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Interim Guidance Document on Cholera Surveillance


Cholera remains a global threat to public health and a key indicator of lack of social development. Cholera transmission is closely linked to inadequate access to clean water and sanitation. Typical at-risk areas include peri-urban slums and rural areas where basic infrastructure is not available, as well as camps for internally displaced persons or refugees, where living conditions and access to water and sanitation systems are disrupted.

In 2015, more than 170,000 cases and 1300 deaths (CFR: 0.8%) were notified to WHO from 42 countries, of which 41% was reported from Africa 37% from Asia and 21% from Hispaniola. However, the true number of cholera cases occurring globally is thought to be much higher. Factors contributing to underreporting of cases and deaths may include weak surveillance systems, inconsistencies in case definitions, lack of laboratory diagnostic capacities, fear of negative impact on travel and trade, etc. An operational surveillance system for cholera is crucial for detecting outbreaks, monitoring disease occurrence and estimating disease burden to orient implementation of prevention and control measures and to allocate resources.

The objective of this guidance document is to support the public health professionals in implementing effective surveillance of cholera in at-risk, endemic and epidemic areas. This document has been developed by the Surveillance Working Group of the Global Task Force for Cholera Control (GTFCC) at the World Health Organization based on the existing documents, guidelines, tools and articles related to surveillance of cholera disease, as well as technical discussions with experts held during GTFCC meetings.

The document is aimed at health professionals working at Ministries of Health, Public Health Institutes, WHO Country Offices and partners who are involved in cholera surveillance. This interim version will be regularly updated. Acknowledgement is given to all members of the Surveillance Working Group of the GTFCC, experts and partners who have actively participated in the development of this guideline.