Zimbabwean Cholera Outbreak - Impact

Impact

The outbreak began in Chitungwiza on 27 August 2008, with the first case in Harare reported four days later. The next district to report cholera was Kariba on 21 September 2008, with Makonde following on 3 October 2008. Thereafter, the disease spread to reach all of Zimbabwe's ten provinces. The attack rate was highest in Beitbridge, Chegutu, Mudzi and Zvimba Districts (above 1,000 cases per 100,000 people or 1.0%).

The number of infected cases reported by the United Nations Office for the Coordination of Humanitarian Affairs escalated from 30 on 1 September 2008 to 15,572 by 10 December. It was argued by some agencies that the reported number of cases probably underestimated the extent of the outbreak, since many people were unlikely to have reached the clinics or treatment where the numbers were recorded. According to the Red Cross, around 46% of reported deaths occur en route to clinics and hospitals. The head of the British Department for International Development in Harare said that "there are probably twice as many people with cholera as turn up for treatment."

The case fatality rate for the outbreak was higher than expected for such outbreaks, although it began declining by January 2009. Official estimates of fatalities have run from 484 to 800, since the outbreak in August 2008, with an upper estimate of 3,000 from an anonymous senior official in the Ministry of Health and Child Welfare. Fatality rates varied from 2.5% in Harare to 18% in Chitungwiza. In Harare, the crisis reached the extent that the city council offered free graves to cholera victims. On 4 December, Oxfam estimated that by the end of March 2009, some 60,000 would be infected. By 7 December, Oxfam had revised their estimate to 60,000 cases by the end of January 2009 and a 10% fatality rate, with UNICEF giving a similar estimate. On 4 December 2008, the Zimbabwe government declared the outbreak to be a national emergency.