Cholera deaths increased by 30% in 2025, despite fewer cases being reported to the World Health Organization (WHO).
In 2025, 47 countries reported 451 499 cholera cases and 7870 deaths to WHO. This is the highest number of annual cholera deaths reported to WHO since 1999. These figures reflect surveillance data reported to WHO and not the actual global burden of cholera, which is estimated to be substantially higher as many cases go unreported.
Seven countries – Angola, Bangladesh, the Democratic Republic of the Congo, Nigeria, South Sudan, Sudan and Yemen – accounted for around 90% of all reported cholera cases and deaths globally. The WHO African Region reported the largest burden, with a 34% increase in cases and a 58% increase in deaths compared with 2024.
These findings are published in the latest edition of the Weekly Epidemiological Record alongside updates about two other epidemic-prone bacterial diseases: meningitis and plague.
"The rise in cholera deaths is a reminder of the challenge ahead,” said Dr Chikwe Ihekweazu, Executive Director of WHO's Health Emergencies Programme. “No one should be dying from cholera today when we have the tools to prevent and treat this disease. The concentration of cases and deaths in a small number of countries shows where targeted investments in safe water, sanitation and hygiene could have the greatest impact. Combined with stronger disease surveillance, community engagement, vaccination and access to quality care, these investments can help turn this trend around."
Cholera is an acute diarrhoeal disease caused by Vibrio cholerae bacteria. The disease spreads through food and water contaminated with faeces, especially in areas without safe water and sanitation.
While cholera is preventable and treatable, it can be fatal if severe dehydration is not rapidly treated. More than one in five reported cholera deaths occurred outside health facilities, highlighting that too many patients are still not reaching care in time. Among patients treated in health facilities, the fatality rate was below 1% – a threshold for adequate care – globally. However, the rate exceeded 1% in 12 countries in 2025.
Global production of oral cholera vaccines more than doubled between 2022 and 2025, increasing from around 30 million to approximately 80 million doses annually, significantly improving vaccine availability. Last year, the International Coordinating Group (ICG) on Vaccine Provision approved 71 million doses for use in affected countries, including 20 million doses for preventive vaccination, which resumed earlier this year after being suspended for more than three years.
Vaccination is advancing the fight to defeat meningitis by 2030
Bacterial meningitis continues to place a substantial burden on countries in the African meningitis belt, an area extending from Senegal to Ethiopia where epidemics occur regularly. In 2025, 24 of the 26 countries in the region reported 21 526 suspected cases and 971 deaths to WHO, corresponding to a fatality rate of 4.5%. Among countries reporting data for both years, cases declined by 5.9% compared with the previous year.
Meningitis is the inflammation of the tissues surrounding the brain and spinal cord, with bacterial meningitis being the most serious type. Four types of bacteria account for most cases of bacterial meningitis worldwide.
Vaccination has transformed the efforts to combat meningococcal meningitis, one of the main causes of bacterial meningitis. Since the introduction of the meningococcal A conjugate vaccine in 2010, cases of serogroup A have declined by more than 99% among vaccinated populations, and no confirmed case has been reported since 2017 in countries that introduced the vaccine.
A vaccine offering broader protection against five meningococcal serogroups, Men5CV/MMCV, is now being introduced in the region for both outbreak response through the ICG and preventive vaccination campaigns. In 2025, Niger became the first country to carry out a country-wide campaign using this vaccine.
Surveillance remains essential to control plague
Plague is a bacterial disease that usually spreads between animals through fleas and can sometimes infect people.
Between 2019 and 2025, 10 countries reported suspected human plague cases to WHO, six of which reported confirmed cases. Overall, 3847 suspected cases and 423 deaths were reported to WHO, corresponding to a case fatality rate of 11%. Most cases were reported from the Democratic Republic of the Congo and Madagascar, where plague remains endemic in some areas. Plague may also occur in countries that do not report cases, and annual case numbers fluctuated depending on the timing, location and magnitude of outbreaks.
Continued surveillance of rodent and other animal populations, together with rapid response to outbreaks, remains essential to detect plague early, reduce transmission and prevent larger outbreaks.
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