Lebanon: Cholera Outbreak - Oct 2022

Following a cholera outbreak in Syria on 10 September 2022, the disease quickly spread, with Lebanon reporting its first case of cholera on 6 October 2022 and reaching 29 confirmed cases by 13 October in Akkar and Baalbek governorates. Cholera, a virulent bacterial infection caused by contaminated water or food, can spread quickly in areas with limited access to basic services such as safe water, sanitation, and health care. The disease can kill within just hours due to severe acute watery diarrhoea. Recent overlapping crises have severely impacted access to health, safe clean drinking water, and sanitation services for both host and refugee populations in Lebanon. As cases are expected to continue to increase, UNICEF in collaboration with the World Health Organization (WHO), NGO partners and led by the Ministry of Public Health (MoPH), has developed a joint response plan. (UNICEF, 17 Oct 2022)

As of 28 October 2022, [...] in Lebanon 1,225 confirmed and suspected cholera cases have been reported in the 9 governorates of Lebanon (Beirut, Akkar, North, Keserwan-Jbeil, Mt. Lebanon, Bekaa, BaalbekHermel, South, Nabatieh) according to the Lebanon Ministry of Public Health (MoPH). The cazas of Akkar, Minnieh-Dinnieh, Baalbek, Zahle and Keserwan are most heavily affected at present.

A total of 16 associated deaths have also been reported with a case fatality ratio (CFR) of 1.37%. It is reported that 46% of cases are children under the age of 15, of which more than half are in children under 5 years old. Among all cases, 23% have required hospital admission. (OCHA, UNICEF, UNHCR, WHO, 30 Oct 2022)

Since the first case was confirmed on 5 October 2022, over 1400 suspected cases have been reported across the country, including 381 laboratory-confirmed cases and 17 deaths. While the outbreak was initially confined to northern districts, it rapidly spread, with laboratory-confirmed cases now reported from all eight governorates and 18 out of 26 districts. Serotype Vibrio cholerae O1 El-Tor Ogawa was identified as the currently circulating cholera strain, similar to the one circulating in Syria. (WHO, 31 Oct 2022)

The number of suspected cases is gradually increasing across all affected areas. As of 11 November, a total of 3,253 suspected cholera cases (out of which 521 are laboratory-confirmed) have been reported along with a total of 18 associated deaths. (OCHA, UNICEF, UNHCR, WHO, 12 Nov 2022) . As of 18 November, a total of 3970 cholera cases (out of which 573 are laboratory-confirmed) have been reported along with a total of 20 associated deaths (OCHA, UNICEF, UNHCR, WHO, 19 Nov 2022)

The outbreak is spreading across the 8 governorates of Lebanon (20 out of the 26 districts). The number of suspected cases is gradually increasing across all affected areas. As of 9 December, a total of 5,105 cholera suspected and confirmed cases have been reported along with a total of 23 associated deaths [...]. The majority of cases continue to be predominantly reported from Akkar, Mennieh-Donnieh and Tripoli, and to a lesser extent from Mount Lebanon and Baalbek-Hermel. Currently, an increase in cases has been seen in the Bekaa and this is currently being investigated. (OCHA, UNICEF, UNHCR, WHO, 10 Dec 2022)

Following the first reported cholera case in Lebanon, the Ministry of Public Health (MoPH) declared a cholera outbreak on 6 October 2022. As of 17 January 2023, 6,158 confirmed and suspected cholera cases have been reported in Lebanon. The overall response to the cholera outbreak is led by the MoPH on behalf of the Government of Lebanon. The MoPH has developed, in coordination with partners, a Lebanon Cholera Preparedness and Response Strategic Plan and Operational Plan. (UNHCR, 31 Jan 2023)