The continuing cholera outbreak in 22 counties, including in the Dadaab Refugee Camp and El Nino-related flooding presented the greatest challenges in the last quarter of 2015. Starting in November 2015, Kenya experienced flooding associated with the El Niño weather phenomenon. By 28 December 2015, 10,221 cases and 174 deaths (CFR=1.7%) had been reported nationally in 22 counties. An intensified response by the Government and partners has led to outbreak control in 16 counties, with only 6 counties reporting active outbreaks by the end of the year. The Famine and Early Warning System Network (FEWSNET) food security update for December 2015 projected improved food security in the pastoral areas (due to the short rains).