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Cholera in Africa (Update 1)

08 Nov 2017

On 3 November 2017 the World Health Organisation (WHO)  reported that cholera outbreaks are continuing across the African continent. Case numbers up to 3 November 2017 are reported here.

Angola: from 1 January to 21 October of 2017, cholera has been reported from Cabinda (219), Zaire (151), Luanda (3) and Maquela de Zombo (2). The outbreak appears to be coming to an end with only 1 new case (from Maquela de Zombo) was reported in week 42. There have been no cases in Luanda since week ending 28 January, in Soyo Zaire since week ending 1 July or in Cabinda since week ending 15 July.

Burundi: in the week ending 14 October 2017, there were 20 cases in Isare (9), Cibitoke (8) and Bubanza (3). A total of 84 cases were reported up to 15 October 2017. Since 16 October 2017 there have been no new cases in Mabayi (for 48 days), Nyanza-Lac (for 35 days), Mpanda (for 12 days), Bubanza (for 72 days), Cibitoke (for 2 days) or Isare (for 2 days).

Chad: 235 new cases were reported Amtimam Health District in the week ending 21 October 2017. In the current outbreak, there have been cases in Koukou (290) and Goz Beida (71) Health Districts (Sila Region) and in Am Timan (529) and Amdjoudoul (5) Health Districts (Salamat Region).

Democratic Republic of the Congo: in the week ending 14 October 2017, 1 854 suspected cases and 26 deaths were reported. Most cases were in North Kivu, South Kivu, Tanganyika, Haut Lomami, Kongo Central and Maniema.

Ethiopia: there have been 47 711 cases of what is being described as "acute watery diarroea" between 1 January and 23 October 2017. The outbreak is widespread, with seven regions reporting cases.

Kenya: WHO does not provide figures but notes that there are active outbreaks in Nairobi, Garissa, and Kajiado countries. About 60% of cases are in Nairobi county.

Malawi: WHO does not provide total figures but reports that a small outbreak of cholera was detected in the week ending 29 July in Chikwawa District. Small case numbers continue to be reported, with 3 new cases in the past week.

Nigeria: from the beginning of the year, outbreaks have been reported from 7 states: Borno, Kebbi, Zamfara, Kano, Lagos, Oyo, Kwara and Kaduna States. The outbreak was recently confirmed in Kaduna State (40 cases, 2 confirmed). A national case total is not given this week. However, the majority of cases this year have been in Borno state where a total 5 295 cases has been reported in Jere (2 655), Monguno (1 755), Dikwa (736), MCC (58), Mafa (20) and Guzamala (71).

Somalia: WHO Eastern Mediterranean Regional Office  reported on 5 November that the total number of cases in the current outbreak is 77 783 (including 1 159 deaths) . This number is unchanged since 8 October 2017.

South Sudan: there have been 21 097 and 418 deaths since 23 June 2017. Transmission is declining nationally and continues in only Juba, Budi and Fangak counties. Thirty-seven new cases (including 1 death) were reported in the week ending 7 October 2017.

Uganda: cases have been reported only from Kasese District including Nyakiyumbu, Munkunyu, Bwera, Isango, MLTC, Ihandiro, Karambi and Kyondo sub-counties. Figures are not given but WHO reports daily incidence is low.

Zambia: there have been cases in four sub-districts of Lusaka: Chipata (29), Kanyama (93), Chawama (3), Bauleni (1), and Matero (5). Half of the cases are children aged under 2 years.

Advice to Travellers

Prevention is focused on ensuring safe water and food, particularly in countries where cholera is more common or where outbreaks occur (see individual country record). Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables.

Good personal hygiene is essential. Individuals should ensure that they wash their hands frequently, prior to eating and after visiting the bathroom.

A vaccine is available to protect against cholera but as the risk to most travellers is very low, it is only recommended in the following circumstances:

  • Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks likely.
  • Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible.

For further information see Cholera