Myanmar's Cholera and Waterborne Disease Outbreak Risks Remain Very High

Two powerful earthquakes recently struck the central part of the Republic of the Union of Myanmar's Sagaing Region near Mandalay. The full scale of damage, deaths, and injuries has not yet been ascertained.

The World Health Organization's (WHO) Public Health Situation Analysis, released on April 3, 2025, says preliminary assessments indicate high casualties and trauma-related injuries, with an urgent need for emergency care. 

On April 2, 2025, the State Administration Council (SAC) reported that 3,003 people had died and 4,515 had been injured in the earthquake.

In the earthquake-affected areas, with limited access to safe water and worsening sanitation and hygiene conditions, the WHO says the risks for Acute Waterborne (AWD) - cholera outbreaks are assessed as very high. 

Since July 2024, AWD and cholera cases have surged in at least nine states, including Ayeyarwady, Bago, and Mandalay.

Mandalay, which faced a cholera outbreak in October 2024, remains at high risk for further outbreaks due to infrastructure damage and overcrowded shelters, significantly increasing the likelihood of cholera and other waterborne disease outbreaks.

From June 22, 2024, to March 23, 2025, 12,195 AWD cases (not all confirmed as cholera) were reported, along with three deaths.

A vaccination campaign using oral cholera vaccine (OCV) has been conducted in Yangon, Mon, and Mandalay, providing 2.4 million doses.

As of April 7, 2025, the U.S. CDC says, 'OCV vaccination may be considered for children and adults traveling to areas of active cholera transmission.'

In the United States, OCVs such as DUKORAL® are available at travel clinics and pharmacies.

The WHO wrote, 'These deteriorating conditions, combined with overcrowded temporary shelters and reduced sanitation services, significantly increase the risk of cholera and other waterborne disease outbreaks in the affected areas.'