Cholera is endemic in Malawi with seasonal outbreaks during the
wet season. People living around Lake Chilwa rely on the lake for
their water supply. From May 2009 to May 2010, a cholera outbreak
occurred in fishing communities around Lake Chilwa. This paper
describes the outbreak response and lessons learned for prevention
and management of future outbreaks.
Starting in January 2010, Médecins Sans Frontières (MSF) helped
District Health Management Teams (DHMTs) to distribute
educational materials, water disinfectant and hygiene supplies, and
oral rehydration solution (ORS) in fishing communities. MSF also
supported case management by mentoring health workers and
providing equipment and supplies.
A total of 1,171 cholera cases and 21 deaths were reported in
the districts around the lake, with cases also being reported on
the Mozambican side of the lake. The attack rate was highest
among people living on or around the lake, particularly among
fishermen. Samples of lake water had high turbidity conducive to
the propagation of Vibrio cholerae
A number of practical measures could be taken to prevent future
outbreaks and to manage outbreaks more effectively. These
measures should address surveillance, environmental management,
outbreak preparedness, and case management.