The Weekly Epidemiological Record (WER) was first issued in 1926 by the Health Office of the League of Nations. It was entrusted to the World Health Organization (WHO) when it was created in 1948 and has appeared every week since then.
It serves as an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the IHR and on other communicable diseases of public health importance, including emerging or re-emerging infections.
An electronic version of the WER is accessible every Friday and can be downloaded free of charge.
Inside this issue
Highlighted signals and events
During epidemiological week 31 (27 July to 2 August 2026), WHO Public Health Intelligence (PHI) teams conducted digital event based surveillance (DEBS) to support the early detection and assessment of potential public health threats. During the reporting period, approximately 654 954 raw signals were scanned and triangulated through DEBS. From this large pool of signals, 29 signals and/or events met assessment thresholds and underwent further analysis and categorization. Of the 29 categorized signals, 27 represented unique signals. 19 signals and/or events were escalated for operational attention.
In the reporting week, three new events were verified through PHI activities. One Disease Outbreak News was published during this reporting week. A summary of identified raw signals, assessed signals, and published outputs is presented in the tables below.
| Screened signals1 | Signals categorized2 | Unique signals3 | Signals escalated4 |
| 654 954 | 29 | 27 | 19 |
1 Signals screened: Total volume of raw signals reviewed from across multiple sources during the reporting period.
2 Signals categorized: Number of signals categorized for further detailed WHO assessment and actions during the reporting period.
3 Unique signals: Count of distinct signals after removing duplicate or repeated entries from different sources within the same epidemiological week.
4 Signals escalated: Subset of categorized signals that triggered escalation actions.
| Region | Hazard |
| Africa | • Cholera • Lassa fever • Yellow fever |
| Americas | • Cholera • Hantavirus disease • Lassa Fever •Mpox • Not yet diagnosed • Substandard Falsified medical product • Alpha-gal syndrome •Bourbon virus |
| Eastern Mediterranean | • No publicly available signals identified |
| Europe | • Cyclospora |
| South-East Asia | • Not yet diagnosed |
| Western Pacific | •Circulating vaccine-derived poliovirus type 1 |
5 The absence of listed signals indicates that no publicly available signals were identified during the reporting period and does not imply absence of signal activity overall.
6 Signals designated as “Not yet diagnosed” refer to those with ongoing epidemiological and clinical investigations to determine the causative hazard or disease.
| Disease Outbreak News (1) | |
| • | Ebola disease caused by Bundibugyo virus - Democratic Republic of the Congo |
Multi-country outbreak of cholera
Data as of 28 June 2026
Global epidemiological update
In June 2026 (epidemiological weeks 23 to 26), a total of 47 758 new cholera and acute watery diarrhoea (AWD) cases were reported from 18 countries across four WHO regions, representing a 60% increase from the previous month and a 32% decrease compared with the same period last year (70 173 cases across 24 countries). The increase in reported cholera cases is associated with the surge in cases in Borno state in Nigeria, where conflict, population displacement, inadequate sanitation and rainfall have heightened the risk of transmission.
In June 2026, the African Region reported the highest number of cases (27 954 cases; 12 countries), followed by the Eastern Mediterranean Region (19 729 cases; four countries), the South-East Asia Region (67 cases; one country), and the Region of the Americas (eight cases; one country). No cases were reported from the European Region or the Western Pacific Region.
During the same period, 354 cholera-related deaths were reported globally, representing a 25% increase compared with the previous month. The highest number of deaths was recorded in the African Region (284 deaths; nine countries), followed by the Eastern Mediterranean Region (70 deaths; two countries). No deaths were reported from the Region of the Americas, the South-East Asia, the European or the Western Pacific regions.
From 1 January to 28 June 2026, a cumulative total of 163 031 cholera and AWD cases and 1686 deaths were reported from 26 countries across four WHO regions. Representing a 49.5% decrease in cases and 57% decrease in deaths compared with the same period last year (322 732 cases and 3925 deaths; 31 countries). The region with the highest reported case count was the African Region (90 049 cases; 18 countries), followed by the Eastern Mediterranean Region (72 032 cases; five countries), the Region of the Americas (642 cases; one country), and the South-East Asia Region (308 cases; two countries). During the same period, cholera deaths were reported in the African Region (1528 deaths), the Eastern Mediterranean Region (156 deaths), and the Region of the Americas (two deaths). No deaths were reported in other regions.
