Cholera – Lebanon - ISS-G20 Laboratorium Repository

Outbreak at a glance

The Ministry of Public Health of Lebanon notified WHO on 6 October 2022 of two laboratory culture-confirmed cholera cases reported from the northern part of the country. As of 13 October, a total of 18 cases have been confirmed, including two probable deaths. This represents the first cholera outbreak in Lebanon since 1993. Responding to the current cholera outbreak may overwhelm the already fragile health system in the country.

Outbreak overview

On 6 October 2022, the Ministry of Public Health (MoPH) of Lebanon, notified WHO of two laboratory-confirmed cholera cases, confirmed by bacteria culture test, reported from North and Akkar governorates, northern Lebanon. The index case, a 51-year-old Syrian man living in an informal settlement in Minieh-Danniyeh district (North governorate), was reported to the MoPH on 5 October 2022. The patient was admitted to the hospital on 1 October with rice water stool and dehydration. Following a possible healthcare-associated transmission, the second case, a 47-year-old health worker, was reported, representing the first nosocomial infection of this outbreak.

Immediately following the confirmation of the first two cases, active case finding in the informal settlement where the index case lived, identified 10 additional cases confirmed by bacteria culture test. In addition, Vibrio cholerae was found in potable water sources, irrigation, and sewage. These positive cultures were confirmed on 9 October.

In Halba (the capital of Akkar Governorate), an additional two cases were culture-confirmed among Lebanese nationals. On 10 October, an additional four cases were culture-confirmed among Syrian nationals living in an informal settlement in Aarsal town of the Baalbek district.

As of 13 October, a total of 18 confirmed cases have been reported. The most affected age group are children under 5 years (44.4%; n=8), followed by persons aged 45 to 64 years (22.2%; n=4), 25-44 years (16.7%; n=3) and 5-15 years (16.7%; n=3). Females are disproportionally affected in the outbreak (72%; n=13). Of the total cases, 11 (61.1%) were reported from the district of Minieh - Danniyeh, four cases (22.2%) from Baalbek district and three cases (16.7%) from Akkar district (Figure 1).

In parallel, sewage water testing conducted in Ain Mraisseh in Beirut, Ghadir station in Mount Lebanon, and Bourj Hammoud also in Mount Lebanon, confirmed the presence of V. cholerae in all three sources, indicating that cholera has spread to two other regions of the country (Beirut Area and Mount Lebanon) located far from the initial confirmed cases.

Entire content available on: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON416