Multi-country outbreak of cholera: situation report

Preliminary data from Member States indicate that the number of cholera cases reported in 2023 as of 15 December has surpassed that of 2022, with over 667 000 cases and 4000 deaths.

These figures must be interpreted with caution given the varying surveillance systems and capacity across countries, which means that 2023 data are not directly comparable to reports from previous years.

Since the publication of the last situation report on the multi-country outbreak of cholera on 7 December 2023 (which included data up to 15 November), and as of 15 December 2023, one new country (Togo) has reported an outbreak of cholera or acute watery diarrhoea (AWD). In total, at least 30 countries have reported cases since 1 January 2023.

Nearly a year has passed since WHO classified the global resurgence of cholera as a grade 3 emergency, the highest internal level for a health emergency requiring a comprehensive response at the three levels of the organization. WHO is currently reviewing its response to cholera globally to identify key lessons and make evidence-based adjustments where needed to better coordinate activities in the coming months.

Based on the large number of outbreaks and their geographic expansion, alongside the shortage of vaccines and other resources, WHO continues to assess the risk at global level as very high.

Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from faeces. With safe water and sanitation, cholera can be prevented. It can kill within hours when not treated, but immediate access to treatment saves lives.

While the triggers for cholera outbreaks—like poverty and conflict—are enduring, climate change and conflict are now compounding the problem. Extreme climate events like floods, cyclones and droughts reduce access to clean water and create an ideal environment for cholera to thrive.

This increase in outbreaks and cases is stretching the global capacity to respond. There is a shortage of cholera tools, including vaccines.