Using Precipitation Data to Assess Risk of Cholera Outbreaks

Diarrheal diseases such as cholera continue to be a public health threat. Prediction of an outbreak of diarrheal disease, specifically cholera, following a natural disaster remains a challenge, especially in regions lacking basic safe civil infrastructure [water, sanitation and hygiene (WASH)]. The underlying mechanism of a cholera outbreak is associated with disruption in the human access to safe WASH infrastructure that results in the population using unsafe water containing pathogenic vibrios. Presence and abundance of Vibrio cholerae, the causative agent of cholera, are related to modalities of the environment and regional weather as well as the climate systems. Major cholera outbreaks occur in two dominant forms: (a) epidemic, characterized by a sudden and sporadic occurrence of a large number of cholera cases and (b) endemic, in which human cholera cases occur on annual scales with distinct and characteristic seasonality. Natural disasters characteristically leave a trail of destruction, the result of which may be a human population deprived of access to WASH infrastructure. For example, under normal circumstances, the likelihood of a cholera outbreak is low, since the human