The resurgence is spectacular. The number of cholera cases notified to the World Health Organization (WHO) more than doubled worldwide between 2021 and 2022. It increased from 223,000 to 472,000, according to a WHO note released on Friday 22 september. More countries have reported cases: forty-four in 2022, compared to thirty-five the previous year.
Large outbreaks have affected countries that had been spared for a long time, such as Lebanon and Syria – they had not recorded a single case in more than a decade. Epidemics killed 0.5% of cases, with some 2,300 deaths recorded.
Seven nations reported “very large outbreaks”, greater than 10,000 cases: Afghanistan, Cameroon, Malawi, Nigeria, Syria, Democratic Republic of Congo and Somalia. Afghanistan reported the highest number of cases (more than 280,000), followed by Syria, with more than 70,000.
The WHO, however, calls for “interpret the data with caution”. According to the organization, researchers estimate that between 1.3 million and 4 million people actually contract cholera each year, and that of these, between 21,000 and 143,000 die. The gap between official figures and projections is explained by significant gaps in the diagnosis, with capacities varying greatly depending on the country.
Cholera, a bacterial infection caused by ingesting water or food contaminated with feces, and whose symptoms are mainly diarrhea and vomiting, is often confused with other diseases, and vice versa. Not to mention that“a certain number of people are not or only slightly symptomatic”according to John Johnson, medical referent for vaccination and epidemic response at Médecins sans frontières.
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In these conditions, “strengthening laboratory confirmation capacities remains a priority”according to the WHO. “Quality data requires above all an ability to isolate this unusual bacteria in stools, then to confirm its identification using classical bacteriology or even genomic techniques”, confirms Professor François-Xavier Weill, head of the enteric pathogenic bacteria laboratory at the Institut Pasteur. THE expertise has progressed a lot in recent decades, according to him, but it remains very heterogeneous around the world. The researcher notes that neither Yemen nor Haiti have declared any cases to the WHO, while these two countries are suffering cholera in full force.
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