Ethiopia: Cholera Outbreak - Sep 2022

On 16 September 2022, the Ethiopia Ministry of Health declared a cholera outbreak in the Harana Buluk and Berbere woredas of Bale Zone, Oromia Region. On 25 September 2022, a total of 16 new cholera cases (14 severe) were reported. There were no new deaths. While 2 patients were discharged, Cholera Treatment Centers (CTC) reported 14 new admissions. Anecdotally, the outbreak is also reported to have expanded to the Dolo Mena woreda, which constitutes a risk of further spread. Cholera outbreak response activities are ongoing in both woredas. (IFRC, 4 Oct 2022)

As of 10 October, 191 cholera cases were reported in 3 woredas of Bale zone (Harana Buluk, Berbere and Delo Mena) with 4 associated deaths (Cumulative Case Fatality Rate – CFR - of 2.09 per cent1). The use of unsafe water from contaminated water points is the most likely cause of this outbreak. Limited access to water and sanitation (WASH) services, poor hygiene practices, including open defecation and lack of water treatment options are among the factors that have contributed to the rapid spread of the disease across these three woredas. New suspected cases are reported daily in the three affected woredas. As of the reporting date, there are 15 active cases (3 cases in Delo Mena, 10 in Berbere and 2 in Harana Buluk woredas) in the existing Cholera Treatment Center (CTC), with 71 per cent of the patients experiencing severe dehydration symptoms. Due to people’s mobility, there is a high risk that the outbreak could propagate into bordering zones of Southern and Eastern Oromia, SNNP and Somali regions. (OCHA, 13 Oct 2022)

Meanwhile, new cases of cholera continue to be reported in affected areas in Bale Zone of Oromia Region. As of 10 October, and since 27 August, 196 cases were reported in Berbere, Delo Mena and Herena Buluk woredas, including in Burka IDP site. The cholera outbreak has already spread to neighboring Somali Region with 18 cases recently reported in Karsadula Woreda of Liban Zone. In SNNP Region, laboratory test of ten suspected cholera cases from Amaro Special Woreda returned a negative result. (OCHA, 17 Oct 2022)

As of 25 October 2022, 273 cholera cases have been reported including 9 deaths. Suspected cases in East Bale are under investigation. Reportedly, 114 additional woredas are at risk of an outbreak. The caseload has increased by 30 per cent since October 10, with new daily cases reported in Berbere and Kersadula woredas. According to EPHI, close to 459,000 people are at high risk in the four woredas, especially IDPs living in sites. The response is hindered by insufficient funding and partners’ presence. Shortage of WASH treatment chemicals, limited amount of water storage items (reservoir tanks, jerry cans, etc.), insufficient water trucking capacity and large number of non-functional water schemes represent the major gaps. (OCHA, 25 Oct 2022)

A cholera outbreak has been ongoing in Ethiopia since 27 August 2022. The index case was reported from Bekay Kebele, Harana Buluk Woreda of Bale Zone, Oromia Region. As of 13 November 2022, a total of 399 suspected cases of cholera have been reported including 274 cases from Oromia region and 125 cases from Somali region. At least 15 of these cases have been laboratory-confirmed through culture. The cumulative attack rate is 89.6 per 100 000 population. Seventeen deaths have been reported, for a CFR of 4.3%. Six woredas have so far been affected: Berbere (174 cases), Harena Buluk (71), Delo Mena (22), and Gura Damole (7) in Bale Zone of Oromia region, and Guradamole (88) and Kersadula (37) in Liben Zone of Somali region. A total of 38 Kebeles (villages) have reported one or several suspected cases of cholera since the beginning of the outbreak. Of note, no case has been reported from Harena Buluk in the last 36 days and from Dolo Mena over the last 29 days. (WHO, 18 Nov 2022)

