There have been epidemics of cholera in Africa, Asia, and Latin America for many years. The one in Africa has lasted for more than 30 years, and no one knows how long it will continue. There are many reasons for this epidemic, including poverty, poor sanitation, and large populations. Treatment for cholera is helpful, but as yet, has not halted the spread of disease.
There is an ongoing cholera pandemic (which is an epidemic that spreads worldwide or at least over a large region) in Asia, Africa, and Latin America that has lasted for the past four decades. Since 1995, more than 80 percent of reported cases have occurred in Africa.
Predicting how long an epidemic will last is difficult. The current cholera epidemic in Africa has lasted more than 30 years. In areas with inadequate sanitation, the spread of disease cannot be stopped immediately, and although far fewer cases of cholera have been reported in Latin America and Asia in recent years, there are no signs that the global pandemic will end any time soon.
Major improvements in sewage and water treatment systems are needed in many countries to prevent an epidemic of cholera in the future.
Controlling the current cholera epidemics is challenging for a variety of reasons:
- Large population migrations into urban centers in developing countries are straining existing water and sanitation infrastructure, thereby increasing the risk of disease.
- An epidemic is a marker for poverty and lack of basic sanitation.
- Natural infection and currently available vaccines offer incomplete protection of relatively short duration; no multivalent vaccines are available for O139 infections.
- Multiple routes of transmission mean that successful prevention of cholera may require different measures in different areas.
- Simple rehydration treatment saves lives, but the logistics of delivery in remote areas remain difficult during epidemics of cholera.
- Antibiotic treatment is helpful, but can be difficult because of growing antimicrobial resistance.
- Natural reservoirs in warm, coastal waters make eradication (getting rid of the bacteria) highly unlikely.