Regional concerns as Zambia's cholera death toll hits 700

Zambia has witnessed a surge in cholera cases, with the medical charity Doctors Without Borders revealing that fatalities have now reached a staggering 700 since the outbreak last October.

The country has recorded nearly 20,000 infections, initially concentrated in the largest cities - Lusaka and Ndola - but now spreading across all provinces, raising concerns about the potential impact on the entire southern African region. Lusaka, the capital, is hardest-hit.

Neighbouring countries like Zimbabwe, the Democratic Republic of the Congo, and Malawi have already reported infections, prompting worries of a regional health crisis.

Critics are pointing fingers at President Hakainde Hichilema's government, accusing it of initiating a weak response strategy.

President Hichilema's administration has transformed a large soccer stadium in the capital city into a treatment facility and initiated a vaccination campaign targeting 1.5 million people in high-risk transmission areas.

The World Health Organization (WHO) emphasises the severity of the situation in the African region, particularly in East and Southern Africa. Recurrent outbreaks since 2021 have affected 17 countries, with Zambia and Zimbabwe being the primary areas of concern.

The WHO reports a marked increase in global cholera cases and deaths in 2023, with a concerning escalation.

The global cholera response faces challenges, primarily due to a critical shortage of oral cholera vaccines (OCV).

Urgent requests for OCV surged from January 2023 to January 2024, with 76 million doses requested by 14 countries against the 38 million that were available.

The WHO has classified the global resurgence of cholera as a grade 3 emergency - the highest level.

Kenya's case

In Kenya, flood-affected areas experienced waterborne diseases like cholera and diarrhoea in December 2023.

Nationally, since the beginning of 2023, there have been 12,256 cases and 205 deaths. Tana River and Lamu counties reported new cases, marking the third wave of cholera in the country.

Kenya, which is endemic to cholera, faces climate change-induced outbreaks.

The country, however, has demonstrated proactive measures by surpassing its target to vaccinate 1.59 million people in high-risk counties during a 10-day oral cholera vaccine campaign in August.

The response indicates the importance of a swift and comprehensive strategy for combating the spread of the disease.

The urgency of the situation demands immediate collaborative efforts between governments, international organisations, and communities. It is crucial to prioritise the replenishment of vaccine stockpiles, strengthen response strategies, and enhance public awareness to curb the cholera outbreak in Zambia and prevent its further spread across the region.

The health and well-being of the affected populations must remain a top priority for all stakeholders involved.

Disease facts

The vibrio cholerae bacterium causes cholera, a waterborne disease that primarily spreads through contaminated food and water.

Cholera is known for its rapid onset and severe symptoms. Its hallmark is profuse, watery diarrhoea, often described as rice-water stool. This diarrhoea can lead to rapid dehydration, which is one of the defining characteristics of the disease.

Individuals affected by cholera may also experience vomiting, muscle cramps, and a general feeling of weakness. In severe cases, cholera can progress rapidly, causing a sunken appearance of the eyes, dry mucous membranes, and a rapid heart rate.

Timely identification of these symptoms is critical for initiating prompt medical intervention and preventing disease escalation.

Preventing cholera revolves around robust public health measures and personal hygiene practices.

Access to clean and safe water is paramount and communities should also ensure a safe water supply and practise proper sanitation and waste disposal.

Regular handwashing with soap and clean water is a simple yet effective measure to curb the spread of cholera, alongside proper food hygiene, including thorough cooking and avoiding consuming raw or undercooked seafood.

Vaccination campaigns targeting high-risk areas also play a pivotal role in preventing cholera outbreaks and protecting vulnerable populations.

Further, community education and awareness campaigns are indispensable tools in the fight against cholera. It is critical to educate people about cholera symptoms and the importance of seeking medical attention at the onset of illness.

Training communities in proper food and water handling, as well as the importance of maintaining personal hygiene, contribute to a collective defense against cholera outbreaks.

Additionally, local authorities and healthcare providers play a vital role in disseminating information about vaccination campaigns and ensuring preventive measures are accessible to all.

Ultimately, a combination of individual responsibility, community engagement, and public health initiatives forms the most effective defence against the insidious spread of cholera.