Lebanon Cholera Outbreak Situation Report No 4, 12 November 2022

Epidemiological Overview

The outbreak is spreading across the 8 governorates of Lebanon and across 18 out of the 26 districts. 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, resulting in a case fatality ratio of less than 0.6%. About 45% of suspected and confirmed cases are less than 15 years of age, 15% are between 15 and 24 years of age, 22% are between 25 to 44 years of age, 11% are between 45-64 and 7% are aged 65 years and older.

Overall, 98% of suspected and confirmed cases who presented to a health facility have exhibited symptoms. 19% of suspected and confirmed cases have required hospitalization. Across the country, 62 beds are currently occupied for cholera treatment. The majority of cases continue to be predominantly reported from Akkar and the North, and to a lesser extent from Mount Lebanon, Bekaa, and Baalbek-Hermel. Tripoli, Halba and Minieh hospitals continue to receive an increased number of cholera patients. As of 31st October, 57.9% of stool samples, and 33.5% of water samples tested at AUB – WHO collaborating center turned out positive for cholera.

Serotype Vibrio Cholerae O1 El-Tor Ogawa was identified as the currently circulating cholera strain in Lebanon, similar to the one circulating in the region.

WHO has graded the overall risk of the cholera outbreak in Lebanon to be very high at the National level and high at the regional level.