Cholera spreading throughout Lebanon

The first cholera outbreak in nearly three decades in Lebanon is now spreading throughout the country, with more than 1,400 suspected cases, and 17 reported deaths so far, the World Health Organization (WHO) warned on Tuesday.The first case was reported to WHO by the Ministry of Public Health on 6 October, and there have been 381 laboratory-confirmed cases.

While the outbreak was initially confined to northern districts, it has spread rapidly said WHO’s office in Lebanon, with laboratory-confirmed cases now reported from all eight governorates and 18 out of 26 districts.

Serotype Vibrio cholerae O1 El-Tor Ogawa was identified as the cholera strain in circulation, similar to the one circulating in Syria.

Deadly, but preventable

“Cholera is deadly, but it’s also preventable through vaccines and access to safe water and sanitation. It can be easily treated with timely oral rehydration or antibiotics for more severe cases,” says Dr. Abdinasir Abubakar, WHO Representative.

“The situation in Lebanon is fragile as the country already struggles to fight other crises – compounded by prolonged political and economic deterioration.”

WHO is working alongside the public health ministry to try and curb the outbreak, along with other humanitarian partners.

Together they have drawn up a national cholera preparedness and response plan, outlining the most urgent response interventions required, while scaling up surveillance and active case-finding in case hotspots.

WHO support

Given the shortage of both health staff and medical supplies in the country, WHO has provided the two reference laboratories, three prisons and 12 hospitals designated for cholera treatment with laboratory reagents, treatment kits and rapid diagnostic tests.

The UN health agency has also deployed nurses and doctors as surge capacity to hospitals in the most affected areas. The procurement and prepositioning of additional cholera supplies are being also finalized, said WHO.

Additionally, WHO is ensuring that proper clinical management practices, infection prevention and control, and cholera testing protocols are in place to complement the surge in cases.

Training in place

In recent weeks, WHO has supported a series of training sessions nationwide to improve early detection and reporting of suspected cases, enhance clinical management and raise awareness among the public and frontline health workers.

Despite global shortages in cholera vaccine, WHO is supporting the Ministry of Public Health to secure 600,000 doses for those most at risk, including frontline workers, prisoners, refugees and their host communities.

Given the rapid spread of the outbreak, the agency is trying to locate more doses.

Economic meltdown

The vulnerability of people in Lebanon is being exacerbated by the prolonged economic crisis and limited access to clean water and proper sanitation across the country.

The migration of health care workers, disrupted supply chains and unaffordable energy supply have severely weakened the response capacity of hospitals and primary healthcare facilities.

“There is still an opportunity to limit the spread and impact of the outbreak by intensifying response interventions, including improving water and sanitation quality”, said Dr. Abubakar.

Back to basics

“We also need to raise awareness on how to prevent cholera infection so that we can lift the pressure off hospitals. The best way to prevent a cholera outbreak is to ensure people have access to clean water and appropriate sanitation and hygiene.”

He added that in the long term, “we need to scale up global vaccine availability as part of a holistic strategy to prevent and stop cholera outbreaks”.