Angola has been suffering a severe Cholera outbreak, with the first cases reported in January 2025, with 8543 reported cases and 329 fatalities, 112 occurred in the community, by 23 March, according to a press release issued by the World Health Organization. From the outset of the outbreak, the number of cases rose steadily until the first week of February, when over 1000 cases were reported in a single week. The number of cases then fell slightly, plateauing at slightly over 800 cases a week through most of February and March, before starting to rise again at the end of March.
Younger people have been particularly badly hit by the outbreak, with 1976 reported cases (23.1% of the total) among 6-14-year-olds, 1850 cases (21.7% of the total) among 15-24-year-olds, and 1475 cases (17.3%) of cases among 25-34 year-olds. Males have been slightly more affected than females, making up 55.3% of the total (4725 cases). Cases have been reported in 16 of Angola's 21 provinces, with the worst affected provinces being Luanda, with 4143 cases (48.5% of the total) and Bengo, with 2485 cases (29.1% of the total).
Cholera is an acute enteric infection caused by ingesting the Bacterium Vibrio cholerae a Gram-negative, comma-shaped Gammaproteobacterium, related to other pathogenic Bacteria such as Yersinia pestis (Bubonic Plague), and Esherchia coli (food poisoning), which present in contaminated water or food. It is mainly linked to insufficient access to safe drinking water and inadequate sanitation. Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea resulting in high morbidity and mortality, and can spread rapidly, depending on the frequency of exposure, the exposed population and the setting. Cholera affects both children and adults and can be fatal if untreated.
The incubation period is between 12 hours and five days after ingestion of contaminated food or water. Most people infected with Vibrio cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people. The majority of people who develop symptoms have mild or moderate symptoms, while a minority develop acute watery diarrhoea and vomiting with severe dehydration. Cholera is an easily treatable disease. Most people can be treated successfully through prompt administration of oral rehydration solution.
The consequences of a Humanitarian crisis, such as disruption of water and sanitation systems, or the displacement of populations towards inadequate and overcrowded camps, can increase the risk of Cholera transmission, should the Bacteria be present or introduced. A multisectoral approach including a combination of surveillance, water, sanitation and hygiene, social mobilization, treatment, and oral Cholera vaccines is essential to control Cholera outbreaks and to reduce deaths.
Angola has suffered recurrent Cholera outbreaks since the 1970s, with a major outbreak in 1987 which infected around 16 000 people were infected and 1460 people died. Outbreaks were recorded every year from 1987 till 1996, after which the disease disappeared for a decade. Cholera returned in 2006, with another major outbreak in which around 67 000 people were infected and 2700 people died. Subsequent outbreaks were recorded in 2011-13 and 2016-18. Cholera infections generally peak in the rainy season (mid-October to mid-April), and outbreaks in Angola are often linked to outbreaks in the neighbouring Democratic Republic of Congo.
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