Lusaka – As the cholera outbreak in Zambia continues to expand rapidly, efforts are being stepped up to halt the spread of disease and save lives. A vaccination campaign is currently underway targeting 1.5 million people, including children, health workers and people at high risk of infection in the worst affected areas.

In partnership with Gavi, the Vaccine Alliance, UNICEF and others, World Health Organization (WHO) is supporting the government to effectively roll out the oral cholera vaccination campaign as well as bolster ongoing outbreak control measures. More than 1.4 million cholera vaccine doses have been delivered to the country to help stem the outbreak, with another 200 000 additional doses for a total of around 1.7 million doses approved by the WHO International Coordinating Group on Vaccine Provision.

The government declared a new outbreak in October 2023, which began in Lusaka province. As of 18 January 2024, 10 887 cases and 432 deaths were reported across nine of the country’s 10 provinces. Lusaka, Central and Eastern provinces are the worst affected.  Lusaka district is the epicentre of the outbreak. The outbreak is spreading fast, with the country recording an average of 461 new cases every 24 hours over the past seven days.

The rapid spread of the disease and the increasing number of reported cases suggest that the outbreak may be one of the worst in the country's recent history. Densely populated areas of Lusaka with limited or no access to clean water, sanitation services and poor hygiene practices are facing a higher incidence of cholera.

“The current cholera outbreak requires concerted and collaborative efforts to protect the health and well-being of citizens. Our priority is to work closely with the government, local health authorities and cooperating partners to provide immediate support and expertise,” says Dr Nathan Bakyaita, WHO Representative in Zambia. “The epidemiological situation underscores the urgency for a comprehensive response, addressing the root causes and implementing targeted interventions.”

WHO is working with the government to strengthen the key outbreak response areas. The Organization has deployed 23 experts from its Regional Office for Africa to support emergency coordination, case management, surveillance, infection prevention and control, bolster water, sanitation and hygiene services as well as increase public awareness on the risks of the disease.

WHO has also provided more than 14 tons of cholera kits and additional medical supplies to the government. The supplies are enough to treat about 3000 mild to severe cases of cholera, including moderate cases at oral rehydration points in communities. The Organization is also procuring additional supplies and equipment, including cholera beds which are set to be delivered in the coming days.

The government has activated high-level outbreak response coordinated by the Disaster Management and Mitigation Unit. Other efforts to control the outbreak include the provision of water tanks to supply communities with clean drinking water, setting up of oral rehydration points in strategic community places such as markets, churches and bus stops for access to early treatment, and public health campaigns to promote hygiene practices. Cholera treatment centres have been set up to provide medical care for severe cases, with the largest treatment centre at the National Heroes Stadium in central Lusaka

Cholera is an acute, extremely virulent infection that can spread rapidly and dehydration resulting in high morbidity and mortality. However, the disease is easily treatable. Most people can be treated successfully through prompt administration of oral rehydration solution or intravenous fluids.

Effective control relies on implementing comprehensive measures including enhanced epidemiological and laboratory surveillance to detect, confirm and quickly respond to outbreaks, improving access to treatment, vaccines, safe water, and basic sanitation as well as effecting behavioural change and better hygiene practices among communities.