Malawi: Cholera Outbreak - Nov 2017

On 24 November 2017, the Malawi Ministry of Health reported an outbreak of cholera in Karonga District, located in the northern part of the country (at the shore of Lake Tanganyika) and bordering Tanzania. The initial cholera cases emerged on 20 November 2017 and presented to Iponga Health Center in Karonga District. On 24 November 2017, four out of five stool specimens obtained from the initial cholera cases isolated Vibrio cholerae 01 by culture, confirming the outbreak. By 25 December 2017, Nkhatabay District (a second district) located in the Northern Region reported its first cholera case. The outbreak subsequently spread to four other districts in the central region of the country, with Lilongwe reporting its first case on 29 December 2017. During week 1 (week ending 7 January 2018), a total of 58 new suspected cholera cases (with no deaths) were reported, compared to 59 cases reported in week 52 (week ending 31 December 2017). (WHO, 12 Jan 2018.)

The cholera outbreak in Malawi continues. During week 6 (week ending 11 February 2018), a total of 68 new suspected cholera cases with one community death were reported, compared to 74 cases and one death reported in week 5. The new cases came from six districts, namely Lilongwe (33), Karonga (21), Salima (7), Rumphi (4), Dowa (1), Likoma (1), and Blantyre (1). Since the beginning of the outbreak on 24 November 2017, a total of 450 cases including six deaths (case fatality rate 1.3%) have been reported, as of 11 February 2018. Twelve out of 29 districts in the country have been affected, with the majority (57%, 258) of the cases coming from Karonga (where the outbreak originated), followed by Lilongwe (26%, 117), the capital city (WHO, 16 Feb 2018.)

30 new cases were reported in week 13 compared to 31 cases including 1 death (CFR, 3.2%) reported in week 12. The new cases emerged from two districts, namely Lilongwe (28) and Salima (2). Cumulatively a total of 874 cases and 15 deaths have been reported, as from November 2017. Of these, 719 cases and 14 deaths have been reported since the beginning of 2018 (UNICEF, 6 Apr 2018.)

As of 15 April 2018, 904 cases including 30 deaths had been reported from 13 districts. Of these 30 deaths 12 were community deaths and the case fatality rate is 3.3 per cent. The week beginning 16 to 22 April a total of 15 new cholera cases were reported from cholera hot spot areas in Lilongwe (WHO, 20 Apr 2018.)