Tengrinews.kz — In recent weeks, the world has been discussing a cholera outbreak in Sudan. As of early July, 911 cases and 127 deaths had been registered in West and North Kordofan states. Against this background, a Tengrinews.kz correspondent asked experts whether there is a risk of the infection being imported into Kazakhstan and whether the country is prepared for such cases.
Cholera outbreak in Sudan: how many cases and where the epicenter is
A cholera outbreak is spreading in West and North Kordofan states. According to Sudan’s Ministry of Health, cited by Sudan Tribune, the number of cases has reached 911, while 127 patients have died. One of the reasons cited for the rapid spread of the infection is a shortage of medical workers.
The main epicenter is the Al-Mazrub district in North Kordofan. In just three weeks after the disease spread from neighboring West Kordofan, 300 infections and 16 deaths were recorded there.
Volunteers working in these regions report an acute shortage of life-saving medicines.
WHO Director-General Tedros Adhanom Ghebreyesus earlier wrote on his X account that the epidemic is developing against the backdrop of the ongoing armed conflict, which has disrupted the healthcare system.
“Population displacement is further hampering people’s access to life-saving medical care. At the same time, security problems and limited access to affected areas are delaying the delivery of medicines and humanitarian aid,” the WHO chief wrote.
Ghebreyesus added that the organization is expanding the network of cholera treatment centers and oral rehydration points, supplying special kits to treat the disease, installing handwashing stations, training specialists in water chlorination and conducting public awareness work.
Could the disease reach Kazakhstan
Biologist and immunization consultant Assel Mussabekova believes this possibility cannot be completely ruled out. According to her, the risk of imported cases is real and such situations occur periodically.
For example, she noted that from 1993 to 2024, Kazakhstan registered 23 imported cases of cholera. Of these, 12 were linked to countries outside the region: Pakistan, Turkey, India, Indonesia, Iran and Singapore. Another 10 cases were imported from neighboring states, mainly Uzbekistan, Tajikistan, Kyrgyzstan and Turkmenistan.
The expert also noted that most cases imported from countries outside the region were linked to air travel.
“We do not have direct flights to Sudan, but a hypothetical possibility exists,” the expert said.
Assel Mussabekova also explained that cholera is transmitted by the fecal-oral route, and for the disease to develop, a person must swallow a large dose of the vibrio bacterium that causes the infection.
Ordinary contact with an infected passenger on a plane almost never leads to infection. For an outbreak to occur, the bacterium must enter a shared source of water or food.
“In Kazakhstan, imported cases in different years led to ‘epidemic complications’ with further spread within the country, but only where there were preconditions: insufficient access to clean drinking water, a low social level, active migration and ecological niches for the vibrio bacterium to survive,” the biologist said, citing the study “Review of Imported Cholera Cases in the Republic of Kazakhstan for the Period 1993–2024,” published in the Eurasian Journal of Applied Biotechnology.
Factors influencing cholera survival rates
Assel Mussabekova reassures that modern medicine makes it possible to successfully treat most patients.
“With timely and adequate treatment, more than 99 percent of patients survive. The WHO target for mortality is below one percent.”
The main treatment remains rehydration, meaning the replacement of lost fluids. In mild cases, special oral rehydration salts are used, while in cases of severe dehydration, intravenous fluids are administered. Antibiotics are used as an additional treatment.
“Death occurs as a result of rapid loss of fluids and salts, so survival depends primarily on how quickly rehydration is started and on access to medical care,” the biologist explained.
She also noted that without treatment, a severe form of cholera can lead to death in 25–50 percent of patients, and in the most severe cases, the figure can be even higher.
At the same time, dangerous dehydration does not develop in all patients.
"A significant portion of those infected are asymptomatic or have mild cases; life-threatening dehydration occurs in about one in five patients. In Sudan’s West Kordofan, the mortality rate is around 14 percent. This reflects the collapse of healthcare in a war zone rather than the inherent danger of the disease itself," says Assel Musabekova.
Is Kazakhstan ready for imported cases of cholera? What the National Center for Public Health says
The National Center for Public Health also told us that the risk of cholera being imported into Kazakhstan remains, especially during the hot season, but is still low.
Due to the worsening epidemiological situation involving various infectious diseases, including Ebola, dengue and others, in countries of Africa and Asia, Kazakhstan has introduced strengthened sanitary and quarantine control at the state border.
At all airports and checkpoints, arriving passengers undergo non-contact temperature checks, questioning and, if necessary, a medical examination. The National Center assures that if specialists detect an infected person at the border, they will be immediately hospitalized in an infectious diseases hospital and all measures will be taken to prevent the spread of the disease.
“An example of the effectiveness of this system was the three imported cholera cases from India in 2024. At that time, the infection sites were quickly localized, and further spread of the infection was prevented,” the statement said.
Symptoms to watch out for
The National Center for Public Health notes that the main signs of this intestinal infection include profuse watery stool and frequent vomiting. These cause rapid dehydration, the signs of which include:
- severe thirst,
- dry skin and mucous membranes,
- convulsions,
- low blood pressure,
- and low body temperature.
“Cholera, unless the cases are advanced, is fully treatable. Most patients recover successfully if ORS solutions, or oral rehydration salts, are prescribed in time. Patients with severe dehydration who face the risk of death due to dehydration shock require emergency infusion therapy. ORS solutions and antibiotics are also prescribed,” specialists explained.
The center added that infectious diseases hospitals have the necessary supplies of medicines, including ORS solutions, antibiotics and other drugs.
Sanitary and epidemiological control organizations and anti-plague service facilities also have diagnostic tests available in case cholera is detected.