The World Health Organization (WHO) has reported a sharp increase in cholera deaths globally, while noting progress in the fight against meningitis through vaccination and continued surveillance against plague.
According to WHO’s latest epidemiological update, 47 countries reported 451,499 cholera cases and 7,870 deaths in 2025.
The number of reported cholera deaths increased by 30 per cent compared with the previous year, making 2025 the deadliest year for cholera in terms of deaths reported to WHO since 1999.
WHO cautioned, however, that the figures represent cases reported through national surveillance systems and do not reflect the full global burden of the disease, as many cases are believed to go unreported.
Seven countries — Angola, Bangladesh, the Democratic Republic of the Congo, Nigeria, South Sudan, Sudan and Yemen — accounted for around 90 per cent of the reported cholera cases and deaths worldwide.
The WHO African Region recorded the largest burden, with cholera cases increasing by 34 per cent and deaths rising by 58 per cent compared with 2024.
“The rise in cholera deaths is a reminder of the challenge ahead,” said Dr Chikwe Ihekweazu, Executive Director of WHO’s Health Emergencies Programme.
Ihekweazu said cholera deaths could be prevented through improved access to safe water, sanitation and hygiene, alongside stronger disease surveillance, vaccination, community engagement and timely access to quality healthcare.
Cholera deaths linked to delayed access to care
Cholera is an acute diarrhoeal infection caused by Vibrio cholerae bacteria.
It is mainly transmitted through food and water contaminated with faeces, particularly in communities lacking adequate water and sanitation systems.
Although the disease is preventable and treatable, severe dehydration can become fatal if patients do not receive treatment quickly.
WHO said more than one in five reported cholera deaths in 2025 occurred outside health facilities, highlighting continued challenges in ensuring patients reach medical care in time.
Among patients treated in health facilities, the global case fatality rate remained below 1 per cent.
However, the rate exceeded 1 per cent in 12 countries during 2025.
There has also been an increase in the availability of oral cholera vaccines. Global production more than doubled between 2022 and 2025, rising from about 30 million doses to approximately 80 million doses annually.
The International Coordinating Group on Vaccine Provision approved 71 million doses for use in affected countries in 2025, including 20 million doses for preventive vaccination.
Meningitis cases decline in Africa’s meningitis belt
While cholera deaths increased, WHO reported progress in the fight against bacterial meningitis.
In 2025, 24 of the 26 countries in Africa’s meningitis belt reported 21,526 suspected meningitis cases and 971 deaths to WHO.
The figures represented a case fatality rate of 4.5 per cent, while cases declined by 5.9 per cent among countries that reported comparable data for both 2024 and 2025.
The meningitis belt stretches from Senegal to Ethiopia and regularly experiences outbreaks.
WHO said vaccination has played a major role in reducing meningococcal meningitis, particularly infections caused by serogroup A.
Since the introduction of the meningococcal A conjugate vaccine in 2010, serogroup A cases have fallen by more than 99 per cent among vaccinated populations.
No confirmed serogroup A case has been reported since 2017 in countries that introduced the vaccine, according to WHO.
A newer vaccine providing broader protection against five meningococcal serogroups, known as Men5CV/MMCV, is also being introduced through outbreak response and preventive vaccination campaigns.
Niger became the first country to conduct a nationwide campaign using the vaccine in 2025.
WHO calls for continued plague surveillance
WHO also highlighted the need for continued monitoring of plague, a bacterial disease that normally spreads among animals through fleas but can also infect humans.
Between 2019 and 2025, 10 countries reported suspected human plague cases to WHO, with six reporting confirmed infections.
During the period, 3,847 suspected cases and 423 deaths were reported, representing an overall case fatality rate of 11 per cent.
Most reported cases came from the Democratic Republic of the Congo and Madagascar, where plague remains endemic in some areas.
WHO noted that plague can also occur in countries that do not report cases, while annual numbers can vary depending on the timing, location and scale of outbreaks.
The global health agency said continued surveillance of rodents and other animal populations, combined with rapid responses to outbreaks, remains essential to detecting plague early, limiting transmission and preventing larger outbreaks.
The findings on cholera, meningitis and plague were published in the latest edition of WHO’s Weekly Epidemiological Record, highlighting the continuing importance of disease surveillance, vaccination, sanitation and rapid access to healthcare in controlling epidemic-prone bacterial diseases.
