WHO in Lebanon working to stop cholera spread amid conflict

On 16 October, the Ministry of Public Health of Lebanon confirmed a cholera case, highlighting the escalating health risks amidst ongoing conflict. The case was identified in Akkar governorate in the north of the country, marking the first case since the October 2022-June 2023 outbreak was declared over. Authorities are investigating the extent of the disease’s spread, gathering samples from the patient’s contacts, and assessing potential water contamination.

“WHO has been sounding the alarm on the risk of emerging infectious diseases like cholera resurfacing in Lebanon as a result of poor water and sanitation conditions and the impact of the current conflict,” said Dr Abdinasir Abubakar, WHO Representative in Lebanon. “Our immediate focus now is to enhance surveillance and water sanitation conditions to interrupt transmission and prevent further spread.”

The current resurgence occurs as conflict strains Lebanon’s already overburdened health system, exacerbating displacement, and contributing to a further decline in water and sanitation services and infrastructure. Overcrowded shelters are not equipped to accommodate the increasing number of displaced people, raising the risks of the spread of cholera.

WHO is collaborating closely with the Ministry of Health and partners, leveraging lessons from the last outbreak in October 2022 to contain the disease outbreak and prevent its spread. The 2022-2023 outbreak was the first in Lebanon in over 30 years and was driven by economic decline and inadequate access to clean water and sanitation, resulting in 8,007 suspected cases, 671 lab-confirmed cases, and 23 deaths.

Earlier in August, the Ministry of Public Health launched a preemptive oral cholera vaccination campaign in coordination with WHO, UHNCR, UNICEF and other partners, targeting 350,000 people living in high-risk areas. The campaign, which was interrupted by the escalation in violence, aimed to cover individuals aged one year and above residing in high-risk areas in 5 out of Lebanon’s 8 governorates.

In response to the detection of the current case, WHO has immediately activated a cholera preparedness and response plan to enhance surveillance and contact tracing, including environmental surveillance and water sampling, strengthen laboratory testing capacity, preposition cholera supplies and support infection prevention and control measures in designated treatment centre facilities.

On 4 and 5 October, a WHO shipment of essential health supplies arrived in Beirut to support the response to the ongoing emergency. The shipment of over 116 metric tons included cholera supplies as part of the preparedness and response plan. WHO will continue to procure and preposition essential cholera supplies, including laboratory supplies.

As part of the efforts to contain the outbreak, WHO and the Ministry of Public Health will explore whether to introduce oral cholera vaccines in high-risk areas to interrupt the transmission as early as possible.

WHO is also supporting the Public Health Emergency Operations Centre at the Ministry of Public Health to coordinate response activities at national and subnational levels in coordination with the health sector. These response activities include maintaining essential health services to ensure no interruption of health delivery while supporting case identification and management at health facilities, as well as strengthening risk communication and community engagement activities so that people are aware of symptoms, risk factors and preventive measures.

By implementing the comprehensive cholera preparedness and response plan, WHO together with the Ministry of Public Health and partners aims to limit transmission, reduce the burden of the disease, and improve overall health outcomes.