2016–2022 Yemen cholera outbreak

An outbreak of cholera began in Yemen in October 2016.[2][3][4] The outbreak peaked in 2017 with over 2,000 reported deaths in that year alone.[5][6] In 2017 and 2019, war-torn Yemen accounted for 84% and 93% of all cholera cases in the world, with children constituting the majority of reported cases.[7] As of November 2021, there have been more than 2.5 million cases reported, and more than 4,000 people have died in the Yemen cholera outbreak, which the United Nations deemed the worst humanitarian crisis in the world at that time.[8][9] However, the outbreak has substantially decreased by 2021, with a successful vaccination program implemented and only 5,676 suspected cases with two deaths reported between January 1 and March 6 of 2021.[10]

2016–2021 Yemen cholera outbreak
Map of Yemen on the globe
DiseaseCholera
Bacteria strainVibrio cholerae
First outbreakYemeni Civil War
Saudi Arabian–led intervention in Yemen
Saudi Blockade of Yemen
Famine in Yemen (2016–present)
DatesOctober 2016–November 2021
(7 years and 5 months)
Suspected cases2,510,806 through December 2020[1]
Deaths
3,981[1]
Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

Vulnerable to water-borne diseases before the conflict, 16 months went by before a program of oral vaccines was started.[8] The cholera outbreak was worsened as a result of the ongoing civil war and the Saudi Arabian-led intervention in Yemen against the Houthi movement that began in March 2015.[8][6] Airstrikes damaged hospital infrastructure,[11] and water supply and sanitation in Yemen were affected by the ongoing conflict.[6][12] The government of Yemen stopped funding public health in 2016;[13] sanitation workers were not paid by the government, causing garbage to accumulate,[11] and healthcare workers either fled the country or were not paid.[6]

The UNICEF and World Health Organization (WHO) executive directors stated: "This deadly cholera outbreak is the direct consequence of two years of heavy conflict. Collapsing health, water and sanitation systems have cut off 14.5 million people from regular access to clean water and sanitation, increasing the ability of the disease to spread. Rising rates of malnutrition have weakened children's health and made them more vulnerable to disease. An estimated 30,000 dedicated local health workers who play the largest role in ending this outbreak have not been paid their salaries for nearly ten months."[14]

Background edit

 
Scanning Electron Microscope (SEM) image of Vibrio cholerae bacteria

As of 2017, Yemen had a population of 25 million and was geographically divided into 22 governorates.[6]

The Yemeni Civil War is an ongoing conflict that began in 2015 between two factions: the internationally recognized Yemeni government, led by Abdrabbuh Mansur Hadi, and the Houthi armed movement, along with their supporters and allies. Both claim to constitute the official government of Yemen.[15] Houthi forces controlling the capital Sanaʽa, and allied with forces loyal to the former president Ali Abdullah Saleh, have clashed with forces loyal to the government of Abdrabbuh Mansur Hadi, based in Aden.[16] A Saudi Arabian-led intervention in Yemen was launched in 2015, with Saudi Arabia leading a coalition of nine countries from the Middle East and Africa, in response to calls from President Abdrabbuh Mansur Hadi for military support.[17][18]

Cholera is an infection of the small intestine by strains of the bacterium Vibrio cholerae.[19][20] It is spread mostly by unsafe water and unsafe food that has been contaminated with human feces containing the bacteria.[21] Symptoms may range from none, to mild, to severe.[20] The classic symptom is large amounts of watery diarrhea lasting a few days.[21] Diarrhea can be so severe that it leads, within hours, to severe dehydration and electrolyte imbalance.[21] Vomiting and muscle cramps may also occur. The primary treatment is oral rehydration therapy—the replacement of fluids with slightly sweet and salty solutions.[21] In severe cases, intravenous fluids may be required, and antibiotics may be beneficial.[21]

Prevention methods against cholera include improved sanitation and access to clean water.[22] Cholera vaccines that are given by mouth provide reasonable protection for about six months.[21] Two oral killed vaccines are available: Dukoral and Shanchol.[2] Total cost, including delivery costs, of oral cholera vaccination is under US$10 per person.[8]

Outbreak edit

 
Visualization showing the progression of the cholera outbreak in Yemen, from May 2017 – February 2018

Following "on the heels of civil conflict between Houthi rebels and the internationally recognized Yemeni regime",[6] the Yemen cholera outbreak began in early October 2016,[8][23] and by January 2017, the WHO Regional Office for the Eastern Mediterranean (WHO EMRO) considered the outbreak to be unusual in its rapid and wide geographical spread.[24] The serotype of vibrio cholerae O1 involved is Ougawa.[6][25]

The earliest cases were predominantly in the capital, Sana'a,[6] with some occurring in Aden.[26] By the end of October, cases had been reported in the governorates of Al-Bayda, Aden, Al-Hudaydah, Hajjah, Ibb, Lahij and Taiz and,[27] by late November, also in Al-Dhale'a and Amran.[28] By mid-December, 135 districts of 15 governorates had reported suspected cases, but nearly two-thirds were confined to Aden, Al-Bayda, Al-Hudaydah and Taiz.[6][29] By mid-January 2017, 80% of cases were located in 28 districts of Al-Dhale'a, Al-Hudaydah, Hajjah, Lahij and Taiz.[24] A total of 268 districts from 20 governorates had reported cases by 21 June 2017;[30] over half are from the governorates of Amanat Al Asimah (the capital Sana'a), Al-Hudaydah, Amran and Hajjah, which are all located in the west of the country.[25] In particular, 77.7% of cholera cases (339,061 of 436,625) and 80.7% of deaths from cholera (1,545 of 1,915) occurred in Houthi-controlled governorates, compared to 15.4% of cases and 10.4% of deaths in government-controlled governorates.[31]

Using genomic sequencing, researchers at the Wellcome Sanger Institute and Institut Pasteur concluded the strain of cholera originated in eastern Africa and was carried to Yemen by migrants.[32]

Morbidity and mortality edit

Yemen authorities announced the cholera outbreak on October 7, 2016.[2] By the end of that year, there were 96 deaths.[2]

Following the October 2016 outbreak, the rate of spread in most areas declined by the end of February 2017,[33] and by mid-March 2017, the outbreak was in decline after a wave of cold weather.[6] A total of 25,827 suspected cases, including 129 deaths, were reported by 26 April 2017.[23]

