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1
Management of a cholera epidemic
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Practical guide for doctors, nurses,laboratory technicians, medical auxiliaries,water and sanitation specialists and logisticians.
The document is a comprehensive guide for managing cholera epidemics, providing detailed protocols for prevention, outbreak investigation, treatment, and control mea
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sures. It covers essential aspects like rehydration therapy, water sanitation, hygiene promotion, and setting up treatment centers. Designed for medical and non-medical staff, it aims to support effective epidemic response and reduce cholera-related morbidity and mortality.
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For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source
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of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
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National Strategic Plan: Malaria Elimination 2023-27
National Centre for Vector Borne Disease Control (NCVBDC)
Ministry of Health and Family Welfare (MoHFW) - India
(2023)
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The National Strategic Plan for Malaria Elimination in India (2023-2027) focuses on achieving malaria elimination by 2030, in alignment with the Global Technical Strategy. The document outlines the strategies, targets, and goals for malaria elimination, aiming for zero indigenous malaria cases by 20
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27. It emphasizes district-based planning, robust surveillance systems, and enhancing case management and vector control. The plan stresses the importance of universal access to treatment, prevention, and data-driven decision-making. Furthermore, it encourages innovation and research in malaria elimination efforts, fostering multisectoral coordination and community engagement.
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Biosafety involves the implementation of containment principles, technologies and practices to prevent unintentional exposure to biological agents. Biosecurity involves the protection, control and accountability of biological materials and information related to these materials and dualuse research,
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to prevent their unauthorized access, loss, theft, misuse, diversion or intentional release.
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The NIAID Pandemic Preparedness Plan describes the strategy of the National Institute of Allergy and Infectious Diseases (NIAID) to strengthen research and development for future pandemic threats. The plan focuses on identifying and studying viruses
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with the potential to cause epidemics or pandemics and developing medical countermeasures such as vaccines, therapeutics and diagnostics. A key concept is the research on “prototype pathogens,” which represent virus families that may cause future outbreaks, allowing scientists to prepare tools and knowledge in advance. The document also outlines the importance of surveillance, epidemiological research, technological innovation, clinical trials and international collaboration to enable a faster and more effective response to emerging infectious diseases. Overall, the plan aims to improve scientific preparedness so that new health threats can be detected earlier and controlled more rapidly.
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This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers, and partners to plan and implement readiness and response activities for yellow fever outbreaks. The toolkit conta
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ins: information about yellow fever; RCCE considerations for how to approach key issues during yellow fever outbreaks; tools for understanding the context in which yellow fever outbreaks occur; methods for collecting data to inform strategy development and bring evidence into planning and implementation of activities; guidance to support vector control and immunization campaigns; and links to existing RCCE tools and training. It is one of a suite of toolkits on RCCE readiness and response to a range of disease and response areas.
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Mpox is a zoonotic disease caused by a double-stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family. The disease presents with symptoms similar to smallpox but with a l
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esser severity. It was first discovered in 1958 when two outbreaks of a poxlike disease occurred in colonies of monkeys kept for research, hence the name ‘mpox. The first human case of mpox was recorded in 1970 in the Democratic Republic of the Congo (DRC), which has subsequently spread to other central and western African countries. There are two known clades of the virus: clade I and clade II. Clade I, which is most frequently reported from countries in Central Africa, tends to be more severe than clade II. Cameroon is the only country known to harbour both clades.
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Managing epidemics
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Key facts about major deadly diseases.This manual provides concise and up-to-date knowledge on 15 infectious diseases that have the potential to become international threats, and tips on how to respond to each of them.
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ve version directly at the website
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Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-to-human transmission of the disease
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, and reducing spillover of the virus from animals to humans.
Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks.
There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks.
A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world.
Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years.
The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission.
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The report provides an update on the cholera outbreak in Haiti as of January and February 2024. A total of 79,411 suspected cases have been reported, with 4,608 confirmed cases and 1,172 deaths across all 10 departments. The most affected regions include Ouest, Centre, Artibonite, and Nord, with chi
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ldren aged 1-9 being the most impacted. Despite a recent decline in reported cases, underreporting due to security issues remains a concern. Response efforts include coordination meetings, epidemiological surveillance, case management, WASH interventions, vaccination campaigns, and community engagement. However, logistical challenges, insecurity, and funding shortages are hindering effective response efforts.
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Populations affected by emergencies are continually at risk of outbreaks of epidemic-prone diseases and other public health hazards. This operational guidance aims to guide decision-making on when and how to implement and strengthen Early Warning Al
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ert and Response (EWAR) in preparation for and response to emergencies. Each module aims to provide updated operational guidance for EWAR practices, which may be more easily understood and applied during emergencies. Through its application, this operational guidance aims to contribute to:
- earlier detection of acute public health events
- earlier and more effective response
- reduced impact of emergencies on health
- increased trust of the population in the (public) health system
- fulfilling our collective commitments to the International Health Regulations (IHR,
2005).
