The Red Cross estimates that cholera could affect one million people in the Arabian Peninsula country of Yemen, By the end of the year,
The cholera outbreak in Yemen is being described as "unprecedented" and "the worst ... in the world.” According to the Red Cross, there are currently about 750,000 cases of the infectious disease — up from 276,000 on just July 5.
"Given this trend, we could reach up to 1 million by the end of the year," International Committee of the Red Cross delegation in Yemen Alexandre Faite told CNN.
Cholera is a diarrheal illness of the small intestine that can be deadly within hours if left untreated, according to the World Health Organization. It's typically contracted from contaminated water and symptoms include severe vomiting, nausea, and diarrhea which leads to dehydration, cramps, seizures, coma and death. Cholera kills up to 143,000 people on average each year, the WHO said.
In Yemen, a bloody civil war that's gripped the country since March of 2015, a collapsing health care system, famine and a devastated infrastructure have all lead to the virulent spread of the disease. The WHO approximates that about 5,000 more people are being infected every day.
Health care workers in Yemen's public hospitals are not being paid by the country, Faite said, leaving many concerned that a future outbreak could be even worse.
"The tragedy is, both malnutrition and cholera are easily treatable if you have access to basic health care. But hospitals and clinics have been destroyed, government health workers haven't been paid for almost a year, and the delivery of vital aid is being obstructed," Save the Children's country director for Yemen, Tamer Kirolos, told CNN.
Health system at breaking point
Faite said the health system is at a breaking point, raising concerns about how the country would cope with a further major outbreak. The situation is becoming even worse given that salaries for civil servants -- including health workers in public hospitals -- have not been paid for more than a year, he said.
"The tragedy is, both malnutrition and cholera are easily treatable if you have access to basic health care. But hospitals and clinics have been destroyed, government health workers haven't been paid for almost a year, and the delivery of vital aid is being obstructed," Tamer Kirolos, Save the Children's country director for Yemen, said previously.
"Yemen's health workers are operating in impossible conditions. Thousands of people are sick, but there are not enough hospitals, not enough medicines, not enough clean water. These doctors and nurses are the backbone of the health response -- without them, we can do nothing in Yemen," Dr. Tedros Adhanom Ghebreyesus, WHO director-general, said in a statement.
Dehydration from rapid loss of body fluids is the reason cholera can be so deadly within hours if not treated. But 80% of cholera cases can be treated and resolved with oral hydration salts -- if they are available.
Faite urged the full reopening of the airport in Sana'a, Yemen's largest city, to all humanitarian flights, to allow access for commercial flights to evacuate patients for treatment abroad. His organization, Médecins Sans Frontières and the United Nations can currently use the airport.
"To save lives in Yemen today, we must support the health system, especially the health workers. And we urge the Yemeni authorities -- and all those in the region and elsewhere who can play a role -- to find a political solution to this conflict that has already caused so much suffering," Tedros said.
A disease fueled by unrest
Cholera is rare in industrialized countries, and outbreaks occur predominantly in nations ravaged by civil unrest or natural disasters, where infrastructure, access to water and sanitation and health care systems are lost or damaged among a displaced population.
A cholera outbreak in the Democratic Republic of Congo has claimed 528 lives as of September 22, according to the World Health Organization.
The country has reported more than 27,000 suspected cases, with this year's outbreak appearing to be more severe than those of the past three years, the WHO said in a statement. The organization added that ongoing conflict and unrest have created population displacement and worsened access to safe water, sanitation and basic services.
Médecins Sans Frontières has treated 17,000 people and set up 30 treatment centers since the government declared a cholera epidemic on September 9, the nongovernmental organization confirmed. "We are carrying out a wide response to cover the most affected areas of the country, and the number of patients in our centers has declined in recent weeks," Cisco Otero, Médecins Sans Frontières' head of mission in Congo, said in a statement.
The Greater Kasai region of central Congo remains at high risk of disease spread due to poor health and safety conditions. The heavily endemic zone in the east experienced annual surges in cholera cases, while the disease continuously affects other zones throughout the year.
According to the United Nations Office for the Coordination of Humanitarian Affairs, youth, minors and internally displaced persons are among the most affected.
"The year 2017 is likely to be one of the worst years of this decade in number of cases (in Congo). An unusual and worrying increase has already been noted in the last few weeks, before the onset of the rainy season in the provinces most at risk," an agency representative said.
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