An infectious disease that can be devastating, cholera caused the first death in Mayotte this Wednesday, May 8. This is the first death recorded in the territory since the detection of a first case in mid-March.
In the French department of Mayotte, located in the Indian Ocean, a three-year-old child died of cholera this Wednesday, May 8. Two days earlier, as of May 6, 56 cases of this infectious disease were identified on the island, while there were none two months ago.
The first case of cholera was detected in Mayotte on March 18, 2024. The number of sick people stood at 13 on April 26, before doubling to 26 cases on April 28.
This outbreak comes as a major epidemic is underway in the neighboring archipelago of the Comoros, where there have been 98 deaths and more than 4,900 cases since the start of the year.
“It is the mixing of populations which favors the proliferation of the disease”, recalls Fahad Idaroussi Tsimanda, specialist on the island and doctor in geography at Montpellier III University. If the epidemic outbreak comes from cases from the Comoros, the proliferation of cholera would also be favored by “the lack of infrastructure and hospital staff”.
Global explosion in the number of cases
But Mayotte is no exception. As a result of climate change and the increase in conflicts, the number of cholera cases is currently exploding around the world, underlines the World Health Organization (WHO).
Reported cases (only a portion of proven cases) more than doubled between 2021 and 2022 to reach 473,000, then climbed further to more than 700,000 in 2023.
Comoros, Democratic Republic of Congo (DRC), Ethiopia, Mozambique, Somalia, Zambia and Zimbabwe are among the countries most severely affected currently.
Contaminated water
An acute diarrheal infection, cholera is caused by the absorption of food or water contaminated by a bacteria, the bacillus vibrio cholerae or cholera vibrio.
Three-quarters of infected people express no symptoms. But when it occurs, the disease can be serious in 10 to 20% of cases, with severe diarrhea and vomiting which cause accelerated dehydration.
If left untreated, cholera is one of the most rapidly fatal infectious diseases: death can occur within one to three days. Only rapid treatment by infusion, with the administration of rehydration salts and antibiotics, can prevent death.
Poverty and conflict marker
Haiti, Syria or the DRC: the list of recent cholera outbreaks shows how this disease is a marker of poverty, instability and armed conflicts.
“There is a strong link between cholera transmission and inadequate access to safe drinking water and sanitation facilities,” underlines the WHO.
Places at risk of epidemics are typically refugee camps: humanitarian crises with the displacement of populations and difficulties in accessing drinking water considerably increase the risks.
Favored by climate change
Climate change, by increasing the intensity and frequency of floods, cyclones and droughts, disrupts access to drinking water and “creates an ideal environment for the development of cholera”according to the WHO.
Recent example: cases of cholera in Mozambique increased tenfold after the passage of Cyclone Freddy which, at the start of 2023, deprived some of the inhabitants of drinking water.
Insufficient vaccines
Several oral vaccines have been developed and are recommended by the WHO for areas where cholera is endemic and during epidemics. But the multiplication of outbreaks has dangerously limited stocks and forced humanitarian organizations to reduce the number of doses administered during vaccination campaigns.
In April, the WHO gave the green light to the simplified version of a vaccine, produced by the South Korean group EuBiologics, to speed up production and replenish global stocks of anticholera serums.
In Mayotte, a vaccination campaign is underway with more than 4,000 people vaccinated to date, according to the Regional Health Agency. Asked whether the health situation risks getting worse, Fahad Idaroussi Tsimanda responds that “the situation is worrying.” He recalls that even if the measures restricting access to water have been reduced, they still exist and that “the current context favors proliferation”.
