Africa is experiencing its largest cholera outbreak in a quarter of a century, with about 300,000 confirmed and suspected cases and more than 7,000 deaths reported so far in 2025, according to the Africa Centres for Disease Control and Prevention (Africa CDC).
The agency says the continent-wide total is already more than 30% higher than last year’s tally, underlining a sharp resurgence of the disease.
Africa CDC data indicate that the steepest increases in recent weeks have been recorded in Angola and Burundi, where many communities have limited access to safe drinking water and basic sanitation. In the Democratic Republic of the Congo the overall number of cases is now declining, but health officials caution that transmission remains a concern in conflict-affected areas and crowded displacement camps. Situation reports also note improving trends in South Sudan and Somalia, though both countries continue to report new infections.
The same briefing from Africa CDC highlighted eight suspected cases of viral haemorrhagic fever detected in Ethiopia, with laboratory testing under way to confirm the cause, and noted that the mpox outbreak in parts of the continent is easing but still poses a risk in Kenya, Guinea, Liberia and Ghana. These parallel threats are placing additional pressure on already stretched public health systems.
Cholera itself is a bacterial infection caused by Vibrio cholerae, transmitted mainly through water or food contaminated with human faeces. Most infected people either have no symptoms or only mild illness but can still excrete the bacteria for several days. A minority develop sudden onset, profuse watery diarrhoea that can lead to severe dehydration. Symptoms typically appear between 12 hours and five days after exposure. Without prompt treatment with oral or intravenous fluids, the disease can be fatal, but where proper care is available, case-fatality rates can be kept below 1%.
Globally, surveillance data show that the current African outbreak sits within a wider pattern of increased cholera activity. The European Centre for Disease Prevention and Control (ECDC) reports that, from 1 January to 29 October 2025, 562,449 cholera cases and 7,201 deaths were notified worldwide, up from 462,096 cases and 3,434 deaths in the same period of 2024. The five countries reporting the most new cases since May are Afghanistan, Yemen, Sudan, South Sudan and the Democratic Republic of the Congo. Sudan, the DRC, South Sudan, Nigeria and Angola have reported the highest numbers of deaths.
WHO’s most recent multi-country situation report lists cases from 32 countries across five regions, with the Eastern Mediterranean and African regions accounting for the largest shares. No locally acquired cases were reported from the WHO European Region during the reporting period, although cholera remains present in parts of Asia, the Middle East, Africa and the Americas.
For Europe, including the EU/EEA, cholera is predominantly an imported infection. ECDC notes that only a small number of travel-related cases are reported each year, usually in people returning from countries where the disease is circulating. The agency continues to publish monthly global overviews and advises that the overall risk to most travellers is low, provided basic food and water precautions are followed. Vaccination is recommended for specific higher-risk groups such as humanitarian and emergency workers travelling to affected areas.
Ukraine provides one example of how countries distant from current hotspots are approaching the threat. Official reporting under the UN water and health protocol shows a single confirmed cholera case in 2018 in Zaporizhzhia oblast, with no confirmed cases identified since then. Public health assessments in 2023 and 2025 stated that, despite concerns after the destruction of the Kakhovka dam, cholera had not been detected through epidemiological or environmental surveillance. Ukrainian authorities have repeatedly urged the public not to rely on unverified claims of outbreaks and to follow routine hygiene and water-safety advice.
Across the African continent, health agencies attribute the current surge to a combination of fragile water and sanitation systems, rapid urbanisation, flooding and protracted conflicts that displace large populations into overcrowded camps with inadequate infrastructure. In response, national ministries of health, with support from WHO and partners, are expanding access to rehydration therapy, reinforcing water treatment and hygiene measures, and deploying oral cholera vaccines where supplies allow, although global vaccine stocks remain tight.
Experts emphasise that, for individuals, the most effective protective steps are straightforward: consuming only boiled, treated or bottled water; avoiding ice of uncertain origin; eating food that is thoroughly cooked and served hot; avoiding raw or undercooked shellfish; and washing hands with soap and safe water after using the toilet and before handling food. Travellers returning from affected countries who experience sudden onset of acute watery diarrhoea are advised to seek medical care promptly and to mention their recent travel history.
