State of Emergency in Harare - Zimbabwe

On 17 November, authorities declared a state of emergency in Harare over a cholera outbreak. At least 7000 suspected cases of cholera have been registered including over a dozen deaths. The epicentre is the suburb of Kuwadzana. The outbreak can be expected to cross the border.

Advice

Most infected individuals, approximately 75%, do not show any symptoms. However, in those who do exhibit symptoms, only a small proportion develop a severe form of the disease. All travellers can minimize the risk of exposure to this disease. Strictly observe all food and water precautions in any area where there is cholera. If gastrointestinal symptoms (e.g., vomiting and profuse watery diarrhoea) develop while visiting the affected area, travellers should seek medical care at once.

Currently there are three WHO pre-qualified oral cholera vaccines: Dukoral, Shanchol, and Euvichol-Plus. All three vaccines require two doses for full protection. However, due to the large number of cholera outbreaks and limited global supply of vaccine, WHO is temporarily recommending only one dose of cholera vaccine in outbreak situations.

The U.K. National Travel Health Network and Centre recommends the oral cholera vaccine for some travellers whose activities or medical history put them at increased risk when travelling to areas of active cholera transmission. There is an increased risk of acquiring cholera for aid workers; for those going to areas of cholera outbreaks who have limited access to potable water and medical care; and for travellers for whom vaccination would be considered potentially beneficial, e.g., persons with chronic medical conditions.

 The U.S. Centers for Disease Control and Prevention (CDC) recommends the cholera vaccine for travellers who are 18-64 years of age and who plan to travel to areas of active cholera transmission. CDC notes that most travellers do not travel to areas of active cholera transmission and that safe food and water practices can prevent many cholera infections.