In recent years, conflict, mass displacement, disasters associated with natural hazards, and climate-related events have contributed to conditions that may facilitate cholera transmission, particularly in rural and flood-affected areas, where poor infrastructure and limited access to healthcare can delay treatment. These cross-border factors have made cholera outbreaks increasingly complex and harder to control.
The data presented here should be interpreted with caution. Potential underreporting and reporting delays may affect timeliness and accuracy, while variations in surveillance systems, standard case definitions, and laboratory capacities can limit direct comparability among countries. These factors also influence the global case fatality rate (CFR), requiring careful examination. Unless otherwise specified, the term ‘cholera cases’ includes both suspected and confirmed cases. Data in this report may be adjusted retrospectively as more information becomes available. For the latest data, please refer to the WHO Global Cholera and AWD Dashboard.
For the latest data, please refer to the WHO Global Cholera and AWD Dashboard.
-cases-per-100-000--1-january-to-28-june-2026.png?sfvrsn=14cdaf49_4 "Cholera and acute watery diarrhoea (AWD) cases per 100 000, 1 January to 28 June 2026")
| WHO Region | Country, territory, area | 1 January to 28 June 2026 | Last 28 days | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Cases | Deaths | CFR (%) | Cases per 100 000 | Cases | Deaths | CFR (%) | Monthly cases % change | Monthly deaths % change | ||
| African Region | Angola | 5 326 | 116 | 2.2 | 15 | 474 | 20 | 4.2 | -73 | -41 |
| Burundi | 1 497 | 4 | 0.3 | 12 | 334 | 2 | 0.6 | 77 | - | |
| Cameroon | 108 | 6 | 5.6 | 0 | 108 | 6 | 5.6 | - | - | |
| Central African Republic | 386 | 31 | 8.0 | 7 | 363 | 31 | 8.5 | 1 715 | - | |
| Chad | 109 | 3 | 2.8 | 1 | 109 | 3 | 2.8 | - | - | |
| Congo | 767 | 49 | 6.4 | 12 | 98 | 15 | 15.3 | -60 | 15 | |
| Democratic Republic of the Congo | 32 193 | 908 | 2.8 | 27 | 3 637 | 92 | 2.5 | 0 | 11 | |
| Ethiopia | 50 | 2 | 4.0 | 0 | - | - | - | - | - | |
| Kenya | 40 | 0 | 0.0 | 0 | 14 | 0 | 0.0 | -46 | - | |
| Malawi | 3 210 | 30 | 0.9 | 18 | 122 | 0 | 0.0 | -83 | - | |
| Mozambique | 7 570 | 66 | 0.9 | 26 | 70 | 0 | 0.0 | -70 | - | |
| Namibia | 213 | 0 | 0.0 | 7 | - | - | - | - | - | |
| Nigeria | 26 848 | 181 | 0.7 | 12 | 19 887 | 97 | 0.5 | 242 | 67 | |
| Rwanda | 58 | 0 | 0.0 | 0 | - | - | - | - | - | |
| South Sudan | 10 526 | 111 | 1.1 | 85 | 2 738 | 18 | 0.7 | 67 | -18 | |
| United Republic of Tanzania | 113 | 2 | 1.8 | 0 | - | - | - | - | - | |
| Zambia | 999 | 17 | 1.7 | 5 | - | - | - | - | - | |
| Zimbabwe | 36 | 2 | 5.6 | 0 | - | - | - | - | - | |
| Eastern Mediterranean Region | Afghanistan† | 61 524 | 32 | 0.1 | 188 | 18 232 | 14 | 0.1 | 34 | 75 |
| Pakistan§ | 4 090 | 0 | 0.0 | 2 | 653 | 0 | 0.0 | -6 | - | |
| Somalia | 233 | 0 | 0.0 | 1 | - | - | - | - | - | |
| Sudan | 847 | 117 | 13.8 | 2 | 320 | 56 | 17.5 | -38 | -8 | |
| Yemen¥ | 5 338 | 7 | 0.1 | 16 | 524 | 0 | 0.0 | -11 | - | |
| Region of the Americas | Haiti | 642 | 2 | 0.3 | 6 | 8 | 0 | 0.0 | -85 | - |
| South-East Asia Region | India# | 36 | 0 | 0.0 | 0 | - | - | - | - | - |
| Myanmar† | 272 | 0 | 0.0 | 1 | 67 | 0 | 0.0 | 24 | - | |
* Case and death numbers presented are not directly comparable due to differences in case definitions, reporting systems, and general underreporting. All data are subject to verification and change due to data availability and accessibility. Respective figures and numbers will be updated as more information becomes available. The data in Table 1 includes suspected, rapid diagnostic test (RDT) positive, and culture-confirmed cholera cases. As multiple countries report only total data on deaths, the reported CFR is calculated throughout based on the total number of deaths reported. The Global Task Force on Cholera Control (GTFCC) recommends that CFR be calculated using only facility deaths, with the number of community deaths reported separately.
