This blog was updated on 17 July 2017

Yemen is in the grip of an unprecedented cholera outbreak. Since April, there have been more cholera cases in Yemen than those reported in the whole world in 2015 – over 320,000 to date. More than 1,700 people have died.

The number of cholera cases in East Africa is also growing quickly. More than 17,400 people in South Sudan have been infected and at least 320 have died. Somalia is badly affected as well, with 53,000 cases this year and 795 deaths.

In this blog, British Red Cross health adviser Greg Rose explains the threat posed by this potentially life-threatening disease.

What is cholera?

Cholera is a bacterial infection that is spread when people consume contaminated food or water – it is nearly always waterborne.

It is preventable and treatable. Without treatment, however, death can occur within hours.


Where is cholera found?

The disease is usually found in places where there is a lack of clean water, poor hygiene and limited access to health care.

It is most prevalent in sub-Saharan Africa, Central America, the Caribbean, South Asia and parts of South-East Asia.

What are the symptoms?

Cholera has a short incubation period, between two hours and five days. This explains why you often see a sudden burst of cases.

Most people have mild or no symtoms. Those who do develop symptoms will usually experience:

  • Severe, watery diarrhoea
  • Stomach cramps
  • Vomiting

It’s important to note that even if people do not display symptoms, the bacterium, Vibrio cholerae, stays in their faeces for up to two weeks.

So if people are practising open defecation, or if infrastructure is damaged after a natural disaster, then you can see how the bacteria can spread.

Can it be treated?

Absolutely – there is no reason why anyone should die from cholera. Treatment is often very simple depending on the stage of infection.

If cholera is detected early, then the patient may just need an oral rehydration solution to prevent dehydration.

If it’s more serious, then the patient may require intravenous fluid replacement at hospital.


A lady recovering from cholera at treatment centre in Burundi

It’s not the bacterium that will kill a person. A combination of acute diarrhoea and vomiting can lead to severe dehydration – a victim can lose several litres of fluid in a matter of hours. This is what proves fatal.

While cholera is easily treatable, the issue is that in places where cholera is prevalent, such as in Haiti and sub-Saharan Africa, health care is not always readily available.

Why is cholera so common after a conflict or natural disaster?

An elderly man in Yemen walks with a stick over the rubble of his destroyed town

In Yemen, South Sudan and Somalia, hundreds of thousands of people have had to flee their homes.

Conflict has destroyed essential infrastructure, especially in Yemen. Water and sewer systems no long function in many cities.

In Somalia, people forced to leave home by widespread fighting may not have enough clean water for drinking and washing. This problem has been made even worse by drought.

Conditions then become ripe for waterborne diseases like cholera.

So how do you prevent cholera?

The most effective solution in the aftermath of a disaster is to make sure people are aware of the dangers and have access to clean, chlorinated water, soap and toilets.