Haiti's cholera resurgence has caused 88,087 cases and 1,324 deaths since 2022

Cholera has come back to Haiti and stayed. Since the country reported a resurgence in October 2022, the epidemic has caused 88,087 suspected cases and 1,324 deaths through December 2024 — a return of a disease that spreads wherever safe water and functioning health care break down [s1]. Two new analyses fill in what that toll looks like on the ground, and what has helped hold it down.

The first, a study of 17,912 suspected cholera patients treated at 15 cholera treatment centres in the Artibonite and Centre departments between October 2022 and December 2024, recorded 134 deaths, an overall case-fatality ratio of 0.7% [s1]. Just over half the patients were male (9,056 of 17,822), and 32.2% were children aged five or under (5,688 of 17,659) — a reminder that cholera concentrates in the young [s1]. A quarter arrived with severe dehydration (4,490 of 17,912), and 65.1% reported vomiting (8,951 of 13,759) [s1].

Who died, and why the ratio improved

After accounting for differences between treatment centres, three factors stood out as predictors of death: being aged 60 or older (adjusted odds ratio 6.08, 95% CI 3.56–10.38), arriving with severe dehydration (aOR 5.24, 2.85–9.64), and vomiting (aOR 2.96, 1.33–6.56) [s1]. Cholera can kill within hours through fluid loss, and each of those is a marker of either advanced illness or reduced physiological reserve. Encouragingly, the odds of dying fell sharply after the first year: compared with 2022, patients treated in 2023 (aOR 0.32, 0.20–0.50) and 2024 (aOR 0.24, 0.07–0.79) were far less likely to die, consistent with treatment capacity catching up to the outbreak [s1].

That improvement is worth reading carefully. A case-fatality ratio of 0.7% across the two departments is low for cholera, which can exceed several percent where treatment is out of reach, and the further drop after 2022 suggests that the bottleneck was access to rehydration rather than the severity of the strain [s1]. The disease itself is simple to treat: most patients recover with oral rehydration solution, and even severe cases survive with prompt intravenous fluids and antibiotics [s3]. The deaths that do occur cluster, as this study shows, among the very old and those who reach care already severely dehydrated — the people for whom a delay of hours is decisive [s1].

A vaccine still working, five years on

The second study asks whether the oral cholera vaccine deployed in Haiti years earlier still mattered. In a case-control study in Mirebalais between October 2022 and February 2023, researchers compared 93 confirmed cholera cases with 135 community controls, all of whom had been eligible for a killed oral cholera vaccine campaign back in 2017 [s2]. Just 22% of the cases reported having been vaccinated, against 51% of the controls — and after adjustment, a single dose or more of the vaccine was associated with 78% protection against cholera a full five years later (95% CI 57–89, p<0.0001) [s2]. WHO recommends killed oral cholera vaccines as part of cholera prevention and control, but solid data on how long that protection lasts have been scarce; a durable effect at five years is a useful and somewhat reassuring signal for how campaigns are timed and boosted [s2].

The larger picture

Cholera is preventable and treatable, yet it persists as a marker of inequity. WHO describes the disease as an indicator of the absence of social and economic development, and estimates 1.3 to 4.0 million cases and 21,000 to 143,000 deaths worldwide each year, driven above all by gaps in safe water, sanitation and hygiene [s3]. Haiti's resurgence sits squarely in that pattern: an outbreak that took hold as basic services frayed, that hit children and the old hardest, and that has been blunted — not by any single measure — but by rebuilt treatment capacity and by protection banked from a vaccination campaign years earlier [s1][s2][s3].

This article is informational and is not medical advice.

Sources

• [s1] "Predictors of mortality from diarrhea during a cholera outbreak in Haiti's Artibonite and Centre regions, 2022–2024," PLOS Neglected Tropical Diseases, 14 August 2026. https://doi.org/10.1371/journal.pntd.0014626
• [s2] "5-Year effectiveness of an oral cholera vaccine in a cholera outbreak in rural Haiti: a case-control study," The Lancet Regional Health – Americas, 30 May 2026. https://doi.org/10.1016/j.lana.2026.101500
• [s3] World Health Organization, "Cholera" (fact sheet). https://www.who.int/news-room/fact-sheets/detail/cholera