** Missing data in this report do not imply the absence of cholera or AWD cases or deaths in the respective country. The data presented in this report are based on the latest available information and may not reflect the current situation.
† Afghanistan and Myanmar report AWD cases.
§ The reported number of suspected cholera and AWD cases is based on the available Public Health Bulletin published by the National Institute of Health of Pakistan.
¥ Includes all reported suspected cholera and AWD cases from Yemen.
# Among the total of 36 cases reported from India, 27 cases were confirmed.
WHO regional overviews
African Region
In June 2026, the African Region reported 27 954 new cholera cases across 12 countries, marking a 95% increase compared with the previous month. During this period, the highest numbers of cases were reported from Nigeria (19 887), the Democratic Republic of the Congo (3637), and South Sudan (2738). The increase in reported cholera cases is linked to a surge in infections in Borno state in Nigeria, impacted by conflict, population displacement, inadequate WASH conditions and rainfall.
Additionally, there were 284 cholera-related deaths reported, with the highest numbers coming from Nigeria (97), the Democratic Republic of the Congo (92), and Central African Republic (31).
From 1 January to 28 June 2026, a total of 90 049 cholera cases were reported across 18 countries in the African Region. The highest numbers of cases were reported from the Democratic Republic of the Congo (32 193), Nigeria (26 848), and South Sudan (10 526). During the same period, a total of 1528 deaths were reported from 15 countries. The highest numbers of deaths were reported from the Democratic Republic of the Congo (908), Nigeria (181), and Angola (116).
Eastern Mediterranean Region
In June 2026, the Eastern Mediterranean Region reported 19 729 new cholera and AWD cases across four countries, marking a 28% increase compared with the previous month. During this period, the highest numbers of cases were reported from Afghanistan (18 232), Pakistan (653), and Yemen (524). Additionally, there were 70 cholera-related deaths, showing similar numbers compared with the previous month. Those deaths were reported from Sudan (56) and Afghanistan (14).
From 1 January to 28 June 2026, a total of 72 032 cholera and AWD cases were reported across five countries in the Eastern Mediterranean Region. The highest numbers of cases were reported from Afghanistan (61 524), Yemen (5338), and Pakistan (4090). During the same period, a total of 156 deaths was reported from three countries: Sudan (117), Afghanistan (32), and Yemen (7).
Region of the Americas
In June 2026, the Region of the Americas reported eight new cholera cases in Haiti, marking an 85% decrease compared with the previous month. No deaths were reported during this period.
From 1 January to 28 June 2026, a total of 642 cholera cases and two deaths was reported in Haiti.
South-East Asia Region
In June 2026, the South-East Asia Region reported 67 new cholera and AWD cases, all from Myanmar, marking a 24% increase compared with the previous month. No deaths were reported during this period.
From 1 January to 28 June 2026, a total of 308 cholera and AWD cases were reported across two countries in the South-East Asia Region. Cases were reported from Myanmar (272) and India (36). No deaths were reported during this period.