The number of cholera cases resurged in a second wave that began on 27 April 2017.[23] According to Qadri, Islam and Clemens, writing in The New England Journal of Medicine, the dramatic April 2017 resurgence was "coincident with heavy rains that may have contaminated drinking water sources, and was amplified by war-related destruction of municipal water and sewage systems".[6]

During May 2017, 74,311 suspected cases, including 605 deaths, were reported.[23] By June, UNICEF and WHO estimated that 5,000 new cases per day were occurring, and that the total number of cases in the country since the outbreak began in October had exceeded 200,000, with 1,300 deaths.[14][34][35] The two agencies stated that it was then "the worst cholera outbreak in the world".[14]

By 4 July 2017, there were 269,608 cases and the death toll was at 1,614 with a case fatality rate of 0.6%.[36] On 14 August 2017 the WHO updated the number of suspected cholera cases to 500,000.[37] Oxfam said in 2017 the outbreak would become the largest epidemic since record-keeping began, overtaking the 754,373 cases of cholera recorded after the 2010 Haiti earthquake.[38] In six months, more people were ill with cholera in Yemen than in seven years after the earthquake in Haiti, and the situation in Yemen was made worse by hunger and malnutrition.[13]

On 22 December 2017, WHO reported the number of suspected cholera cases in Yemen had surpassed one million.[39]

By October 2018, there were more than 1.2 million cases reported, and more than 2,500 people—58% children—have died in the Yemen cholera outbreak, which is the worst epidemic in recorded history and was, according to the United Nations (UN), the worst humanitarian crisis in the world.[8] Between 1 January 2018 to 31 May 2020, the cumulative total number of suspected cases was 1,371,819 with 1566 associated deaths.[40] The case fatality rate for the outbreak was 0.11% as of 2020,[40] having declined from a high of 1% when the outbreak first began.[13]

Causes and challenges edit

UNICEF and the WHO attributed the outbreak to malnutrition, collapsing sanitation and clean water systems due to the country's ongoing conflict, and the approximately 30,000 local health care workers who had not been paid for almost a year.[14] These factors resulted in a delayed vaccination program, which was not started until more than one million people were already ill.[8]

Pre-civil war conditions edit

Even before civil war affected Yemen, it was "beset by circumstances that made it ripe for cholera".[6] A country with high poverty rates, Yemen also suffered frequent droughts and severe water access problems, with only about half of the population having had access to good water and sanitation before the war.[6]

Children under five showed a high prevalence of malnutrition, making them further susceptible to disease;[8] Yemen had "one of the highest rates of childhood malnutrition worldwide".[2] The health care system in Yemen before the conflict was weak and lacking infrastructure.[2] For instance, before the war, 70–80% of children were vaccinated against measles, but the vaccination rate had dropped by the end of 2015.[41]

Ongoing conflict edit

Because of the ongoing conflict in Yemen, and resulting displacement of people who do not have adequate food, waster, housing or sanitation, pre-existing conditions were exacerbated. Shortages have been made worse by naval and air blockades.[6] Bombing has damaged water and sanitation infrastructure.[6] Airstrikes have destroyed facilities in the country for health care;[6] "half of the nation's hospitals have been either destroyed by Saudi airstrikes, occupied by rebel forces, or shut down because there are no medical personnel to staff them".[11]

Doctors Without Borders reported that a Saudi Arabian coalition airstrike hit a new Médecins Sans Frontières cholera treatment center in Abs, in northwestern Yemen.[42] Doctors Without Borders reported that they had provided GPS coordinates to Saudi Arabia on twelve separate occasions, and had received nine written responses confirming receipt of those coordinates.[42]

Grant Pritchard, Save the Children's interim country director for Yemen, stated in April 2017, "With the right medicines, these [diseases] are all completely treatable – but the Saudi Arabia-led coalition is stopping them from getting in."[43]

Wastewater and solid waste management systems edit

 
Wastewater stabilization ponds are generally used as a primary treatment, and are inefficient at completely removing infectious agents.[44]

Yemen's wastewater and solid waste management systems are the least developed among Middle Eastern countries, which has been a major contributor to the cholera outbreak.[45] With 16 functional sewage treatment plants (STPs) and a growing population,[45][46] the country's sewage systems are ill-equipped to meet the needs of citizens and serve just 7% of the population.[45] Actual flow rates through the STPs in Yemen exceed the flow rates they were designed to accommodate, which reduces their efficiency.[45]

The treatment processes used are also suboptimal, with 68% of STPs using only stabilization ponds - which are generally intended as a primary treatment - to remove pathogens from sewage.[45] This has resulted in high quantities of infectious agents in effluent, which is hazardous to health and can enable the spread of cholera.[45]

Moreover, wastewater in Yemen is frequently reused for irrigation purposes by farmers due to a lack of awareness about safety risks.[47][48] High concentrations of Escherichia coli, Streptococcus faecalis, Klebsiella pneumoniae, Enterobacter aerogenes, Salmonella  typhi, S. typhimurium, and Shigella sonnei - among other harmful fecal coliforms - are present in this wastewater, and transmit to humans when they consume foods irrigated by it.[49]

Official dumping sites for solid waste are being created increasingly close to communities, which has increased the risk of infection and general health issues among citizens.[45] This is especially true for the roughly 70% of citizens without access to potable water, who consume water from wells near dumping sites.[45]

El Niño edit

 
Adult Chironomid

The El Niño–Southern Oscillation phenomenon is a major driver of climate variability associated with health outcomes, including influencing cholera dynamics due to changes in rainfall.[50] For example, in East Africa, there was an upsurge in cholera cases in areas with increased rainfall, along with an increase in cases in areas with decreased rainfall.[50] In the 2015-2016 El Niño event, there were an additional 50 000 cases of cholera in East Africa.[50] Based on genomic approaches, there was a linkage found between the epidemic in Yemen starting in 2016 and the earlier outbreaks in East Africa.[51]  This alludes to a possible connection between cholera in East Africa and Yemen.[50] Chironomidae are natural reservoirs and carriers of the Vibrio cholerae bacterium.[50] It has been suggested that adult chironomidae may aerially carry the bacterium between bodies of water, assisting in the transmission of cholera.[50] Based on this evidence, it is hypothesized that the El Nino conditions over the Gulf of Aden may have contributed to the transmission of cholera from the Horn of Africa to Yemen through wind effects on cholera-contaminated flying insects.[50]

