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Zimbabwe: Cholera Outbreak - Sep 2018

On 6 September 2018, a cholera outbreak was declared in Harare by the Ministry of Health...after confirmation of 11 cases for cholera on rapid diagnostic test kits and the clinical presentation. ([WHO, 7 Sep 2018](

Authorities report that the outbreak began on 1 September in Harare and as of that date to 11 September, the Ministry of Health and Child Care reports that there have been nearly 2000 suspected cholera cases, including 58 confirmed cases and 24 deaths.

Glenview, a high density suburb of Harare with an active trading area and a highly mobile population, is at the epicentre of the outbreak. The area is vulnerable to cholera because of inadequate supplies of safe piped water, which has led people to use alternative unsafe supplies such as wells and boreholes. Cases that are linked to the epicenter in Harare have been confirmed in 5 additional provinces.

The Government of Zimbabwe has declared a state of emergency and is working with international partners to rapidly expand recommended cholera response actions, including increasing access to clean and safe water in the most affected communities and decommissioning contaminated water supplies. Authorities and partners are also intensifying health education to ensure that suspect cases seek care immediately and establishing cholera treatment centres closer to affected communities. ([WHO, 13 Sep 2018](

An outbreak of cholera declared on 6 September has killed at least 30 people and infected at least 5,460. The most severely affected areas are the two epicentres of the outbreaks in the suburbs of Glenview and Budiriro in western Harare. The outbreak has spread from Harare to Chitungwiza, and west to Gokwe and Bulawayo. Cholera is reportedly spreading to different areas of the country. Poor WASH and health infrastructure are facilitating the rapid spread of the disease. High WASH needs, including clean drinking water, hygiene promotion and temporary sanitation facilities, have been reported. ([ACAPS, 18 Sep 2018](

As of 3 October 2018, 8535 cumulative cases, including 163 laboratory confirmed cases, and 50 deaths have been reported (case fatality rate: 0.6%). Of these 8535 cases, 98% (8341 cases) were reported from the densely populated capital Harare...The most affected suburbs in Harare are Glen View and Budiriro. ([WHO, 5 Oct 2018](

As of 19 October 2018, a cumulative total of 9 404 cases with 54 deaths (case fatality ratio 0.57%) have been reported from nine provinces across the country. Of the reported cases, 231 are confirmed by culture. Harare (9 096 cases) and Chitungwiza (110 cases) cities in Harare Province have reported the majority of the cases (suspected and confirmed) accounting for 98% of the cumulative cases reported across the country. The most affected areas in Harare City are the densely populated urban suburbs of Glen View (4 154 cases), Budiriro (2 691 cases), Mbare (373 cases) and Glen Nora (297 cases). Other provinces reporting cases include Manicaland Province (100), Bulawayo (38), Mashonaland East province (35), Mashonaland Central province (11), Midlands Province (10), Masvingo (2), atabeleland South (1), and Mashonaland West (1). ([WHO, 19 Oct 2018](

The cholera outbreak in Zimbabwe has markedly improved, following strong interventions by the national authorities and partners. However, sporadic cases continue to occur in Harare city, while a new and fast-evolving foci has emerged in Mount Darwin District, which requires urgent attention. The occurrence of poradic cholera cases in Harare city has been dragging on for several weeks and could serve as a potential source of infection to other places, such as the ongoing flare-up in Mount Darwin District. ([WHO, 30 Nov 2018](

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