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Keywords
Zambia
Outbreak Response
WASH
7-1-7 Framework
Case Area Targetted Intervention
Oral Cholera Vaccine
Categories
Abstract
Background: Cholera remains a recurring public health emergency in Zambia, particularly in lakeshore and border districts, where inadequate water, sanitation, and hygiene (WASH) infrastructure increases the risk of transmission. In August 2025, an outbreak that started in Mpulungu District spread to Nsama and Mbala, triggering the activation of Zambia’s integrated outbreak response frameworks.
Methods: We conducted a descriptive analysis of the response from August 5 to September 24, 2025, using surveillance line lists, laboratory registers, situation reports, and partner activity records. The analysis focused on how the 7-1-7 framework, Incident Management System (IMS), Case Area Targeted Interventions (CATI), risk communication and community engagement (RCCE), WASH/IPC measures, and Oral Cholera Vaccination (OCV) preparedness were operationalized within a multi-pillar coordination structure.
Results: By September 24, 2025, there were 239 cholera cases and two deaths (case fatality rate of 0.8%) reported across the three districts. Early detection and quick IMS activation met the 7-1-7 timeliness targets. CATI allowed rapid containment of emerging clusters through household disinfection and contact tracing, while WASH and RCCE efforts reached over 58,000 people. Preparatory OCV micro-planning was finished in Mpulungu and Nsama. However, implementation faced several challenges, including transport and fuel shortages, limited trained personnel, weak real-time data systems, and a shortage of multilingual RCCE materials in remote areas.
Conclusions: The 2025 outbreak proved the effectiveness and importance of Zambia’s integrated, multi-pillar cholera response. Enhancing decentralized rapid-response capabilities, investing in digital surveillance and multilingual communication, and improving cross-border coordination for CATI and OCV campaigns will be essential to maintain progress toward cholera elimination.