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Zambia reels from a cholera outbreak with more than 400 dead and 10,000 cases

People walk down a water-logged road in Lusaka, Zambia.
People walk down a waterlogged road in Lusaka, Zambia, on Friday.
(Associated Press)
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Zambia is reeling from a major cholera outbreak that has killed more than 400 people and infected more than 10,000, leading authorities to order schools across the country to remain shut after the end-of-year holidays.

A large soccer stadium in the capital city has been converted into a treatment facility.

The Zambian government is embarking on a mass vaccination program and says it’s providing clean water — 2.4 million liters a day — to affected communities across the southern African nation.

The national disaster management agency has been mobilized.

Cholera is an acute infection caused by a bacterium that is typically spread through contaminated food or water. The diarrheal disease is strongly linked to poverty and inadequate access to clean water.

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The outbreak in Zambia began in October, and as of Wednesday, 412 people had died and 10,413 cases had been recorded, according to the latest count from the Zambia Public Health Institute, the government body that deals with health emergencies.

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The Health Ministry says that cholera has been detected in nearly half of the country’s districts and nine out of 10 provinces, and that the nation of about 20 million people has been recording more than 400 new cases a day.

“This outbreak continues to pose a threat to the health security of the nation,” said Health Minister Sylvia Masebo.

The United Nations Children’s Fund, UNICEF, called the fatality rate of around 4% in the three-month outbreak “a devastatingly high number.” When treated, cholera typically has a death rate of less than 1%.

There have been recent cholera outbreaks in other southern African nations, including Malawi, Mozambique and Zimbabwe. More than 200,000 cases and over 3,000 deaths have been reported in southern Africa since the start of 2023, according to UNICEF. Malawi had its worst cholera outbreak in decades in 2023.

The World Health Organization said last year that about 30 countries globally, including Nigeria and Uganda, had suffered serious outbreaks in the last few years.

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Cholera barely affects countries in the developed world and can be easily treated — but it can quickly become fatal if untreated.

More than half — 229 — of those who have died in the Zambian outbreak did so before being admitted to a health facility, the Public Health Institute said.

Zambia has had several major cholera outbreaks since the 1970s, but this one is the worst in 20 years in terms of the caseload, according to Dr. Mazyanga Mazaba, director of public health policy and communication at the Public Health Institute.

Cholera bacteria can survive longer in warmer weather, and unusually heavy rains and storms in southern Africa recently have contributed to outbreaks, experts say.

WHO said last year that although poverty and conflict remain the main drivers for cholera, climate change has contributed to its upsurge in places across the globe since 2021 by making storms wetter and more frequent. Last year, a cyclone led to a spiraling cholera outbreak in Mozambique.

Heavy rains and flash flooding in Zambia have left some neighborhoods soggy or waterlogged.

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Cholera, the illness that has afflicted at least six passengers on a flight from South America to Los Angeles, is a potentially life-threatening diarrheal disease.

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The Zambian government announced in early January that schools — which were to open for the year on Jan. 8 — will not open until Jan. 29. Parents and children were urged to make use of education programs on public TV and radio, a situation that had echoes of the COVID-19 pandemic.

The education minister also ordered that schools be cleaned and inspected.

Zambia’s Disaster Management and Mitigation Unit has been mobilized to truck in large water tanks and clean water to neighborhoods.

Granulated chlorine to treat water is also being provided, the government said.

The majority of cholera cases are in the capital, Lusaka, where a 60,000-seat stadium has been converted into a treatment center that is dealing with about 500 patients at a time, the health minister said.

Masebo said Zambia had received about 1.4 million doses of the oral cholera vaccine from the WHO and expected more than 200,000 more to arrive soon. She was among the Zambian government officials who took a vaccine publicly to encourage others to also do so.

Health experts have previously warned that the numerous cholera outbreaks globally have strained the supply of vaccines, which are mostly distributed to poor countries through an international body run by the U.N. and partners. The organization Gavi, the Vaccine Alliance, predicted that the vaccine shortage could last until 2025.

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