New Outbreak of Cholera in Sudan’s Central and Eastern States

An outbreak of cholera was officially declared on 12 August 2024 by Sudan’s Federal Ministry of Health, after a new wave of cholera cases was reported beginning on 22 July 2024.  Between 22 July and 8 October, 21,288 cases, including 626 deaths, were reported across eight states in Sudan. Cholera is especially spreading fast in eastern Sudan, that has recently been affected by heavy rainfalls and floods, and is sheltering millions of people displaced by the conflict between the Sudanese military and the Rapid Support Forces (RSF).

The U.N. estimates that 20.000 people have been killed and thousands injured since the conflict in Darfur began. The war has also displaced over 10 million people, including 2.4 million who fled to neighbouring countries and other nations. The health system in Sudan is reportedly in ‘freefall’, with 75% of health facilities in Khartoum non-functional, according to Hanan Balkhy, the WHO Regional Director for the Eastern Mediterranean, during a media briefing on 8 Oktober. She added that the situation in western Darfur states is worse.

Cholera is a waterborne illnesses that is caused by bacteria that are ingested through contaminated water or by coming in contact with faeces. Cholera is associated with diarrhoea , vomiting and dehydration, which can develop within hours after infection has taken place. Lack of clean water supply, sanitation and hygiene (WASH) are major causes for the spread of waterborne diseases in a community.  Cholera is highly contagious and can rapidly prove fatal, within hours, if not treated. But cholera is very simple to treat – re-hydration is key.

The scale of this new outbreak in Sudan is large: “The menacing mix of heavy flooding and torrential downpours with woeful living conditions and inadequate access to drinking water that millions have today, particularly in crowded camps for displaced people, have created the perfect storm for the spread of this often-deadly disease,” says Esperanza Santos, MSF’s emergency coordinator for Sudan. Relief organisations WHO and UNICEF are working with Sudan’s  Ministry of Health on disease control measures and also report that they see a faster spreading of the disease than they saw during the outbreak of last year which is concerning the officials.

Save the Children is conducting daily water quality testing, monitoring and chlorination at 35 water sources within the Sawakin locality, Red Sea state, and has disposed of 125 tons of solid waste at designated dumping sites. In Gedaref state, they are supporting with treatment and management of cholera cases and providing safe drinking water to cholera treatment centres. Médecins Sans Frontières (MSF) (Doctors Without Borders) emergency teams are supporting by treating patients and providing water and sanitation services. In the second week of Oktober, a second round of the oral cholera vaccination campaign, that kicked off last month, has been administered. The vaccination campaign aims to reach 1.81 million people in the most affected states: Kassala, River Nile, and Gedaref.

Cholera vaccines in and of themselves are not a silver bullet for cholera, Richard Brennan, the regional emergency director at WHO says in a media briefing on 8 Oktober. “They’re a very useful tool, but we still need to continue with all the other disease control measures in terms of the disease surveillance, treatment of patients once they become sick, engaging communities, and very importantly, giving people access to adequate quantities of clean water and sanitation”.