Outbreak at a glance

In Pakistan, cholera is endemic with an epidemic threshold of a single laboratory confirmed case.

In 2022, Sindh province is facing a significant increase in cholera cases with 234 laboratory confirmed cases reported between 15 January to 27 May.  Balochistan and Punjab provinces have also reported 31 and 25 confirmed cases of cholera, respectively.

Currently, there is no evidence of cross-border spread of the disease. The risk of potential international spread exists given that Pakistan has long land borders with significant cross border movement and multiple major urban hubs including Karachi city in Sindh province, with international transport hubs. 

Description of the outbreak

On 26 April 2022, the National IHR Focal Point of Pakistan reported a laboratory confirmed outbreak of cholera in Sindh province, Pakistan.  As of 27 May, three provinces - Sindh, Balochistan, and Punjab, have reported a total of 290 confirmed cases of cholera.  

The first laboratory confirmed case was reported on 15 January 2022 in Sindh province.  Between 15 January and 27 May, 234 laboratory confirmed cases, with no deaths, have been reported from the province. Of these cases, 126 (54%) were females, and 114 (49%) were in children younger than nine years old. According to the cholera surveillance national policy, samples from children are prioritized over adults for confirmatory culture testing which may explain the high proportion of confirmed cases among children. 

As of 27 May, a total of 109 samples have been tested from the public water sources (hydrants) and individual households in Karachi city, Sindh province. Among these, results are available for 71 samples, of which 70% have shown presence of Vibrio cholerae while Escherichia Coli and coliform was detected in 55% and 90% of samples, respectively.

In addition to Sindh province, three districts in Balochistan have reported 31 confirmed cases and nine deaths while two districts in Punjab have reported 25 confirmed cases.