Health services and infrastructure collapse edit

As of 2016, the government ended funding for public health, leaving many employees without salary.[13] The impacts of the outbreak were exacerbated by the collapse of the Yemeni health services, where many health workers remained unpaid for months.[52] A months-long strike of sanitation workers over unpaid wages contributed to the accumulation of garbage[6][11] that entered the water supply.[13]

Qadri, Islam and Clemens write that the dramatic April 2017 resurgence coincided with heavy rains, and "was amplified by war-related destruction of municipal water and sewage systems".[6] An International Committee of the Red Cross (ICRC) worker in Yemen noted that April's cholera resurgence began ten days after Sana'a's sewer system stopped working.[52]

Raslan et al write in Frontiers in Public Health:

A failing sewage system, continued conflict and inadequate health care facilities are only a few of the reasons contributing to this problem. Malnutrition, which is a significant consequence of the Yemen War, has further contributed to this outbreak.[2]

Rainy season edit

Epidemiological modelling of the outbreak from October 2016 to January 2016 together with satellite image-derived meteorological data showed that the rainfall had a strong impact in increasing the chances of transmission, with the rainy season of April 2017 having coincided with the onset of the second wave of the outbreak topping at more than 50,000 cases per week.[53] The geography of Yemen means that the Western mountainous plateau sees more rainfall, and has therefore an increased risk of high cholera incidence due to water precipitations.[53]

Lack of vaccination edit

The International Coordinating Group on Vaccine Provision, which maintains vaccine stockpiles for cholera, announced a plan in June 2017 to send one million doses of oral cholera vaccine (OCV) to Yemen, but this plan stalled.[2][54] Controversy surrounded whether vaccination was the best strategy, whether it was too late to start a vaccination campaign, whether there was enough stockpiled vaccine to meet worldwide needs, whether all of the reported cases of cholera in Yemen were true cases as opposed to simply cases of diarrhea or other similar symptoms, and the effectiveness of the vaccine.[54] The request for vaccine was retracted.[8][6]

In May 2018, the first OCV campaign in Yemen was launched.[55] The WHO and UNICEF delivered oral vaccines to 540,000 individuals in August 2018.[8]

Federspiel and Ali write in BMC Public Health:

OCVs were not delivered until nearly 3.5 years into this humanitarian emergency, which has most likely been due to ongoing conflict, logistical circumstances, the scale of the epidemic, impairment of the humanitarian response by the parts to the conflict and some degree of negligence from donors, politicians and other decision makers. Whatever the reasons, OCVs were not distributed until nearly 16 months into the cholera outbreak by which time more than a million cases had accumulated. Neither were they in the two years of WaSH infrastructure breakdown that preceded the outbreak. This should serve as a historic example of the failure to control the spread of cholera given the tools that are available. Today, "cholera outbreaks are entirely containable" (The Lancet editorial, 2017).[8]

COVID-19 pandemic edit

The COVID-19 pandemic in Yemen is part of the worldwide pandemic of coronavirus disease 2019. As of 12 November 2020, there were 2,070 confirmed cases and 602 deaths.[56] The COVID-19 pandemic has further burdened the already overwhelmed healthcare system in Yemen fighting a number of diseases including cholera, dengue fever, and malaria.[57][58][59] Only half of existing health facilities are fully functioning while more than 17.9 million people of a total population of 30 million need health care services in 2020.[57] In addition, those that remain open lack medical personnel, basic medicine, and essential supplies such as masks and gloves.[57] The lack of flights in and out of Yemen to mitigate the pandemic has also restricted the movement of aid workers responding to the humanitarian crisis.[60]

Humanitarian activity edit

Through 2018, several humanitarian healthcare organizations had reported activity to contain the cholera outbreak. The International Committee of the Red Cross have supported 17 treatment centers with supplies including IV fluids, oral rehydration therapy supplies, antibiotics, chlorine tablets, in addition to sending engineers to help restore water distribution in Yemen.[8] The International Rescue Committee (IRC) supplied seven hospitals with medicine and supplies, deployed health teams and trained volunteers, delivered health and nutrition services, and facilitated referrals of malnourished children.[8]

The World Health Organization coordinated the Yemen Health Cluster with 40 member organizations, and together with Health and Water Sanitation and Hygiene (WaSH) units, explored the use of oral cholera vaccines (OCVs). The WHO reported operating 414 facilities using 406 teams active in 323 districts in Yemen, which included 36 treatment centers for cholera.[8] In the management of cholera, they stated that they trained 900 health workers and ran 139 oral rehydration locations, to treat 700,000 reported cases of the illness.[8] UNICEF reported that they ran awareness campaigns with 20,000 promoters, provided water to more than one million individuals, served as the WaSH lead, and delivered "40 tons of medical equipment including medicine, oral rehydration solution, IV fluids and diarrhea kits".[8]

Médecins Sans Frontières (Doctors Without Borders) said it treated at least 103,000 individuals in 37 locations.[8]

Global responses edit

Canada edit

As of June 2, 2020, Canada has pledged $40 million in humanitarian aid for Yemen to help the politically unstable country cope with cholera, malaria, dengue fever, and diphtheria along with COVID-19.[61] This brings Canada's total contributions to Yemen since 2015 to $220 million, which contributes towards the goal of US$2.4 billion for underfunded humanitarian programs run by UN agencies and humanitarian organizations in Yemen.[61]

Saudi Arabia edit

Saudi Arabia has been backing the Yemen government in the fight against the Houthi rebels, and they are also one of the top donors for UN humanitarian aid operations in Yemen.[62] On 23 June 2017, Saudi Arabia's crown prince, Mohammed bin Salman, authorized a donation in excess of $66 million for cholera relief in Yemen.[63]

Mohammed al-Jaber, the Saudi ambassador to Yemen, has announced half a billion dollars from Saudi Arabia to support UN programs in 2020.[62]

United Nations edit

An aid conference was held in Geneva in April 2017 that raised half of the US$2.1 billion that the United Nations (UN) estimated was needed.[64]

