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Zimbabwe cholera outbreak fact sheet
USAID/ US. Foreign Disaster Assistance (OFDA)
January 09, 2009

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Key developments

• Since the outbreak began in August 2008, cholera has spread to all of Zimbabwe's 10 provinces and 55 of Zimbabwe's 62 districts. As of January 9, cholera had caused more than 1,910 deaths, with more than 37,500 cases reported, according to the U.N. World Health Organization (WHO). Currently, the U.N. health cluster continues to plan relief activities based on a worst-case scenario of 60,000 cases nationwide. However, USAID Disaster Assistance Response Team (USAID/DART) staff note that the cluster may revise estimates to account for potential increased cholera exposure resulting from significant travel during the recent holiday period.
• WHO's updated daily figures for January 9 included 107 new deaths and 914 new cases. WHO reported an overall cholera case fatality rate (CFR) of 5.1 percent as of January 9, representing a decrease from the overall CFR of 5.4 percent reported on December 18, 2008. On January 3, WHO reported that the CFR decrease in recent weeks is likely attributable to improved case management. However, WHO notes that the CFR remains higher than expected at the outbreak's current stage.
• On January 8, the USAID/DART reported that the Government of Zimbabwe (GOZ) Ministry of Health and Child Welfare had approved the deployment of an assessment team from the International Center for Diarrheal Disease Research, Bangladesh (ICDDRB). USAID/DART staff note the potential for the ICDDRB team's technical expertise to significantly improve case management at provincial and district levels and decrease the overall CFR.

Current situation

• On January 9, WHO reported that more than 54 percent of cumulative deaths had occurred outside health facilities, cholera treatment centers (CTCs), and cholera treatment units (CTUs). The figures reflect significant challenges in providing sufficient treatment access to cholera-affected populations, including staff and material shortages at health facilities, CTCs, and CTUs, and a lack of community-level awareness about cholera.
• According to the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), the outbreak has affected border areas of neighboring countries, with confirmed cholera cases reported in Botswana, Mozambique, Zambia, and South Africa. As of December 31, South Africa health authorities and WHO reported 1,419 cholera cases in South Africa, including 1,334 in Limpopo Province alone, with 13 deaths. On December 24, OCHA noted the start of indigenous transmission in South Africa, although Zimbabwe nationals continued to account for most cases.
• As of January 5, WHO reported cholera cases in eight of Mozambique's 11 provinces, with nearly 2,000 cases and 40 deaths reported since early September. According to WHO, Mozambique's cholera caseload appears to result from a combination of rainy season outbreaks and increased case numbers in districts bordering Zimbabwe. As of December 23, WHO reported more than 1,380 cholera cases and 38 deaths in Zambia's Lusaka District since November 2008. In addition, WHO reported eight suspected cholera cases and three confirmed cases in Botswana as of December 17.

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