A month after the first suspected cases were reported, 658 cases and 28 deaths have been reported across five states, with a high case fatality rate of 4.3%, the UN World Health Agency said on Friday (OMS). Among these five states, Kassala reports the highest number of cases (473), followed by Gedaref (110) and Al Jazirah (51), while Khartoum and River Nile report fewer cases.
According to the World Health Organization (WHO), these cases are not linked to the previous cholera outbreak that was declared in September 2023. “It technically ended in May 2024 after no cases were reported for two consecutive incubation periods,” Dr Shible Sahbani, WHO Representative in Sudan, said from Port Sudan during a regular UN press briefing in Geneva.
On the ground, WHO is working closely with federal and state ministries of health to coordinate the response to the cholera outbreak. The UN agency has pre-positioned cholera kits and other essential medical supplies in high-risk states in anticipation of the risks associated with the rainy season.
More than 455,000 doses of vaccines mobilized
“These supplies are helping to jumpstart the response to the outbreak in all affected states, including states like Khartoum and Al Jazirah that are difficult to access due to security concerns,” added Dr. Sahbani.
A three-day oral cholera vaccination campaign ended yesterday Thursday in two localities in Kassala State. These are localities that have reported high numbers of cases. “We have deployed 51,000 doses of oral cholera vaccines (OCV) with the aim of reaching 97% of the eligible population in these localities,” Dr. Sahbani detailed.
The oral cholera vaccination campaign is being conducted in parallel with the oral polio vaccination campaign, and a multi-antigen immunization campaign is being prepared for Darfur.
In the same vein, WHO is providing technical, operational and financial support to the campaign and is supporting preparations to submit a request for vaccine doses to the International Coordination Group for Vaccine Allocation (ICG) to conduct a second campaign in other locations.
“The good news is that the ICG has fully approved the request for a total of 455,000 doses to implement a reactive vaccination campaign targeting the unvaccinated high-risk population in Kassala State.
Displaced women carry their belongings at a flooded site near Kassala, Sudan.
The health intervention plan for 2024 is more than 40% funded
To strengthen case management, WHO is establishing 10 stabilization centres – 2 in each affected state – and 48 oral rehydration points (ORPs) to facilitate free access to life-saving oral rehydration salts (ORS) for affected communities.
To launch and sustain a robust response to the cholera outbreak, WHO and its partners, as well as health workers, need safe and unhindered access to all affected areas. The UN agency also needs sustained financial support to address the growing health needs arising from disease, malnutrition, natural hazards such as heavy rains and floods, and direct threats from war.
Eight months into the year, the 2024 humanitarian response plan is only 37% funded and the health response 42%.
Outbreaks of measles, dengue fever, malaria, meningitis and polio
In addition to this new cholera outbreak, Sudan is currently facing outbreaks of measles, dengue fever, malaria and meningitis, as well as polio. At least 12 of Sudan’s 18 states are experiencing three or more outbreaks simultaneously.
Malaria is one of the leading infectious causes of morbidity and mortality in Sudan. Between 4 November 2023 and 12 July 2024, more than 1.67 million cases were reported from 15 states. A total of 173 deaths were reported from six states.
Dengue remains a major health burden in the country. From July 15, 2023 to July 19, 2024, 9,396 cases were reported from 12 states. During the same period, 73 deaths were reported from nine states.
The current measles outbreak in Sudan began in late 2023. As of 12 July 2024, 4,937 cases have been reported in 14 states. A total of 109 deaths have been reported in 14 states. Parts of Sudan are in the “meningitis belt,” which has the highest rates of meningococcal disease in the world. Between 15 April 2023 and 2 August 2024, 155 cases have been reported in 10 states, with 20 associated deaths.
Five refugees among cholera deaths in Kassala State
For its part, the United Nations High Commissioner for Refugees (HCR) warns that this new wave of cholera in Sudan, the second since the war began sixteen months ago, threatens displaced communities across the country.
The spread of the disease in refugee-hosting areas, mainly in Kassala, Gedaref and Jazirah states, is of particular concern. In addition to hosting refugees from other countries, these states are also home to thousands of displaced Sudanese who have sought safety from the ongoing hostilities.
To date, 119 cases of cholera have been confirmed in three refugee sites in Kassala state, according to the Sudanese Ministry of Health.
“Sadly, five refugees have died after contracting the disease. Although cholera cases have been reported in Gedaref State, no refugees have been affected by the outbreak to date, but we continue to monitor the situation,” said Kristine Hambrouck, UNHCR Representative in Sudan.
© HCR/Nicolo Filippo Rosso
Sudanese refugees line up to receive food in Adre, near Chad’s border with Sudan.
Alarming context of malnutrition and risk of cholera in neighboring countries
Across Sudan’s borders, particularly in South Sudan and Chad, UNHCR teams have reported an increase in malaria cases in refugee sites, triggered by the start of the rainy season. “This is happening against a backdrop of alarming malnutrition, measles, acute respiratory infections, acute watery diarrhoea and the risk of cholera outbreaks,” Hambrouck said.
Since the start of the conflict in Sudan, more than 10.3 million people have been forced from their homes and have sought refuge elsewhere in Sudan or in neighbouring countries. With the humanitarian situation and funding already precarious before this latest cholera outbreak, funds are desperately needed to support the provision of health care and other life-saving assistance.
These include expanding cholera treatment centres and other health facilities, strengthening health personnel and increasing stocks of intravenous fluids and medicines.
