Governments may be under-reporting cholera outbreaks, expert warns

According to a study reported in the Bulletin of the World Health Organization, researchers from the International Vaccine Institute found that many governments may be under-reporting cholera outbreaks.

The researchers from the South Korean facility estimated that the global cholera burden is 10 times higher than what is reported to the World Health Organization. They estimated that there are close to three million cases of the disease per year and approximately 93,000 deaths, reports.

Under-reporting outbreaks is against an international law that requires governments to report all outbreaks. The team used cholera data reported to the WHO but also incorporated information from alternative disease monitoring systems, previous multi-country studies, and media and government reports. By surveying each country individually, the team was able to more accurately estimate the spread of the disease.

The authors blamed multiple factors for the underestimation of the disease burden, including poor in-country surveillance and a reluctance on the part of governments to report cases or conduct surveillance due to a potential loss in tourism and trade.

"Unless the magnitude of the problem is reported, we will not know how to solve [it]," Mohammad Ali, the leader of the study, said, according to

Other factors in the under-reporting of the disease include a lack of resources available to diagnose cholera in remote areas and a lack of funding in the efforts to improve cholera treatment and prevention.

Ali is leading a study in collaboration with the WHO to assess the roll-out of a cheap cholera vaccine across the Zanzibar Islands. If successful, the program might be usable as a model in other endemic countries.