Lebanon reports slowing cholera caseload amid vaccine campaign

Lebanon's Ministry of Health (MoH) has reported between zero and two cases of cholera over the last seven days, a sharp decrease from weeks prior.

On Wednesday, the MoH reported just two more confirmed cases of cholera, bringing the total of cumulative cases to 660.

The number of suspected and confirmed cases was much higher, however, at 5,186 cases on Wednesday.

Most cholera cases do not require hospitalisation, and many are treated for symptoms without testing for the presence of the bacteria, meaning the actual number of cases could be understated.

On 8 December, Lebanon's Minister of Health Firass Abiad said that the cholera outbreak was "under control," citing the low number of confirmed cases and the almost 500,000 vaccines distributed.

"A lot of work has been done to implement prevention measures. The first round of vaccination has been finalised … along with awareness campaigns launched in different regions could have contributed to the decrease in reported cases," Farah Nasser, the deputy medical coordinator for Doctors Without Borders (MSF) Lebanon, told The New Arab.

The disease, spread by water contaminated with human faecal matter, causes diarrhoea, dehydration and in severe cases, death. Lebanon reported its first case of cholera this October, the first time the disease appeared in Lebanon since 1993.

Nasser noted that there have been increased admissions of cholera patients in MSF's treatment centre in Arsal in the Bekaa Valley. She said that this "does not necessarily suggest an increase in confirmed cases, but could be linked to awareness [of] health-seeking behaviour."

According to the UN's latest situation report on 10 December, Lebanon's first wave of cases has "currently plateaued."

The UN report encouraged vigilance, however, as "having different spikes in cases and then a plateau, followed by another spike, is a usual trait in any cholera outbreak."

Several risk factors for the spread of cholera remained, particularly, due to the country's poor water infrastructure.

According to testing from Save the Children, 62 per cent of wells tested across the country are "bacteriologically contaminated."

In addition, among public schools whose water supplies were tested, 59 per cent had a "high prevalence of coliforms."

To contain the spread of cholera, Lebanon's MoH and international partners have launched a vaccination campaign in affected areas, in addition to setting up emergency treatment shelters.

The first phase of the vaccination campaign has been completed, with medical teams going door-to-door in affected areas to distribute it.

Lebanon's request for an additional 1.8 million doses of cholera vaccines was approved by the International Coordinating Group on vaccines.

Lebanon is expected to receive the first batch – 900 thousand doses – by 20 December.

The rapid vaccination campaign has largely been credited with slowing the spread of the disease but experts have warned that poor infrastructure and lack of access to safe drinking water means cholera will remain a persistent risk.