As of July 8, 2019, the UN and partners are running 1200 cholera treatment facilities around the country, however, funding is an issue.[65] The 2019 Yemen Humanitarian Response Plan required $4.2 billion to deliver assistance, but they ended up receiving $3.6 billion.[62] For the 2020 plan, the UN has so far received 15% of the necessary $3.5 billion needed.[62]

United States edit

On April 3, 2018, the United States (U.S.) announced $87 million in additional humanitarian assistance to help the people of Yemen, bringing the U.S. total assistance since 2017 to more than $854 million.[66] This money will be used for food assistance, safe drinking water, emergency shelter, and medical supplies.[66] The U.S. is also planning to provide $55 million in economic and development assistance, including programs to support livelihoods, rebuild infrastructure, and restore access to education.[66]

On March 27, 2020, the Trump administration cut $70 million in assistance destined for northern Yemen, framing the decreased funding as a response to the interference of Houthi rebels.[67] The U.S. officials were concerned that the assistance was directed to fighters instead of civilians.[67] South Yemen, which is less populous, still received aid dollars.[67]

United Kingdom edit

The United Kingdom (UK) government has been one of the largest humanitarian donors to Yemen, budgeting £139 million in 2017/2018 and earmarking £8m from the Yemen budget specifically to respond to cholera.[68] The UK has partnered with organizations including UNICEF and the International Organisation for Migration (IOM) to combat the cholera disease in Yemen.[68] The UK's humanitarian response includes nutrition support, clean water, sanitation, and medical supplies, such as chlorine tablets and hygiene kits.[68] The UK Department for International Development (DFID) has also worked with the Met Office, NASA and U.S. scientists to deploy a model to predict and effectively respond to outbreaks of cholera.[69] DFID Secretary Priti Patel has urged the international community to follow the UK government's steps to curb the cholera outbreak.[68]

World Bank edit

On August 25, 2017, the World Bank announced $200 million U.S. to support Yemen as it struggles to contain the cholera outbreak.[70] This money is being used to strengthen the country's health, water, and sanitation systems.[70]

Statistics edit

The WHO provided regular outbreak updates for the epidemic in Yemen up until August 2020. Since then the epidemic has declined in numbers of cases and deaths, with 2020 seeing a total of 230,540 suspected cases and 84 deaths and 5,676 suspected cases with two deaths between January 1 and March 6 of 2021[10][71] Furthermore, UNICEF reports that in 2021 over 190,000 children received a cholera vaccine, achieving 94% coverage.[10]

Date Suspected cholera cases Cholera-related deaths Source
2016-10-10 11 0 [72]
2016-10-13 186 0 [73]
2016-10-23 644 3 [74]
2016-10-30 1,410 45 [75]
2016-10-31 2,241 47 [76]
2016-11-06 2,733 51 [76]
2016-11-17 4,825 61 [77]
2016-11-24 6,119 68 [78]
2016-12-01 7,730 82 [79]
2016-12-08 8,975 89 [80]
2016-12-13 10,148 92 [81]
2016-12-28 12,733 97 [82]
2017-01-10 15,468 99 [83]
2017-01-18 17,334 99 [84]
2017-02-26 20,583 103 [85]
2017-03-07 22,181 103 [86]
2017-03-21 23,506 108 [87]
2017-04-27 26,070 120 [88]
2017-05-20 49,495 362 [89]
2017-06-10 96,219 746 [90]
2017-06-15 140,116 989 [91]
2017-06-22 185,301 1,233 [92]
2017-06-29 224,989 1,416 [93]
2017-07-06 275,987 1,634 [94]
2017-07-18 351,045 1,790 [95]
2017-07-27 408,583 1,885 [96]
2017-10-26 862,858 2,177 [97]
2017-12-19 1,009,554 [a] 2,345 [98]
2018-01-18 1,061,746 2,364 [100]
2018-02-01 1,072,744 2,368 [101]
2018-03-01 1,089,856 2,378 [102]
2018-04-05 1,112,175 2,391 [103]
2018-05-03 1,116,350 2,395 [104]
2018-05-20 1,126,790 2,411 [99]
2018-07-01 1,141,448 2,430 [105]
2018-09-23 1,233,666 2,630 [106]
2018-10-21 1,291,550 [b] 2,604 [107]
2018-11-11 1,303,839 2,614 [108]
2018-11-25 1,317,319 2,625 [109]
2018-12-09 1,329,285 2,641 [110]
2018-12-16 1,341,020 2,666 [111]
2018-12-30 1,350,139 2,682 [112]
2019-01-06 1,359,279 2,694 [113]
2019-01-13 1,367,849 2,703 [114]
2019-01-20 1,376,488 2,708 [115]
2019-02-03 1,383,907 2,716 [116]
2019-02-17 1,390,625 2,724 [117]
2019-04-07 1,420,393 2,775 [118]
2019-04-14 1,448,233 2,823 [119]
2019-04-28 1,470,735 2,873 [120]
2019-05-05 1,488,906 2,886 [121]
2019-05-12 1,505,610 2,898 [122]
2019-05-19 1,522,437 2,916 [123]
2019-05-26 1,539,305 2,928 [124]
2019-06-02 1,555,073 2,944 [125]
2019-06-09 1,572,731 2,955 [126]
2019-06-16 1,592,995 2,970 [127]
2019-06-23 1,613,872 2,989 [128]
2019-06-30 1,635,737 3,002 [129]
2019-07-07 1,657,286 3,020 [130]
2019-07-21 1,676,745 3,031 [131]
2019-07-28 1,694,765 3,045 [132]
2019-08-04 1,711,380 3,055 [133]
2019-08-11 1,727,688 3,069 [134]
2019-08-18 1,743,984 3,077 [135]
2019-08-25 1,761,482 3,089 [136]
2019-09-01 1,780,028 3,099 [137]
2019-09-29 1,796,653 3,114 [138]
2019-10-06 1,813,480 3,127 [139]
2019-10-13 1,827,904 3,143 [140]
2019-10-20 1,842,251 3,151 [141]
2019-10-27 1,855,175 3,161 [142]
2019-11-03 1,864,556 3,167 [143]
2019-11-10 1,875,918 3,170 [144]
2019-11-17 1,887,449 3,174 [145]
2019-12-01 1,898,236 3,176 [146]
2019-12-22 1,907,658 3,178 [147]
2019-12-29 1,916,811 3,181 [148]
2020-01-05 1,925,087 3,184 [149]
2020-01-12 1,932,798 3,188 [150]
2020-01-26 1,940,893 3,192 [151]
2020-05-17 1,944,360 3,192 [152]
2020-05-24 1,946,84 3,192 [153]
2020-05-31 1,949,920 3,192 [40]
2020-06-07 1,953,033 3,194 [154]
2020-06-14 1,956,124 3,198 [155]
2020-06-21 1,959,308 3,198 [156]
2020-06-28 1,962,357 3,199 [157]
2020-07-12 1,965,664 4,001 [158]
2020-07-19 1,968,536 4,001 [159]
2020-07-26 1,971,551 4,001 [160]
2020-08-02 1,973,697 4,002 [161]
2020-08-16 1,975,403 4,002 [4]
2021-04-30 5120 3 [162]
  1. ^ Starting in December 2017,[98] The World Health Organization began counting cases of cholera from 27 April 2017 onwards instead of from October 2016.[99] This is resolved by adding 26,070 suspected cholera cases and 120 deaths from December onwards.
  2. ^ Starting on 8 November 2018, The World Health Organization began counting cases of cholera from 1 January 2018 onwards instead of from 27 April 2017.[107] This is resolved by adding 1,048,701 suspected cholera cases and 2358 deaths from 21 October onwards.

