Cholera epidemic in Yemen: 2020 update

The ongoing cholera epidemic in Yemen, which started in September 2016, is considered one of the worst cholera epidemics in recent history (1). The rapid spread of the epidemic has been directly linked to the country's ongoing armed conflict (2). According to the World Health Organization, the total number of suspected cholera cases reported from January 2018 to May 2020 is 1,371,819. The case fatality rate is 0.11%. Overall, the epidemic has affected 22 of the 23 governorates of Yemen (3).

In 2020, the governorates reporting the highest number of suspected cholera cases include Al Hudaydah, Sana’a, Taizz, Ibb, Al Bayda, Amanat Al Asimah, Hajjah, and Dhamar. Currently, children under five represent 23% of the total suspected cases (3).

Recently, the already strained efforts to control the cholera outbreaks in this war-torn country have been further compounded by the COVID-19 pandemic (4). As of July 3, Yemen has reported 1,240 COVID-19 cases and 335 deaths (5). Although, with few tests available and limited government and hospital capacity, these numbers likely do not reflect the true impact of the COVID-19 pandemic in Yemen (4). 

Indeed, Yemen’s health care system is already overrun. Many healthcare professionals have not been paid in years, causing many to leave the public health system. Those who have stayed are now being asked to treat COVID patients without personal protective equipment. Furthermore, the authorities are often too weak to prohibit large-scale gatherings, thereby creating an environment conducive to increased spread of the highly contagious virus (4). 

Clearly, strong advocacy from the public health community is critical to raise awareness of the impact that the armed conflict in Yemen has on the health of the population and to bolster efforts to stop both the COVID-19 and cholera epidemics.