about 3% of cases, but the World Health Organization says it kills at an accelerated rate in recent outbreaks, even though it is is relatively cheap and easy to process. It is most often fatal in children, who rapidly progress to severe illness and organ failure.

Cholera outbreaks tend to follow displacement: when droughts, floods, famines or the threat of violence force large groups of people to move, and they lose access to clean water and sanitation facilities, the cholera bacteria can spread through a population. This year has seen cholera both in places where it is a familiar threat and in countries that have not faced it in decades.

"La situation is very worrying, very worrying," said Dr Philippe Barboza, who leads the World Health Organization's cholera response. "We had to worry about war, poverty and population movements, and that hasn't changed. But now we have climate change on top of that. He called the profusion of cholera outbreaks "a fire that will only get worse".

In Nigeria, one million people have been displaced by floods in recent weeks, and there are at least 6,000 cases of cholera Kenyan authorities are reporting suspected cases of cholera among people fleeing violence in Somalia and arriving at the gigantic refugee camp of Dadaab, where tens of thousands of children s are in danger.

ImageA recently opened a cholera medical center in the city Syrian town of Darkush, on the outskirts of the northwestern rebel-held province of Idlib.Credit...Aaref Watad/Agence France-Presse — Getty Images

In Haiti, cholera has erupted as entire neighborhoods of people displaced by violence are crammed into small open plots in Port-au-Prince, sharing a single cracked water pipe running through untreated waste. Cholera is also rampant in the country's overcrowded prisons.

In Syria, millions of people displaced by the civil war do not have access to drinking water, while years of fighting have destroyed sanitation infrastructure. Raw sewage is pumped into the Euphrates, which hundreds of thousands of people depend on for water. The United Nations reports more than 20,000 suspected cases of cholera and 75 deaths.

In Pakistan, where a third of the country is entirely under water after massive floods of monsoon, and nearly 10 million people have been displaced, there are reports of cholera cases in a dozen localities. These are not full-fledged epidemics yet, and vaccination could help avert a catastrophe.

But the demand for vaccination is so high that the World Health Organization suspended the two recommended recommendations. single-dose vaccination regimen and switched to single-dose, in an effort to stretch the supply so that there is enough...