Cameroon Cholera Outbreak - Situation Report #1 (May 19, 2022)




  • A total of 6,652 cases, with 134 deaths, have been reported by the WHO as of April 30
  • According to the Regional Delegation of Public Health, since the beginning of May there have been 244 new cases reported and eight deaths, while the number of health districts involved have increased from 18 to 21
  • Three (Littoral, Center and Southwest) regions are especially active, with the Southwest recording the highest number of cases
  • The number of cholera cases is increasing rapidly, affecting 6 of 10 regions
  • The case fatality rate is high, according to WHO standards, at 2.0%

Cholera cases in Cameroon have increased significantly since early 2021. On October 31, Cameroon’s health authorities declared a cholera outbreak.

Between October 25 and December 10, 2021, three active regions reported a cumulative number of 309 suspected and four laboratory-confirmed cholera cases, with 19 deaths, for a case fatality ratio (CFR) of 6.1%. Suspected cases increased from 200 recorded on average each week in 2021, to more than 1,262 in the second week of March 2022. As of April 30, 2022, the WHO had reported 6,652 cases in total. Since March 2022, the cholera outbreak has affected six regions: Centre, Littoral, Far North, North, South and Southwest. In 2021, the epidemic was concentrated only in two regions—Centre and Southwest—with the majority of cases in the Southwest region. Cameroon recently identified priority cholera hotspots through the Global Task Force of Cholera Control methodology (see the map above).

That region’s cases account for about three-quarters of Cameroon’s cases nationwide. As Advocacy Adolescent Health Promotion (ACAP) has reported, 40% of health centers in the Southwest region closed before 2020 due to an escalation of political tensions and presidential elections that were likely to intensify deteriorating health conditions for more than 4 million people living in the English-speaking regions. Today, the majority of internally displaced persons have moved to major towns such as Limbe and Buea, where there is relative calm. The subsequent overcrowding led to a rise in cases, as documented in Southwest Regional Situation Report 23, which reported a cumulative number of 4,980 cases identified at the end of April 2022, with 49% (2,469) in Limbe and 31% (770) in Tiko health districts.

Contributing Factors

One factor behind Cameroon’s cholera outbreak is the dry season and resulting shortage of water, which has also heightened risks for waterborne diseases. Moreover, the high lethality rate indicates a gap in early detection and case management. The following challenges have been identified by the Ministry of Public Health (MoPH):

  • a breakdown in the water supply system in the Southwest region, leading to the scarcity of potable water for households;
  • limited resources for prevention and care activities in the wide geographical areas involved;
  • a lack of multi-sectoral involvement, exacerbated by a lack of experts in water, sanitation and hygiene (WASH);
  • a lack of training for community health workers (CHWs);
  • a lack of quality healthcare workers needed in treatment centers, which is leading to fatigue, weak infection prevention and control, and inconsistent application of norms and standards;
  • an insufficient number of cholera treatment kits and medical supplies, such as rapid diagnostic tests;
  • insufficient capacity in treatment centers due to overcrowding, lack of cholera beds and other equipment, and poor control of patient flow; and
  • inadequate communication tools.

Response to Date and Current Preparations

Organizations such as WHO, UNICEF and the Global Alliance for Vaccines and Immunization (GAVI) have already provided some support, such as boats for maritime areas and vaccination support. However, according to the MoPH response plan, more than $1.3 million is required to support the pillars of the response to the cholera epidemic in Cameroon’s six affected regions.

The WHO and the MoPH have requested that International Medical Corps support the response in the Southwest region, specifically in the Limbe and Buea health districts. They also have asked for support in surveillance and preparation for an outbreak in the Northwest region.