The cholera epidemic in Syria spreads into neighboring Lebanon

The cholera outbreak in Syria, which started on September 10, 2022, has quickly spread throughout the country affecting 13 of the 14 governorates (1). As of October 15, a total of 20,014 suspected cholera cases and 75 cholera-related deaths have been reported in the country (2).

Neighboring Lebanon has not been affected by a cholera outbreak since 1993. However, the outbreak in Syria has spread into Lebanon, with the first cholera case reported on October 6, 2022 (3). The index case was a 51-year-old Syrian man living in an informal settlement in Miniyeh-Danniyeh District. Lebanon hosts the largest number of refugees in the world (per capita and km2), with 1.5 million Syrian refugees and over 13,000 refugees from other countries, according to the United Nations High Commissioner for Refugees (4).

During the first week of the outbreak in Lebanon, a total of 29 confirmed cases were reported in the governorates of Akkar and Baalbek (3), which both share a border with Syria. The first cholera-related death was reported on October 12, 2022 (5).

As of October 20, 2022, Lebanon has reported a total of 220 confirmed cholera cases and five cholera-related deaths across eight governorates. The majority of cases have been reported in Akkar District (approx. 47%), followed by Miniyeh-Danniyeh District (approx. 24%). Currently, the most affected age group is children 0-4 years of age (32% of cases) (6).

Recent compound crises in Lebanon have severely hindered access to healthcare, safe drinking water, and sanitation services for both refugee and host communities (3). The already limited access to safe water is further impacted by increasing fuel costs, resulting in reduced production of safe drinking water and thereby forcing people to use unsafe water sources, especially in remote areas of the country (7). The continued spread of this cholera outbreak poses a serious threat to vulnerable communities in the entire region.