There has been an ongoing outbreak of Cholera in Somalia specifically in the regions of; Hiraan, Banadir, Lower Juba and Middle Shabelle since December 2017. As of the 18th of March, the World Health Organisation has reported 1613 cases with nine deaths. There have been Cholera outbreaks in the past specifically in these regions.

The outbreak first began in Beletweyne, Hiraan Region; before spreading to the Banadir Region in early January 2018, to Lower Juba in early February 2018, and to Middle Shabelle in early February 2018. There were 66 stool samples tested in 2018, 19 of which were positive for cholera. The Banadir Region has one of the highest concentration of internally displaced persons. Lower Juba has particularly experienced severe cholera outbreaks in the past; on the border with Kenya and the region has many people who have been displaced by conflict in Middle Juba. Middle Shabelle has also previously had cholera outbreaks. We can deduce that the lack of safe water and sanitation is limited in all of these regions have played a role in the outbreak.

Cholera is an acute diarrhoeal infection that has the possibility of death within several hours if left untreated. It is caused by the ingestion of contaminated food or water with the bacterium Vibrio cholerae. There are approximately 1.3-4 million cases every year with a mortality rate of 60% if not treated immediately or appropriately. Cholera can spread in different ways such as; contaminated water, unwashed hands and flies who have the bacterium on their feet can all spread the disease. The symptoms consist of painless but severe watery diarrhoea and dehydration which can start to appear 12 hours to 5 days after the patient initially contracts the bacterium, however, a noticeable portion of patients do not develop any symptoms.

Treating the disease is a relatively simple and self-explanatory process. Rehydration is one of the most important factors in treatment by replacing the lost fluids and salts, methods of rehydration can often be found at pharmacies. If in a rural or undeveloped area the common method is to first decontaminate any water the patient drinks by first pouring/filtering the water through cloth and then boiling it for one minute. Then taking one litre of this clean water, mix half a teaspoon of salt and six teaspoons of sugar. In the event that the patient cannot keep the fluids down, the patient must be transported to a hospital where intravenous fluids can be administered. Another step in treatment is the use of antibiotics to shorten the illness, but, this is not crucial or needed and is nowhere near as important as rehydrating the patient.


The aim, however, is preventing the disease from spreading in the first place. Cholera is rarely present in developed nations due to the sophisticated water treatment facilities and procedures. Keeping those with cholera in isolation away from the community and especially from water supplies, infants and the elderly. Following good hand washing procedures, rinsing, pealing and cooking food at high temperatures, keeping food away from flies, decontaminating water through filtering and boiling or through the use of chlorine, disposing of faeces and vomit in appropriate ways and either throwing away linen and clothing of the patient while they were sick or washed in hot soapy water are all ways to prevent the further spread of the disease.

If you are planning to travel to a high-risk country there are vaccines available, however, they may not protect against all strains of the disease.

Further Reading

WHO – Cholera Factsheet

SAHealth – Cholera – including symptoms, treatment and prevention

WHO – Full Report on Cholera Outbreak and Control (2004)

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s