The Cholera outbreak has spread out to 41 kebeles of 4 woredas of Bale Zone of Oromia and 2 woreda of Liban zone of Somali region. As of 23 November 2022, 491 cholera cases have been reported, including 20 deaths. Close to 555,000 people are at high-risk in the six woredas. The caseload of affected people has increased by 28 per cent in the last two weeks with new daily cases reported in Berbere, Gura Damole, Quarsadula woredas. In Guradamole woreda of Liban zone, cases are expanding at high pace, especially across IDP spontaneous sites where more than 60 per cent of the new affected caseloads are recorded. The response is hindered by insufficient funding and limited partners’ presence. (OCHA, 24 Nov 2022)

The Cholera outbreak has spread out to 55 kebeles of 5 woredas of Bale,1 woreda of Guji zones of Oromia and 2 woredas of Liban zone of Somali region. As of 14 December 2022, 669 cholera cases have been reported including 24 deaths. Close to 743,000 people are at high-risk in the eight affected woredas. The caseload of affected people has increased by 30 per cent in the last two weeks. In Girja woreda of Guji zone, cases are expanding at high pace with over 100 cases reported in less than two weeks. (OCHA, 14 Dec 2022)

A cholera outbreak has been ongoing in Ethiopia since 27 August 2022. The index case was reported from Bekay Kebele, Oromia Region and the outbreak was confirmed on 9 September. As of 2 February 2023, a total of 1 068 suspected cases of cholera with 28 deaths (CFR 2.6%) have been reported, including 869 cases and 13 deaths (CFR 1.5%) from Oromia region and 199 cases and 15 deaths (CFR 7.5%) from Somali region. A total of 66 kebeles (villages) have so far been affected, distributed in ten woredas. Cholera outbreak in Somali region is controlled. (WHO, 11 March 2023)

A cholera outbreak has been ongoing in Ethiopia since 27 August 2022. The index case was reported from Bekay Kebele, Oromia Region and the outbreak was confirmed on 9 September. As of 27 March 2023, a total of 2 370 suspected cases of cholera with 51 deaths (CFR 2.2%) have been reported. There are 17 out of 22 affected woredas reporting active outbreaks as of week 12 (ending 27 March 2023). (WHO, 27 April 2023)

Cholera cases and deaths in Ethiopia decreased in the past week. There was a 53% decrease in new cases, with 373 new cases in week 21 from 787 new cases in week 20. Deaths also decreased by 80% in week 21 with two reported deaths from 10 deaths in week 20. As of 28 May 2023, Ethiopia reported a cumulative case load of 8 391 with 125 deaths (CFR = 1.5%). There is ongoing outbreak in 58 woredas in Oromia (30), Somali (3), SNNP (21) and Sidama (4) since 27 August 2022. So far, 68 woredas have reported cases in four regions (Oromia=38, Somali=5, SNNP =21 and Sidama/Hawassa =4). The index case was reported on 27 August 2022 from Harana Buluk. Current water supply coverage for the cholera outbreak-affected woredas in Oromia and Somali regions is low. (WHO, 29 May 2023)

The ongoing cholera outbreak has spread across 74 woredas in Oromia, Sidama, Somali, and SNNP at a cumulative total of 11,960 cases and 165 deaths as of 24 June, and since its onset in August 2022. The case fatality rate (CFR) is at 1.38, while the standard indicator for adequate case management is a CFR less than 1 per cent. Eighty-one cholera treatment centres have been established and oral vaccinations have been provided across affected regions, however challenges remain around the administration of single dose vaccinations due to shortage in global supply. Current clean water supply coverage in cholera affected woredas in Oromia and Somali regions is also low, further exasperating the spread. Separate from the cholera affected regions, close to 18,000 people in Debre Birhan benefited from health education as preventative measures following a confirmed isolated cholera case in the city on 19 June. (OCHA, 03 Jul 2023)

The cholera outbreak is currently active with 16,346 cases in 88 woredas in Oromia, Somali, SNNP, and Sidama regions, with the recent addition of 18 woredas in Amhara as of 27 July. The Amhara Region is responding with limited number of partners and resources to control the new Cholera outbreak; a total of 2,343(1) reported cases, 40 unverified deaths, and a case fatality rate of 1.7 per cent(2), as of 27 July 2023, since it was first reported on 23 July. (OCHA, 04 Aug 2023)

