2023-05-10-世界卫生组织-Multi-country_outbreak_of_cholera,_External_situation_report_2_-_11_May_2023_19页_1mb

Multi-country Cholera Outbreak Summary

Report: External Situation Report #2, authored by WHO, published 11 May 2023

Status: As of 18 April 2023, spanning 24 countries since the pandemic resurgence.

Key Features:

1. Global Risk: Very high global risk for cholera.
2. Cases: 24 countries reported cases, geographical spread increased significantly across Africa, particularly SE Africa (south-east, Malawi, Mozambique, South Africa, Tanzania, Zambia, Zimbabwe) and Horn of Africa (Ethiopia, Kenya, Somalia, DRC).
3. Drivers: Natural disasters (like Tropical Cyclone Freddy, severe flooding), complex humanitarian crises, fragile health systems, and climate change exacerbate spread.
4. Mortality: High case fatality ratios (CFR) of >1% in many countries, although reported rates are inconsistently tracked due to varying surveillance and reporting systems. Global average CFR was 1.9% in 2021.
5. Challenges:
   • Resource Shortages: Severe shortage of oral cholera vaccines (OCV). Partial solutions involve effective campaigns using single-type, single-dose OCV courses.
   • Case Management: Shortage of essential materials for cholera treatment centers and infection prevention control (IPC).
   • Operational Strain: Overextended national and international health resources due to multiple concurrent outbreaks.
   • Logistical Barriers: Difficulties obtaining import authorizations for supplies.
6. Key Response Measures:
   • WHO coordinates global surveillance, technical support, resource mobilization, case management, IPC, WASH, RCCE, operational support & logistics.
   • Vaccination: Limited campaigns implemented (e.g., DRC, Somalia, Cameroon, Kenya, Ethiopia, Mozambique, NW Syria, Dominican Republic). Upcoming SPRP established for 2024.
   • Case Management Optimization: Relocalization of treatment points, rational use of PPE.
   • Enhanced Surveillance: Standardized data reporting and lab capacities.
   • RCCE: Distribution of vital messages in multiple languages.
7. Outbreak Dynamics (Examples):
   • Malawi (SE Africa): Largest outbreak (EEW), case reduction (60-70%). Threat from Cyclone Freddy impacts.
   • Mozambique (SE Africa): Active since Sep 2022, case reduction underway (dry season approaching).
   • Horn of Africa (Ethio-Kenya Som): Persistent outbreaks, exacerbated by drought. Clusters often along international borders.
   • DRC (Central Africa): Growing case load in Nord-Kivu province. On-going conflict creates vulnerable populations.
   • NW Syria: Harsh conditions complicated by earthquake disruptions and vaccines.
8. Upcoming Post-Outbreak Focus: Monitoring potential resurgence during the West Africa rainy season (May to October).
9. Core Strategy: Strengthening regional coordination, improving surveillance systems, and efficient distribution of vaccines and treatment materials to mitigate the high-level global threat of cholera, prioritizing preparedness and response in high-risk areas.