See also edit

References edit

  1. ^ a b "CHOLERA SITUATION IN YEMEN" (PDF). WHO OCHA reliefweb. December 2020. Archived (PDF) from the original on 10 March 2021. Retrieved 30 December 2020.
  2. ^ a b c d e f g h Raslan R, El Sayegh S, Chams S, Chams N, Leone A, Hajj Hussein I (2017). "Re-Emerging Vaccine-Preventable Diseases in War-Affected Peoples of the Eastern Mediterranean Region-An Update". Frontiers in Public Health (Review). 5: 283. doi:10.3389/fpubh.2017.00283. PMC 5661270. PMID 29119098.
  3. ^ "Yemen: Health Cluster Bulletin, December 2020 - Yemen". ReliefWeb. 15 February 2021. Archived from the original on 15 February 2021. Retrieved 4 March 2021.
  4. ^ a b "WHO EMRO | Outbreak update – Cholera in Yemen, 16 August 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 9 November 2020. Retrieved 2 November 2020.
  5. ^ "WHO EMRO Outbreak update - cholera in Yemen, 19 December 2017 Cholera Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 1 December 2018. Retrieved 10 November 2018.
  6. ^ a b c d e f g h i j k l m n o p q r s Qadri F, Islam T, Clemens JD (November 2017). "Cholera in Yemen - An Old Foe Rearing Its Ugly Head". The New England Journal of Medicine. 377 (21): 2005–2007. doi:10.1056/NEJMp1712099. PMID 29091747.
  7. ^ "Cholera – Global situation". www.who.int. Retrieved 24 April 2023.
  8. ^ a b c d e f g h i j k l m n o p q Federspiel F, Ali M (December 2018). "The cholera outbreak in Yemen: lessons learned and way forward". BMC Public Health (Review). 18 (1): 1338. doi:10.1186/s12889-018-6227-6. PMC 6278080. PMID 30514336.
  9. ^ "Humanitarian crisis in Yemen remains the worst in the world, warns UN". UN News. United Nations. 14 February 2019. Archived from the original on 27 December 2021. Retrieved 29 April 2020.
  10. ^ a b c "UNICEF Yemen Humanitarian Situation Report - reporting period 1 – 28 February 2021 [EN/AR] - Yemen". ReliefWeb. 13 April 2021. Archived from the original on 17 August 2021. Retrieved 17 August 2021.
  11. ^ a b c d Snyder S (15 May 2017). "Thousands in Yemen get sick in an entirely preventable cholera outbreak". Public Radio International. Archived from the original on 25 July 2018. Retrieved 19 September 2018.
  12. ^ "Access to water continues to be jeopardized for millions of children in war-torn Yemen". UNICEF. 24 July 2018. Archived from the original on 25 July 2018. Retrieved 19 September 2018.
  13. ^ a b c d e Lyons K (12 October 2017). "Yemen's cholera outbreak now the worst in history as millionth case looms". The Guardian. Archived from the original on 23 March 2018. Retrieved 23 February 2018.
  14. ^ a b c d "Statement from UNICEF Executive Director Anthony Lake and WHO Director-General Margaret Chan on the cholera outbreak in Yemen as suspected cases exceed 200,000" (Press release). UNICEF. 24 June 2017. Archived from the original on 2 July 2017. Retrieved 26 June 2017.
  15. ^ Orkaby A (25 March 2015). "Houthi Who?". Foreign Affairs. Archived from the original on 27 March 2015. Retrieved 25 March 2015.
  16. ^ "Yemen in Crisis". Council on Foreign Relations. 8 July 2015. Archived from the original on 9 May 2015. Retrieved 22 April 2019.
  17. ^ "Yemeni's Abed Rabbo Mansour Hadi arrives in Saudi capital". CBC News. 26 March 2015. Archived from the original on 22 April 2019. Retrieved 26 March 2015.
  18. ^ "Yemeni leader Hadi leaves country as Saudi Arabia keeps up air strikes". Reuters. 26 March 2015. Archived from the original on 30 November 2021. Retrieved 10 July 2021.
  19. ^ Finkelstein R (1996). "Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios". Medical microbiology. University of Texas Medical Branch at Galveston. ISBN 9780963117212. PMID 21413330. Archived from the original on 1 September 2017. Retrieved 14 August 2016.
  20. ^ a b "Cholera – Vibrio cholerae infection Information for Public Health & Medical Professionals". Centers for Disease Control and Prevention. 6 January 2015. Archived from the original on 20 March 2015. Retrieved 17 March 2015.
  21. ^ a b c d e f "Cholera vaccines: WHO position paper" (PDF). Relevé Épidémiologique Hebdomadaire. 85 (13): 117–28. March 2010. PMID 20349546. Archived (PDF) from the original on 13 April 2015.
  22. ^ Harris JB, LaRocque RC, Qadri F, Ryan ET, Calderwood SB (June 2012). "Cholera". Lancet. 379 (9835): 2466–2476. doi:10.1016/s0140-6736(12)60436-x. PMC 3761070. PMID 22748592.
  23. ^ a b c d "Cholera situation in Yemen" (PDF). WHO EMRO. May 2017. Archived (PDF) from the original on 14 March 2019. Retrieved 27 June 2017.
  24. ^ a b "Weekly update: cholera cases in Yemen". WHO EMRO. 15 January 2017. Archived from the original on 22 May 2017. Retrieved 27 June 2017.
  25. ^ a b "Yemen: Cholera outbreak response: Situation report No. 3" (PDF). WHO EMRO. 12 June 2017. Archived from the original (PDF) on 14 March 2019. Retrieved 26 June 2017.
  26. ^ "Cholera cases in Yemen". WHO EMRO. 10 October 2016. Archived from the original on 22 May 2017. Retrieved 26 June 2017.
  27. ^ "Update on the cholera situation in Yemen, 30 October 2016". WHO EMRO. 30 October 2016. Archived from the original on 9 July 2017. Retrieved 27 June 2017.
  28. ^ "Cholera cases in Yemen, 24 November 2016". WHO EMRO. 24 November 2016. Archived from the original on 7 June 2017. Retrieved 27 June 2017.
  29. ^ "Weekly update: cholera cases in Yemen". WHO EMRO. 22 December 2016. Archived from the original on 6 May 2017. Retrieved 27 June 2017.
  30. ^ "Weekly update – cholera in Yemen, 22 June 2017". WHO EMRO. 22 June 2017. Archived from the original on 28 June 2017. Retrieved 26 June 2017.
  31. ^ Kennedy J, Harmer A, McCoy D (October 2017). "The political determinants of the cholera outbreak in Yemen". The Lancet. Global Health. 5 (10): e970–e971. doi:10.1016/S2214-109X(17)30332-7. PMID 28826973.
  32. ^ "Yemen cholera epidemic strain 'came from eastern Africa'". BBC News. 3 January 2019. Archived from the original on 17 August 2021. Retrieved 17 August 2021.
  33. ^ "Update on cholera in Yemen". WHO EMRO. 26 February 2017. Archived from the original on 7 June 2017. Retrieved 27 June 2017.
  34. ^ "UN: 1,310 dead in Yemen cholera epidemic". Al Jazeera. Archived from the original on 25 June 2017. Retrieved 26 June 2017.
  35. ^ "Yemen faces world's worst cholera outbreak – UN". BBC News. 25 June 2017. Archived from the original on 25 June 2017. Retrieved 26 June 2017.
  36. ^ "Epidemiology bulletin 26, 4 July 2017" (PDF). WHO-EMRO. Archived from the original (PDF) on 14 February 2019. Retrieved 4 July 2017.
  37. ^ McNeil Jr DG (14 August 2017). "More Than 500,000 Infected With Cholera in Yemen". NY Times. Archived from the original on 15 August 2017. Retrieved 14 August 2017.
