Health Professionals

Clinical Updates

22 August 2012

Cholera outbreak in Sierra Leone


As of 19 August 2012 Sierra Leone has reported a total of 11,653 cases and 216 cholera related deaths [1-2].

Ten of the 14 districts in the country have been affected: Bo, Bombali, Bonthe Kambia, Kono, Moyamba, Port Loko, Pujehun, Tonkolili and Western Area. Western Area reports the highest number of cases (5,209) and deaths (65), followed by Port Loko (2,806 cases and 45 death) and Kambia (1,134 cases and 28 deaths) [1-3].

The previous outbreak in March 2012, affected three of the currently affected districts (Kambia, Port Loko and Puhehun) [4]. Heavy rains and possible flooding are likely to accelerate the spread of this outbreak. Emergency control measures, including the improvement of sanitation and enhanced cholera surveillance are underway [1].

The increase in the number of cases in Western Area is of particularly concern, due to crowded living conditions, poor sanitation and inadequate access to safe water.

Advice for travellers

Cholera is an acute diarrhoeal disease caused by the Gram negative bacillus Vibrio cholerae serogroup O1 or O139.  Vibrio cholerae is transmitted through contaminated water or food in areas of poor sanitation.

The risk of cholera for most travellers to Sierra Leone is very low. All travellers should practise food and water hygiene precautions. Cholera vaccine is not routinely recommended for travellers, but can be considered for those travelling to affected areas that may be at higher risk, such as humanitarian aid and relief workers and travellers with remote itineraries in areas with limited access to safe water and medical care [5,6].

Before travelling, it is essential that travellers follow Foreign and Commonwealth Office  advice regarding security and safety in Sierra Leone.



1. World Health Organization. Regional Office for Africa. Cholera situation in Sierra Leone -19 August 2012. [Accessed 22 August 2012]. Available at:

2. UN Office for the Coordination of Humanitarian Affairs. Sierra Leone: Cholera in the capital. 25 July 2012. [Accessed 22 August 2012]. Available at:

3. UN Office for the Coordination of Humanitarian Affairs. West Africa: Cleaner toilets to save slums from cholera. 16 August 2012. [Accessed 22 August 2012]. Available

4. The International Federation of Red Cross and Red Crescent Societies. Cholera epidemic (MDRSL003). Emergency appeal. Sierra Leone: Cholera Epidemic. 16 August 2012. [Accessed 22 August 2012]. Available at: DR, 5. Ford L, Lalloo DG. Oral cholera vaccines: use in clinical practice. Lancet Infect Dis 6:361-73, 2006.

6. Cholera. In Salisbury D, Ramsay M, Noakes K [eds]. Immunisation against infectious disease.2006. [Accessed 5 July 2012]. Available at:




NaTHNaC Health Information Sheet: Cholera

NaTHNaC Health Information Sheet: Prevention of food and water borne diseases