Zimbabwe Declares State of Emergency Amid Cholera Outbreak

The Ministry of Health and Child Care of Zimbabwe has declared a state of emergency in the African nation as cholera infections are suspected in thousands of citizens.

The outbreak was first declared on September 6, 2018, in the capital city of Harare, according to the World Health Organization (WHO) Regional Office for Africa’s Weekly Bulletin on Outbreaks and Emergencies.

Harare is home to over 2 million individuals and epidemiological links to Harare have been confirmed in 5 additional provinces in Zimbabwe. The epicenter of the outbreak is in the Glenview suburb of the city which is an active trading area with a highly mobile population. The area is particularly vulnerable due to a lack of safely piped drinking water which has led to the use of borehole and wells.

A total of 3349 cholera cases were reported in Zimbabwe between September 1 to 14, with 71 confirmed cases and 32 reported deaths, according to the WHO.

Zimbabwe has experienced cholera outbreaks in the past, the largest of which killed more than 4000 individuals between August 2008 and May 2009. Cholera cases are reported every year, but the incidence of the disease has been considerably lower in the past 3 years, with 20 cases reported in 2015, 2 in 2016, and 6 in 2017.

In a statement, Amina Mohammed, deputy chief of United Nations Children’s Fund (UNICEF), indicated that patients are not responding to the drugs typically used to fight the infection and that doctors are now using second- and third-line drugs being imported by UNICEF.

The government is working with international partners, including the WHO and Medecins Sans Frontires, to expand response to the outbreak; efforts include creating access to clean water in the most affected areas and eliminating contaminated water sources.

The WHO is also working to provide health education to ensure that anyone who is suspected to have cholera seeks appropriate care; they are also working on establishing treatment centers closer to affected areas.

Further, the WHO is mobilizing health experts from across the globe to create a cholera surge team. The team is tracking down cases, assisting laboratories with processing samples, and strengthening infection prevention and control in areas of need.

“When cholera strikes a major metropolis such as Harare, we need to work fast to stop the spread of the disease before it gets out of control,” Matshidiso Moeti, MSc, MB, BS ,the WHO Regional Director for Africa in the WHO African Region, said in a recent statement. “WHO is working closely with the national authorities and partners to urgently respond to this outbreak.”

In August, 47 African nations, including Zimbabwe, adopted the Regional Framework for the Implementation of the Global Strategy for Cholera Prevention and Control. Participation in the framework indicates that the country pledges to reduce the magnitude of cholera outbreaks by 90%.

The African region was experiencing 8 cholera outbreaks at the time of the adoption. The region is vulnerable to cholera due to 92 million people drinking water from unsafe sources and poor sanitation conditions.

Part of this strategy includes taking evidence-based actions which include enhancing surveillance, tracing hotspots, improving access to treatment, promoting the use of the oral cholera vaccine (OCV) and investing in clean water.

Investigators in Zimbabwe are currently exploring whether or not the OCV would be beneficial to prevent further spread of this outbreak. Additionally, the WHO is providing cholera kits containing oral rehydration solution, IV fluids, and antibiotics to treatment centers.

This is an ongoing outbreak and updates will be provided as they become available.

For the most recent case counts in the Cholera Outbreak in Zimbabwe, check out the Contagion® Outbreak Monitor.