2025-01-23-世界卫生组织-Multi-country_outbreak_of_cholera,_External_situation_report_22_-_24_January_2025_15页_1mb

Overall Summary:

• Global Situation: A multi-country outbreak of cholera continues, with a total of 804,721 cases and 5,805 deaths reported across 33 countries since January 2024.
• Update Period: December 2024 (Epizootological weeks 49-52) and Total (1st Jan - 29th Dec 2024).
• Prevalence: High case numbers were concentrated in the African (#177,570) and Eastern Mediterranean (#597,026) regions.
• Event Severity & Risk: Situation remains precarious; "Very High" global risk rating; outbreaks exacerbating in areas affected by conflict or natural disasters due to inadequate Water, Sanitation, and Hygiene (WASH) infrastructure.
• Vaccine & Supply: New vaccine production remains 'high' (5.5 million doses Dec 2024), increasing global stockpile, but the OCV supply still falls short of growing demand.

Detailed Breakdown:

1. Recent Trends (Dec 2024):

   • Cases & Deaths: Slight decrease in new cases (-22%) and new deaths (-8%) compared to November; still significantly lower than Dec 2023 (Dec 2023 vs Dec 2024).
   • Regional Cases: Regions: Eastern Mediterranean (highest), African, South-East Asia, Americas, European (lowest in 2024). Death numbers peaked in the African Region.
   • Countries: High case numbers in Yemen, Afghanistan, Democratic Republic of the Congo, Ethiopia, Sudan, Pakistan, South Sudan, Nigeria, Ghana.
   • Risk Factors: Explosive spread driven by cross-border factors, displacement, conflict, limited access to healthcare/WASH, inadequate public health infrastructure, surveillance gaps, and delayed data.

2. Cumulative Since Jan 1st, 2024:

   • Cases: 804,721 across 33 countries (plus territories), distributed globally: Eastern Mediterranean > African > South-East Asia > Americas > European (Western Pacific escapes surveillance).
   • Deaths: 5,805 reported across regions and countries. Significant death tolls in African and Eastern Mediterranean regions. Notably low CFR and no deaths in South-East Asia region. “Very High” Global Risk Status.

3. Focus on Affected Countries (Sudan, South Sudan, Yemen):

   • Sudan (CFR: 2.5%, Dec): High numbers, especially Gezira State; 51k+ cases, 1.3k+ deaths by Dec.
   • South Sudan (CFR: 1.8%, Dec): Sharp increase (+800%) in Dec cases/deaths, now heavily impacted.
   • Yemen (CFR: 0.3%, Dec): Decline Dec (-50%), but overall remained serious.

4. Operational Activities & Challenges:

   • Expert Deployment: WHO supporting numerous countries globally (GOARN/SBP/EMT).
   • Surveillance & Data Management: New guidance, tools, and support provided to improve country systems, reporting standardized data, and identifying priority areas.
   • Laboratory Support: Ongoing effort to support testing strategies, and PCR method uptake.
   • Vaccination: OCV stockpile improved, but severely constrained demanding response campaigns. Mostly single-dose reactive campaigns occurred.
   • WASH Intervention Support: Provided, especially in Sudan/Malawi/South Sudan.
   • Coordination & Resources: Constraints include inadequate WASH infrastructure, insufficient OCV stocks, lack of coordination, difficulties in FCV zones/barriers to care, surveillance gaps, low community awareness, funding/infrastructure gaps.

5. Next Steps/Proposed Actions:

   • Continue scenario planning, forecasting, streamlining supplies and support with concrete tools.
   • Support the implementation of strategies in local contexts, improve cross-border coordination, and prioritize funding for cholera responses.

Key Considerations:

• Data is influenced by reporting delays, different definitions, and surveillance capacity.
• Cases and deaths show significant geographic and population among WHO regions.