Abstract
Cholera is an acute diarrheal illness caused by Vibrio cholerae and occurs as widespread epidemics in Africa. In 2005, there were 31,719 cholera cases, with 458 deaths in the Republic of Senegal. We retrospectively investigated the climate origin of the devastating floods in mid-August 2005, in the Dakar Region of Senegal and the subsequent outbreak of cholera along with the pattern of cholera outbreaks in three other regions of that country. We compared rainfall patterns between 2002 and 2005 and the relationship between the sea surface temperature (SST) gradient in the tropical Atlantic Ocean and precipitation over Senegal for 2005. Results showed a specific pattern of rainfall throughout the Dakar region during August, 2005, and the associated rainfall anomaly coincided with an exacerbation of the cholera epidemic. Comparison of rainfall and epidemiological patterns revealed that the temporal dynamics of precipitation, which was abrupt and heavy, was presumably the determining factor. Analysis of the SST gradient showed that the Atlantic Ocean SST variability in 2005 differed from that of 2002 to 2004, a result of a prominent Atlantic meridional mode. The influence of this intense precipitation on cholera transmission over a densely populated and crowded region was detectable for both Dakar and Thiès, Senegal. Thus, high resolution rainfall forecasts at subseasonal time scales should provide a way forward for an early warning system in Africa for cholera and, thereby, trigger epidemic preparedness. Clearly, attention must be paid to both natural and human induced environmental factors to devise appropriate action to prevent cholera and other waterborne disease epidemics in the region.
Highlights
IntroductionIt has been well established that environmental conditions combined with climate are important factors in the dynamics of cholera, influencing the abundance and ecology of the pathogen naturally present in the environment and increasing exposure and risk of human infection
Cholera is an acute diarrheal illness caused by toxigenic Vibrio cholerae and occurs as widespread epidemics that are a major public health concern for Africa
The role of climate in cholera transmission has been extensively investigated in recent years because of growing concern about the effects of climate change on infectious disease dynamics [1,2,3]
Summary
It has been well established that environmental conditions combined with climate are important factors in the dynamics of cholera, influencing the abundance and ecology of the pathogen naturally present in the environment and increasing exposure and risk of human infection. This pattern is well documented, especially for Southeast Asia, but only a limited number of studies have focused on Africa, currently one of the most impacted continents [7,8,9,10,11]
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