Syria Facing Major Cholera Epidemic

Three months after the initial infection, cholera is still rapidly sweeping through Syria as death tolls continue to rise amid inadequate access to water and sanitation facilities.

Doctor explains to refugees how to prevent the spread of cholera

Syria is currently facing a major cholera epidemic, as damaged water and sanitation infrastructure have resulted in mass contamination and alarmingly rapid transmission. In the first cholera outbreak Syria has seen in 14 years, 56,879 suspected cases have arisen between August 25 and December 3, leading to 98 deaths. The outbreak was first linked to crop irrigation and drinking contaminated water from the Euphrates River in northeast Syria, as drought and a national water infrastructure decimated by war have left water sources especially vulnerable to bacterial contamination.

In the face of the infrastructure crisis, many communities have resorted to fetching water from rivers or open canals, while farmers have been relying on untreated river water for crop irrigation. After the mass contamination of the Euphrates river with sewage water, drinking water and vegetables became contaminated, causing cholera to run rampant throughout the country. Internally displaced people (IDP) and children are among the most vulnerable, as overcrowded IDP sites are scarcely equipped with water and sanitation facilities, while malnourished children are the most susceptible to fatal infection.

Cholera

Cholera is a waterborne disease caused by ingestion of the bacteria Vibrio cholerae, often by drinking contaminated water or eating food irrigated/processed with untreated water. As a result, cholera is closely linked to inadequate access to clean water and sanitation facilities, putting refugee and IDP camps at especially high risk.

If ingested, Vibrio cholerae can cause watery diarrhea, stomach cramps, vomiting, fever, and chills. Although most people only experience mild to moderate symptoms, cholera can become life-threatening if dehydration is left untreated. Malnourished children under the age of five are especially vulnerable, as their already-weakened immune systems leave them susceptible to infection, while diarrhea and vomiting can become a death sentence without re-nutrition.

Water surveillance

As cases continue to increase, one major difficulty is predicting where the disease will spread next since new infections are arising in previously-unaffected areas. With treatment centres and resources in short supply and rapid treatment essential for dehydration, water surveillance is important to provide an outlook on future spread. Determining which regions will likely be affected next can help direct resources to the appropriate areas, making sure health officials are prepared for upcoming cases.

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