  38. ^ McKernan B (29 September 2017). "Yemen's man-made cholera crisis is set to become the worst outbreak on record". The Independent. Archived from the original on 29 December 2017. Retrieved 21 April 2019.
  39. ^ "Suspected cholera cases in Yemen surpass one million, reports UN health agency". www.news.un.org. 22 December 2017. Archived from the original on 4 April 2018. Retrieved 22 December 2017.
  40. ^ a b c "WHO EMRO | Outbreak update – Cholera in Yemen, 31 May 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 5 February 2021. Retrieved 2 November 2020.
  41. ^ Qirbi N, Ismail SA (July 2016). "Ongoing threat of a large-scale measles outbreak in Yemen". The Lancet. Global Health. 4 (7): e451. doi:10.1016/S2214-109X(16)30070-5. hdl:10044/1/51373. PMID 27340001.
  42. ^ a b "Yemen: Airstrike hits cholera treatment center in Abs". Médecins Sans Frontières–Doctors Without Borders. 12 June 2018. Archived from the original on 28 June 2018. Retrieved 27 June 2018.
  43. ^ Osborne S (1 March 2017). "Saudi Arabia delaying aid to Yemen is 'killing children', warns Save the Children". The Independent. Archived from the original on 1 May 2022. Retrieved 21 April 2019.
  44. ^ Al-Gheethi A, Noman E, Jeremiah David B, Mohamed R, Abdullah AH, Nagapan S, Hashim Mohd A (October 2018). "A review of potential factors contributing to epidemic cholera in Yemen". Journal of Water and Health. 16 (5): 667–680. doi:10.2166/wh.2018.113. PMID 30285950.
  45. ^ a b c d e f g h Al-Gheethi A, Noman E, Jeremiah David B, Mohamed R, Abdullah AH, Nagapan S, Hashim Mohd A (October 2018). "A review of potential factors contributing to epidemic cholera in Yemen". Journal of Water and Health. 16 (5): 667–680. doi:10.2166/wh.2018.113. PMC 2018. PMID 30285950.
  46. ^ "Population growth (annual %) - Yemen, Rep. | Data". data.worldbank.org. Archived from the original on 28 October 2020. Retrieved 16 November 2020.
  47. ^ Al-Gheethi AA. "Management of wet market wastewater in Yemen". Waste Management.
  48. ^ Al-Gheethi AA. "Reduction of bacteria in storage system of sewage effluents". Journal of Sustainable Water Resource Management.
  49. ^ Al-Gheethi AA. "Effectiveness of selected wastewater treatment plants in Yemen for reduction of faecal indicators and pathogenic bacteria in secondary effluents and sludge". Water Practice Technology.
  50. ^ a b c d e f g Paz S (September 2019). "The cholera epidemic in Yemen - How did it start? The role of El Niño conditions followed by regional winds". Environmental Research. 176: 108571. Bibcode:2019ER....176j8571P. doi:10.1016/j.envres.2019.108571. PMID 31288197.
  51. ^ Weill FX, Domman D, Njamkepo E, Almesbahi AA, Naji M, Nasher SS, et al. (January 2019). "Genomic insights into the 2016-2017 cholera epidemic in Yemen". Nature. 565 (7738): 230–233. Bibcode:2019Natur.565..230W. doi:10.1038/s41586-018-0818-3. PMC 6420076. PMID 30602788.
  52. ^ a b Bruwer J (25 June 2017). "The horrors of Yemen's spiralling cholera crisis". BBC News. Archived from the original on 25 June 2017. Retrieved 26 June 2017.
  53. ^ a b Camacho A, Bouhenia M, Alyusfi R, Alkohlani A, Naji MA, de Radiguès X, et al. (June 2018). "Cholera epidemic in Yemen, 2016-18: an analysis of surveillance data". The Lancet. Global Health. 6 (6): e680–e690. doi:10.1016/S2214-109X(18)30230-4. PMC 5952990. PMID 29731398.
  54. ^ a b "What's really stopping a cholera vaccination campaign in Yemen?". IRIN. 17 October 2017. Archived from the original on 11 October 2018. Retrieved 11 October 2018.
  55. ^ "WHO EMRO | Fighting the world's largest cholera outbreak: oral cholera vaccination campaign begins in Yemen | Yemen-news | Yemen". WHO EMRO. 10 May 2018. Archived from the original on 2 November 2018. Retrieved 11 October 2018.
  56. ^ "Yemen: WHO Coronavirus Disease (COVID-19) Dashboard". covid19.who.int. Archived from the original on 16 April 2020. Retrieved 12 November 2020.
  57. ^ a b c "WHO EMRO | WHO and KSRelief renew partnership to continue sustaining Yemen's health system | News | Yemen site". www.emro.who.int. Archived from the original on 10 November 2020. Retrieved 12 November 2020.
  58. ^ Ali Maher O, Pichierri G, Farina G, Panu Napodano CM, Bellizzi S (August 2020). "COVID-19 Response and Complex Emergencies: The Case of Yemen". Disaster Medicine and Public Health Preparedness. 14 (4): e27–e28. doi:10.1017/dmp.2020.271. PMC 7443562. PMID 32713416.
  59. ^ Mousavi SM, Anjomshoa M (July 2020). "COVID-19 in Yemen: a crisis within crises". International Journal for Equity in Health. 19 (1): 120. doi:10.1186/s12939-020-01231-2. PMC 7351642. PMID 32652995.
  60. ^ "50 suspected cholera cases every hour for five years in Yemen - Oxfam". Oxfam International. 24 March 2020. Archived from the original on 11 November 2020. Retrieved 12 November 2020.
  61. ^ a b "Canada pledges $40M to 'avert catastrophe' in Yemen | CBC News". CBC. Archived from the original on 7 November 2020. Retrieved 10 November 2020.
  62. ^ a b c d "Yemen: UN makes urgent funding plea as vital operations end". www.aljazeera.com. Archived from the original on 29 September 2020. Retrieved 10 November 2020.
  63. ^ Gladstone R (23 June 2017). "Saudis, at War in Yemen, Give Country $66.7 Million in Cholera Relief". The New York Times. Archived from the original on 1 July 2017. Retrieved 1 July 2017.
  64. ^ McKernan B (29 September 2017). "Yemen's man-made cholera crisis is set to become the worst outbreak on record". The Independent. Archived from the original on 29 December 2017. Retrieved 21 April 2019.
  65. ^ "Yemen: Over 460K cases of cholera registered to date this year". OCHA. 8 July 2019. Archived from the original on 15 February 2023. Retrieved 10 November 2020.
  66. ^ a b c "United States Announces Additional Humanitarian Assistance for Yemen | Press Release | U.S. Agency for International Development". www.usaid.gov. 3 April 2018. Archived from the original on 19 November 2020. Retrieved 10 November 2020.
  67. ^ a b c LaForgia M (28 March 2020). "U.S. Cuts Health Care Aid to Yemen Despite Worries About Coronavirus". The New York Times. ISSN 0362-4331. Archived from the original on 11 November 2020. Retrieved 10 November 2020.
  68. ^ a b c d "UK renews push to tackle world's worst cholera outbreak in Yemen: We Will Respond as Soon as Possible". GOV.UK. Archived from the original on 6 December 2020. Retrieved 28 November 2020.
  69. ^ Noden A (28 August 2018). "UK deploys new model to predict cholera outbreaks in Yemen". Health Europa. Archived from the original on 9 December 2020. Retrieved 28 November 2020.
