Africa: Republic of the Congo's triple outbreak of typhoid fever, shigellosis and cholera

On 14 July 2023, the Ministry of Health of the Republic of Congo notified WHO regarding a cluster of cases of unknown etiology in Dolisie City, Niari Department.

The Ministry of Health of the Republic of Congo officially declared a concurrent outbreak of cholera, shigellosis, and typhoid fever in the country on 17 July 2023.

These are numbers are up from August 4 when the numbers were as follows: shigellosis (919 cases), typhoid fever (705 cases), and cholera (65 cases).

The city of Dolisie - the capital of Niari Department with a population of more than 110,000 inhabitants - is the current epicenter of this outbreak. Five other departments in the Republic of Congo (Bouenza, Brazzaville, Kouilou, Pointe-Noire and Pool) have also reported suspected cases.

Shigellosis is a gastrointestinal infection caused by one of four species of Shigella bacteria (Shigella sonnei, S. flexneri, S. boydii and S. dysenteriae). It is found in the intestinal tract of infected people and can be transmitted through the fecal-oral route by direct or indirect contact (e.g., through flies) with feces from an infected person, fomites, consumption of contaminated food or water and person-to-person contact.

Typhoid fever is a serious disease caused by Salmonella Typhi (Typhi) bacteria. The bacteria spread through contaminated food and water and person-to-person contact.

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Symptoms of typhoid fever include high fever, weakness, stomach pain, headache, constipation or diarrhea, cough, and loss of appetite. Typhoid fever can be fatal without appropriate antibiotic treatment.

Cholera is an acute diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. Cholera is spread through contaminated food or water.

It usually takes 2-3 days for symptoms to appear after ingesting cholera bacteria, ranging from a few hours to 5 days.

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Cholera can cause large amounts of watery diarrhea (described as a rice-water stool), nausea, and vomiting. Rapid loss of body fluids can lead to dehydration, shock, and even death.