As of 24 August 2023, Ethiopia has reported a cumulative case total of 19 277 with 252 deaths (CFR = 1.3%). The outbreak has increased in geographic spread from five regions (Oromia, Somali, SNNP, Sidama and Amhara) to nine; with the new regions being Afar, B Gumuz, Dire Dewa, and Harari. As of week 34, new cases decreased from 724 cases in week 33 to 127. The current data from Amhara region is however not included in this update due to the ongoing crises in that region. (WHO, 27 Aug 2023)

As of 08 September 2023, Ethiopia reported a cumulative case total of 23 449 with 293 deaths (CFR = 1.2%). The outbreak is currently active in nine regions. As of week 36, reported new cases decreased by 83% ((118). Report of cholera cases transmission from Ethiopia to the WHO African regional office is improving, however we have no reports from Amhara region due to ongoing conflict. (WHO, 11 Sep 2023)

The ongoing Cholera outbreak which started in Harena Buluk Woredas of Oromia region, in South Eastern Ethiopia is among the longest outbreaks the country has ever experienced. The outbreak, which started in one region in August 2022 and was subsequently confirmed by laboratory tests on 9 September 2022, later spread to other areas since March 2023. It has been a growing concern which its peak observed in late July 2023. As of now, the outbreak has reached 42 districts in Southern Nations, Nationalities and Peoples and has resulted in over 4 000 cases. In 2022 (27 August – 31 December, 2022), a cumulative total of 1 073 cases and 30 deaths (CFR = 2.8%) were reported, whereas a cumulative total of 23 652 cholera cases (AR = 86.9 per 100 000 Population) and 299 deaths (CFR =1.3%) were reported in 2023 as of 21 September, 2023. (WHO, 24 Sep 2023)

As of 19 November 2023, Ethiopia reported a cumulative case total of 27 451 with 384 deaths (CFR =1.4%). As of week 46, reported new cases decreased by 70% to 180 new cases from 602 new cases. There was no death reported in week 46 compared to four deaths in week 45. The outbreak is controlled in 189 woredas in Amhara (27), Afar (3), Benishangul Gumuz (3), Dire Dawa(1), Harari(1), Oromia (81), Sidama (22), Somali (6) and SNNP (45) regions. (WHO, 20 Nov 2023)

As of 11 February 2024, Ethiopia reported a cumulative case total of 34 058 with 504 deaths (CFR = 1.5%). As of week 06/2024, new cases increased by 33.7% from 264 to 353. In weeks 05 and 06, there was no change as deaths were one for each week. The cholera outbreak is currently active in 47 woredas spanning five regions: Somali (19 woredas), Oromia (17 woredas), Dire Dawa (7 woredas), Harari (3 woredas) and SER (1 woreda). The Oral Cholera Vaccine (OCV) campaign in Tigray continued with 761 012 individuals aged one year and older vaccinated as of 11 February 2024. In the pipeline are 912 633 doses of vaccine for three regions (Somali, Dire Dawa and Hareri). (WHO, 12 Feb 2024)

As of 10 March 2024, Ethiopia reported a cumulative case total of 37 497 with 525 deaths (CFR = 1.4%). In week 10 of 2024, new cases decreased by 21.6% from 630 to 494. New deaths for both weeks 09 and 10 three each. The cholera outbreak is currently active in 54 woredas spanning five regions: Somali (27 woredas), Oromia (10 woredas), Dire Dawa (7 woredas), Afar (3 woreda), SER (2), Sidama (2), Harari (2 woredas) and CER (1 woreda). (WHO, 11 Mar 2024)

The ongoing cholera outbreak in Ethiopia started on 27 August 2022. As of 14 July 2024, a total of 51 068 cases, 624 deaths (CFR 1.2%) are reported. In 2024, from January a total of 19 832 cases and 149 deaths are reported. (WHO, 14 Jul 2024)