2025-05-21-世界卫生组织-WHO_Rapid_Risk_Assessment_-_Cholera,_Global_v.7_18页_467kb

Cholera Global Risk Assessment Summary (March 18, 2025, v7)

Overall Risk and Context

• Global Risk: Very High, with moderate confidence in information. Continuously assessed since October 2022.
• Period Overview: From October 1, 2024, to February 28, 2025, 290,609 cholera cases and 2,615 deaths were reported across 32 countries, marking a slight increase compared to the previous year. Case fatality rates (CFR) were generally low to moderate, with 11 countries reporting rates above 1%.

Key Findings

• Regional Distribution: The highest burden was in the Eastern Mediterranean Region (EMR) and African Region (AFR). For instance:
  • EMR: 196,721 cases and 999 deaths.
  • AFR: 88,156 cases and 1,548 deaths, with high CFR in South Sudan (1.7%).
• Outbreak Dynamics: Renewed transmission in countries previously free of cholera, such as Angola and Ghana. Six countries are in "acute crisis":
  • Angola, Democratic Republic of the Congo (DRC), Myanmar, South Sudan, Sudan, Yemen.
• Cross-Border Transmission: Confirmed cases occurred between Myanmar and Thailand, and between Ethiopia and South Sudan. Cholera was exported internationally, such as from Tanzania to France and from Ethiopia to Germany and the UK, indicating surveillance gaps.
• Mortality and Vulnerabilities: High CFR in some areas, e.g., Angola (3.9%), Zambia (3.1%). Preventable deaths due to delayed healthcare access, poor WASH infrastructure, and weak case management.

Response Capacity and Challenges

• Funding and Supplies: Vaccine supply remains limited, with an OCV stockpile below emergency thresholds at times. Delays in procurement and distribution strained response efforts.
• Surveillance and Data Issues: Underreporting, delayed reporting, and inadequate diagnostic capacity hinder real-time tracking and intervention.
• Other Challenges: Ongoing humanitarian crises, climate change (flooding/drought), and political instability exacerbate risks. Multi-drug resistance or inequity not reported, but treatment delays remain a key issue.

Recommendations and Immediate Actions

• Strengthen surveillance, WASH infrastructure, and case management.
• Prioritize vaccination campaigns due to limited supply, adhering to a one-dose strategy.
• Enhance international coordination and funding support.
• Monitor trends closely, especially during peak seasons in high-risk regions.

Context Assessment

• Cholera proliferation driven by underdevelopment, conflict, displacement, and inadequate healthcare access. The global response requires sustained investment to mitigate risks and ensure equity.