This guidance was developed jointly by 69 experts from more than 20 organizations from global level to country level.
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The technical note by the Global Task Force on Cholera Control (GTFCC) discusses the use of Oral Cholera Vaccines (OCVs) for international workers and travelers in cholera-affected areas. It reviews the effectiveness of WHO-prequalified vaccines (Dukoral®, Shanchol™, and Euvichol®), emphasizing
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their role in preventing infection and reducing transmission risks.
The document highlights concerns about travelers contracting cholera in endemic regions and potentially spreading the disease upon returning home. While the overall risk is considered low, certain groups, such as humanitarian workers and travelers to high-risk areas like South Asia, face a higher exposure.
Recommendations include vaccination for emergency and relief workers who may come into direct contact with cholera patients or contaminated environments. However, routine vaccination for general travelers is not widely recommended. The note also calls for better surveillance and studies to assess the potential of vaccines in preventing international transmission.
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The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, water, sanitation and hygiene, logistics, community en
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gagement and risk communication. All efforts must be well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
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COTS (Cholera Outbreak Training and Shigellosis) Program Health Promotion Worker Pocket Card
recommended
The COTS Cholera Outbreak Training and Shigellosis Program Pocket Card provides essential guidelines for health promotion workers to prevent and manage cholera and shigellosis outbreaks. It emphasizes proper sanitation, hygiene practices, safe water handling, and food safety as the primary methods f
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or disease control. Key recommendations include handwashing, disinfecting water with chlorine, using latrines, and ensuring safe food preparation. The document also outlines hospital policies, waste disposal procedures, and safety measures for healthcare workers dealing with diarrheal diseases. Additionally, it provides dehydration assessment guidelines, treatment protocols using Oral Rehydration Solution (ORS) and IV fluids, and appropriate antibiotic treatments for both cholera and shigellosis. The goal is to equip healthcare workers with quick-reference tools to effectively contain outbreaks and prevent further transmission.
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The WHO Guide on Cholera Control in Complex Emergencies provides key steps for preparedness, prevention, and response to cholera and other diarrheal diseases in crisis situations. It highlights the importance of early warning systems, rapid response, and coordination among health agencies. The guide
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outlines measures for case management, water sanitation, hygiene promotion, and outbreak containment, particularly in refugee camps and disaster-affected areas. It emphasizes community involvement, surveillance, and proper health infrastructure to reduce mortality and control disease spread in vulnerable populations.
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The Zimbabwe Multi-Sectoral Cholera Elimination Plan (2018–2028) aims to eradicate cholera by improving water, sanitation, and healthcare infrastructure, strengthening disease surveillance, and expanding oral cholera vaccination (OCV). The strateg
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y focuses on five pillars, including public health response, WASH, infrastructure, community empowerment, and financing. A multi-sectoral approach involving government, international organizations, and local communities targets cholera hotspots to prevent outbreaks and ensure long-term disease control.
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World malaria report 2024
recommended
New data from the WHO reveal that an estimated 2.2 billion cases of malaria and 12.7 million deaths have been averted since 2000, but the disease remains a serious global health threat, particularly in the WHO African Region. According to WHO’s la
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test World malaria report, there were an estimated 263 million cases and 597 000 malaria deaths worldwide in 2023. This represents about 11 million more cases in 2023 compared to 2022, and nearly the same number of deaths. Approximately 95% of the deaths occurred in the WHO African Region, where many at risk still lack access to the services they need to prevent, detect and treat the disease.
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Ebola virus disease preparedness strengthening team Guinea-Bissau country visit 12–20 November 2014
World Health Organization
(2014)
The main objective of this mission was to assess the level of preparedness of Guinea-Bissau in respect of the WHO consolidated checklist. The checklist helps countries to assess and test their level of readiness it is being used to identify concrete action to be taken and where countries will requir
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e support from partners. It lists 10 key components and tasks for both countries and the international community that should be completed within 30, 60 and 90 days from the date of issue of the list, with minimal requirements for equipment, material and human resources.
The components include: overall coordination; rapid response teams; public awareness and community engagement; infection prevention and control; epidemiological and laboratory surveillance; contact tracing; points of entry; laboratory; social mobilization and risk communication; budget.
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About six to seven million people worldwide, mostly in Latin America, are estimated to be infected with
Trypanosoma cruzi, the parasite that causes Chagas disease (WHO data from 2021). Chagas disease
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is
found mainly in endemic areas of 21 Latin American countries.
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