  70. ^ a b "World Bank Mobilizes US$200 Million to Combat Cholera in Yemen". World Bank. Archived from the original on 28 November 2020. Retrieved 10 November 2020.
  71. ^ "Continued cholera epidemic in Yemen". The Global Alliance Against Cholera (G.A.A.C). 7 June 2021. Archived from the original on 15 February 2023. Retrieved 17 August 2021.
  72. ^ "WHO EMRO - Cholera cases in Yemen - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  73. ^ "WHO EMRO - Update on cholera cases in Yemen - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  74. ^ "WHO EMRO - Cholera update in Yemen, 23 October 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  75. ^ "WHO EMRO - Update on the cholera situation in Yemen, 30 October 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  76. ^ a b "WHO EMRO - Cholera update in Yemen, 6 November 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  77. ^ "WHO EMRO - Cholera update, Yemen, 17 November 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  78. ^ "WHO EMRO - Cholera cases in Yemen, 24 November 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  79. ^ "WHO EMRO - Additional cholera cases reported in Yemen - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  80. ^ "WHO EMRO - Update on cholera cases reported in Yemen - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  81. ^ "WHO EMRO - Weekly update - Cholera cases in Yemen, 13 December 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  82. ^ "WHO EMRO - Weekly update: Cholera cases in Yemen, 29 December 2016 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  83. ^ "WHO EMRO - Weekly update: cholera cases in Yemen, 15 January 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  84. ^ "WHO EMRO - Weekly update: cholera cases in Yemen, 23 January 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  85. ^ "WHO EMRO - Update on cholera in Yemen, 26 February 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  86. ^ "WHO EMRO - Weekly update: cholera cases in Yemen, 7 March 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  87. ^ "WHO EMRO - Weekly update: cholera cases in Yemen, 21 March 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  88. ^ Back-calculated from http://www.emro.who.int/pandemic-epidemic-diseases/cholera/weekly-update-cholera-in-yemen-20-may-2017.html Archived 3 November 2018 at the Wayback Machine
  89. ^ "WHO EMRO - Weekly update - cholera in Yemen, 20 May 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  90. ^ "WHO EMRO - Weekly update - cholera in Yemen, 10 June 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  91. ^ "WHO EMRO - Weekly update - cholera in Yemen, 15 June 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  92. ^ "WHO EMRO - Weekly update - cholera in Yemen, 22 June 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  93. ^ "WHO EMRO - Weekly update - cholera in Yemen, 29 June 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  94. ^ "WHO EMRO - Weekly update - cholera in Yemen, 6 July 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  95. ^ "WHO EMRO - Weekly update - cholera in Yemen, 18 July 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  96. ^ "WHO EMRO - Weekly update - cholera in Yemen, 27 July 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  97. ^ "WHO EMRO - Outbreak update - cholera in Yemen - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  98. ^ a b "WHO EMRO - Outbreak update - cholera in Yemen, 19 December 2017 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 December 2018. Retrieved 14 March 2019.
  99. ^ a b "WHO EMRO | Outbreak update – Cholera in Yemen, 31 May 2018 | Cholera | Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 1 November 2018. Retrieved 10 November 2018. The cumulative total of suspected cholera cases, from 27 April 2017 to 20 May 2018, is 1 100 720 and 2 291 associated deaths (case fatality rate 0.21%).
  100. ^ "WHO EMRO - Outbreak update - cholera in Yemen, 18 January 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  101. ^ "WHO EMRO - Outbreak update - cholera in Yemen, 1 February 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  102. ^ "WHO EMRO - Outbreak update – cholera in Yemen, 1 March 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  103. ^ "WHO EMRO - Outbreak update – cholera in Yemen, 5 April 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  104. ^ "WHO EMRO - Outbreak update – cholera in Yemen, 3 May 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  105. ^ "WHO EMRO - Outbreak update – Cholera in Yemen, 19 July 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  106. ^ "WHO EMRO - Outbreak update – Cholera in Yemen, 11 October 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  107. ^ a b "WHO EMRO - Outbreak update – Cholera in Yemen, 8 November 2018 - Cholera - Epidemic and pandemic diseases". WHO EMRO. Archived from the original on 29 November 2018. Retrieved 14 March 2019.
  108. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 7 December 2018 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 31 October 2020.
  109. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 20 December 2018 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 8 November 2020. Retrieved 31 October 2020.
  110. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 31 December 2018 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 31 October 2020.
  111. ^ "WHO EMRO | Outbreak update - Cholera in Yemen 16 December 2018 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 31 October 2020.
  112. ^ "WHO EMRO | Outbreak update - Cholera in Yemen 30 December 2018 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 8 November 2020. Retrieved 31 October 2020.
  113. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 6 January 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 8 November 2020. Retrieved 31 October 2020.
  114. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 13 January 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 31 October 2020.
  115. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 20 January 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 7 November 2020. Retrieved 31 October 2020.
  116. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 3 February 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 7 November 2020. Retrieved 31 October 2020.
  117. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 17 February2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 7 November 2020. Retrieved 31 October 2020.
  118. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 07 April 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 8 November 2020. Retrieved 31 October 2020.
