Over forty thousand cases of cholera and nearly two thousand deaths, the toll of the latest cholera outbreak with an unusually high incidence rate in Central Africa, which began at the beginning of Summer in Cameroon, Chad, Niger and Nigeria. Worse news – it is spreading fast.

Although Central Africa is an area considered endemic for cholera, by October 3 there were 40,468 registered cases of cholera, and 1,879 deaths, an unusually high rate of incidence, exacerbated in part by the movements of peoples across borders, poor sanitary conditions in refugee camps and the onset of the rainy season.

Contaminated water is the main source of infection, for which reason the WHO is conducting programmes to chlorinate and distribute clean drinking water, while the Health Ministries of Cameroon, Chad, Niger and Nigeria are to set up a Summit to discuss the situation around Lake Chad.

The outbreak began in Nigeria in January. 29,115 cases, involving 1,191 deaths have been registered in this country between January 4 and October 3, with 15 states being affected. Flooding and the ensuing displacement of populations is spreading the disease to other regions.

Next affected was Cameroon, where the cholera outbreak registered the first of its 7,869 cases (515 deaths) between May 6 and October 3, affection 6 regions, the vast majority of the cases being in Extreme Nord region, where a cholera command and control center has been set up by the Cameroon health authorities.

Niger\’s first case came on July 3. The outbreak has claimed 62 lives among 976 cases, affecting four regions. Finally, Chad has registered 2,508 cases and 111 deaths between July 13 and October 3, in 6 regions.

According to the WHO, cholera can kill the patient within hours, being an acute diarrhoeal infection caused by ingesting food or water contaminated by the Vibrio Cholerae bacterium. Every year there are between three to five million cases, involving 100,000 to 120,000 deaths.

Incubation is around five days yet curiously, around three-quarters of people infected do not develop symptoms, but become carriers. Of the 25% that do develop symptoms, 80% of these are mild or moderate, while the remaining 20% suffer from acute and severe diarrhoea, leading to dehydration and death within hours, if left untreated.

80% of cases can be cured with oral rehydration salts, (WHO/UNICEF ORS standard sachet), while those most at risk are children, or persons with a low immunity (malnourished, HIV patients, etc.). Severe cases need antibiotics and the administration of intravenous fluids.

Cholera spread from its original reserve in the Ganges, India, in the 19th century, causing six pandemics which claimed millions of lives. The current outbreak is the seventh pandemic which started in South Asia in 1961, reaching Africa in 1971 and America in 1991.