Médecins Sans Frontières (MSF) is responding to a serious cholera outbreak in Zambia. MSF teams have set up a cholera treatment center (CTC) in the capital city, the place most affected by the epidemic. From the declaration of the outbreak on October 3, 2008, until January 21, 2009, there have been 1,169 reported cases of cholera in Lusaka.

In the last four weeks, the situation has dramatically deteriorated. In the week from January 12 to 18, 301 new cases of cholera were reported while the cumulative number of deaths reported overall rose to 36, posing a real threat to the local authorities and health structures.

MSF is responding to this serious cholera outbreak by setting up a treatment centre with a capacity for 150 patients and, as of January 16, five MSF emergency staff have reinforced the teams in Lusaka. More personnel (medical and non-medical) and supplies will arrive in the field in the coming days.

The team is currently directly involved in the treatment of patients as well as in improving treatment centres facilities and in water supply and sanitation activities. "Our immediate priority was to improve case management in the CTC and this is already happening with the arrival of additional staff," said Jon Irwin, MSF head of mission in Zambia.

"The outbreak is spreading in the peri-urban areas characterized by severe overcrowding and almost non-existent water and sanitation facilities to the south of the city. Our next step will be to assess conditions there. The lack of an available site for a CTC in that area means that patients have to be transported in discomfort and at some risk to receive treatment."

Cholera cases have also been reported in other parts of Zambia. MSF has been following up the different outbreaks in the country and conducted an exploratory mission in Chirundu (Southern Province), bordering Zimbabwe.

At this point, MSF has decided not to intervene in this area, as the Ministry of Health has set up a CTC close to the border with Zimbabwe where cases are referred. The organisation is closely monitoring the situation and is ready to provide support if needed. In the Northern Province and Luapula Province where there has been a total of 595 and 463 cases respectively, there have been no reported cases since November, so the outbreak is considered to have been contained.

Cholera is endemic in Zambia – its cycle coincides with the rainy season every year and is directly related to the lack of access to proper water and sanitation facilities. MSF will continue to respond to the new cases of cholera in the country and support the local health structures with medical teams and supplies.