  119. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 14 April 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 21 April 2019. Retrieved 31 October 2020.
  120. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 28 April 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 5 November 2020. Retrieved 31 October 2020.
  121. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 5 May 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 7 November 2020. Retrieved 31 October 2020.
  122. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 12 May 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 25 January 2021. Retrieved 31 October 2020.
  123. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 19 May 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 7 November 2020. Retrieved 31 October 2020.
  124. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 26 May 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 4 November 2020. Retrieved 31 October 2020.
  125. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 2 June 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 5 November 2020. Retrieved 31 October 2020.
  126. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 9 June 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 4 November 2020. Retrieved 31 October 2020.
  127. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 16 June 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 8 January 2021. Retrieved 31 October 2020.
  128. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 23 June 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 4 November 2020. Retrieved 31 October 2020.
  129. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 30 June 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 6 November 2020. Retrieved 31 October 2020.
  130. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 7 July 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 1 November 2020. Retrieved 2 November 2020.
  131. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 21 July 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 28 June 2020. Retrieved 2 November 2020.
  132. ^ "WHO EMRO | Outbreak update - Cholera in Yemen 28 July 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  133. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 4 August 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  134. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 11 August 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  135. ^ "WHO EMRO | Outbreak update - Cholera in Yemen, 18 August 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  136. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 25 August 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  137. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 1 September 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 14 July 2020. Retrieved 2 November 2020.
  138. ^ "WHO EMRO | Outbreak update - Cholera in Yemen 29 September 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  139. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 6 October 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  140. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 13 October 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  141. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 20 October 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  142. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 27 October 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  143. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 03 November 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  144. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 10 November 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  145. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 17 November 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  146. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 1 December 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  147. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 22 December 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 18 July 2020. Retrieved 2 November 2020.
  148. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 29 December 2019 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 18 July 2020. Retrieved 2 November 2020.
  149. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 5 January 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  150. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 12 January 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 22 November 2020. Retrieved 2 November 2020.
  151. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 26 January 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  152. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 17 May 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 26 August 2020. Retrieved 2 November 2020.
  153. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 24 May 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 12 August 2020. Retrieved 2 November 2020.
  154. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 7 June 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 25 July 2022. Retrieved 2 November 2020.
  155. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 14 June 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 6 November 2020. Retrieved 2 November 2020.
  156. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 21 June 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 8 November 2020. Retrieved 2 November 2020.
  157. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 28 June 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 18 July 2020. Retrieved 2 November 2020.
  158. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 12 July 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 25 July 2022. Retrieved 2 November 2020.
  159. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 19 July 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 9 November 2020. Retrieved 2 November 2020.
  160. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 26 July 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 9 November 2020. Retrieved 2 November 2020.
  161. ^ "WHO EMRO | Outbreak update – Cholera in Yemen, 2 August 2020 | Cholera | Epidemic and pandemic diseases". www.emro.who.int. Archived from the original on 13 October 2020. Retrieved 2 November 2020.
  162. ^ "Cholera outbreaks". World Health Organization EMRO. Archived from the original on 31 December 2022. Retrieved 31 December 2022.