The use of cholera oral vaccine for containment of the 2019 disease outbreak in Sudan.

A cholera outbreak in Blue Nile and Sennar states, south-eastern and southern Sudan, took place during September-December 2019. An outbreak surveillance sample collection was made. Vibrio cholerae O1 Ogawa was isolated from clinical samples of all confirmed 200 and 132 cases in Blue Nile state and Sennar state, respectively. The case fatality rate was higher in Blue Nile state, 4% compared with only 2.3% in Sennar state. The Euvichol-Plus oral cholera vaccine was rapidly deployed for the first time in Sudan to the most at-risk populations in the two affected states, 1 471 188 and 1 546 542 individuals in Sennar and Blue Nile states, respectively. The rapid deployment of cholera vaccines as the major prevention and control strategy was successful and helped greatly with the containment of this epidemic. In-depth genomics studies are crucial for understanding the disease dynamics in Sudan by identifying locally circulating strains of the bacteria and further improving prevention and control strategy by characterising the susceptibility and resistance of these locally circulating strains to currently used antibiotics.