Outbreak Notice -Zimbabwe

Cholera in and Neighboring Countries
This information is current as of today, December 21, 2008 at 07:46: December 19, 2008
An outbreak of cholera has been reported by health officials in Zimbabwe. According to the United Nations Office of the Coordination of Humanitarian Affairs, from August 26 through December 15, 18,413 suspected cases and 978 deaths have been reported in the country. The worst-affected areas are the capital city of Harare (8,454 cases and 208 deaths) and Beitbridge in Matabeleland South (3,546 cases and 91 deaths). Cases of cholera have been reported in all of Zimbabwe’s provinces, and Ministries of Health in neighboring countries have begun to report confirmed cholera cases in Musina (South Africa), Palm Tree (Botswana), and Guro district (Mozambique), suggesting that the cholera outbreak in Zimbabwe is spreading.

Cholera is a potentially fatal bacterial infection that causes severe diarrhea and dehydration. The disease is spread through untreated sewage and contaminated drinking water. There is no cholera vaccine available in the United States.

Advice for People Traveling to Zimbabwe

Most travelers are not at high risk for getting cholera, but travelers should be aware of the outbreak and make sure they are taking steps to prevent getting sick. Although no cholera vaccine is available in the United States, U.S. travelers can greatly reduce their risk for cholera by following CDC’s safe food and water advice:

• Before departing for Zimbabwe, talk to your doctor about getting a prescription for an antibiotic to treat traveler’s diarrhea.
• Drink water that you have boiled for at least one minute or treated with chlorine or iodine. Other safe beverages include tea and coffee made with boiled or treated water, as well as drinks that have been bottled and sealed (such as bottled water, carbonated drinks, and sports drinks).
• Do not put ice in drinks, unless the ice is made from boiled or treated water.
• Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself.
• Do not eat undercooked or raw fish or shellfish, including ceviche.
• Make sure all vegetables are cooked. Do not eat salads or other raw vegetables.
• Do not eat foods and drink beverages from street vendors.
• Do not bring perishable seafood back to the United States.

A simple rule of thumb for safe food and water is "Boil it, cook it, peel it, or forget it."
If you are traveling in Zimbabwe or neighboring countries and have severe watery diarrhea seek medical care right away. It is important to remember to drink fluids and use oral rehydration solution (ORS) to prevent dehydration.

More Information

The United Nations Office for the Coordination of Humanitarian Affairs in Zimbabwe has reported that new cases and deaths due to cholera are increasing. Although Zimbabwe has reported several smaller cholera outbreaks in recent years, this outbreak is more severe and may worsen with the onset of the rainy season. On December 3, the government of Zimbabwe declared a national emergency and appealed for international assistance. The humanitarian community has already been responding to this outbreak with water, sanitation, and hygiene initiatives in outbreak areas. WHO and its Health Cluster partners are finalizing a "Cholera Response Operational Plan" to evaluate and control the current outbreak.

For more information about the cholera outbreak in Zimbabwe, including maps:

• Weekly Situation Report—United Nations Office for the Coordination of Humanitarian Affairs (December 3, 2008)
• Cholera in Zimbabwe—World Health Organization (December 2, 2008)
• Relief Web, Zimbabwe—United Nations, Office of the Coordination of Humanitarian Affairs, (December 15, 2008)

For more information for travelers:

• Warden message about cholera, November 26, 2008—American Embassy in Harare, Zimbabwe Warden messages
• Cholera (from CDC Health Information for International Travel 2008)

• Safe food and water (CDC Travelers’ Health website)

For more information about cholera, see the following CDC links:

• Cholera (from CDC, Division of Foodborne, Bacterial, and Mycotic Diseases)
• Cholera (from CDC Health Information for International Travel 2008)

To find medical care in Zimbabwe:

• On the web: List of local medical specialists (Embassy of the United States, Harare, Zimbabwe)
• By phone: 263-4-250593/4 Consular section of the United States Embassy, Harare, Zimbabwe: American Citizen Services