* The epidemic curve of the Western Pacific Region is not included due to limited available weekly data. This does not imply the absence of cholera or AWD cases in the Region.
** Spikes in the Region of the Americas are likely due to batch reporting.
--1-january-2024-to-28-june-2026.png?sfvrsn=c9bd02ab_5 "Cholera and AWD cases by WHO Region (separate Y scales), 1 January 2024 to 28 June 2026")
Focus on selected subregions and countries
Angola
Between 1 January and 28 June 2026, Angola reported a total of 5326 cases and 116 deaths (CFR: 2.2%).
In June 2026, Angola reported 474 new cholera cases and 20 associated deaths (CFR: 4.2%). This represents a 73% decrease in cases and a 41% decrease in deaths compared with the previous month. The highest number of cases were reported in Benguela (26%), Malanje (17%), and Bengo (14%).
Many cholera hotspots are located in remote and hard-to-reach areas, limiting timely case detection, referral, and access to treatment, and thereby contributing to the elevated case fatality rate.
-and-distribution-of-cases-by-province-in-the-last-28-days-(right)--as-of-28-june-2026.png?sfvrsn=21964a31_4 "Weekly case trend (left) and distribution of cases by province in the last 28 days (right), as of 28 June 2026")
Democratic Republic of the Congo
Between 1 January 2026 and 28 June 2026, the Democratic Republic of the Congo reported a total of 32 193 cases and 908 deaths (CFR: 2.8%).
In June 2026, Democratic Republic of the Congo reported 3637 new cholera cases and 92 associated deaths (CFR: 2.5%). The number of cases remained stable compared to the previous month, while an 11% increase in deaths was observed. Overall, 18 out of 26 provinces have been affected, with the highest proportions from Nord-Kivu (31%), Sud-Kivu (19%), and Tanganyika (13%).
Transmission remains high in the East, particularly in lakeside communities, where limited access to safe water, inadequate WASH conditions, and population movements continue to drive transmission. Response efforts are further hampered by insecurity and conflict, which restrict access to affected hotspot areas. In addition, the provinces of Nord-Kivu, Sud Kivu, Ituri, Tshopo and Haut-Uele are facing the current Ebola Bundibugyo Virus Disease outbreak, compounding existing challenges related to healthcare, sanitation, displacement and insecurity.
Nigeria
Between 1 January and 28 June 2026, Nigeria reported a total of 26 848 cases and 181 deaths (CFR: 0.7%).
In June 2026, Nigeria reported 19 887 new cholera cases and 97 associated deaths (CFR: 0.5%). This represents a 242% increase in cases and a 67% increase in deaths compared with the previous month.
Borno State accounts for over 95% of the cases reported across the country in 2026 with Maiduguri, Jere, and Monguno Local Government Areas (LGAs) being the most affected areas. Conflict, population displacement, inadequate sanitation and rainfall have heightened the risk of cholera transmission.
South Sudan
Between 1 January and 28 June 2026, South Sudan reported a total of 10 526 cases and 111 deaths (CFR: 1.1%).
In June 2026, South Sudan reported 2738 new cholera cases and 18 associated deaths (CFR: 0.7%). This represents a 67% increase in cases and a 18% decrease in deaths compared with the previous month. During this period, cases were reported from Unity (93.5%), Upper Nile (5%), Lakes (1%), and Jonglei (0.5%) states. Rubkona in Unity state is driving the caseload, recording 2100 cases and 11 deaths in June (CFR: 0.5%).
Rubkona county hosts the largest internal displaced persons (IDPs) camps in the country with continued community cholera transmission of cholera due to inadequate water, sanitation, and hygiene conditions.
Annex 1. Data, table, and figure notes
Caution must be taken when interpreting all data presented. Differences are to be expected between information products published by WHO, national public health authorities, and other sources using different inclusion criteria and different data cut-off times. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change. Case definitions, laboratory testing strategies, reporting practices, and lag times differ across countries, territories, and areas. These factors, among others, influence the counts presented, with variable underestimation of the true case and death counts, and variable delays in reflecting these data at the global level.
‘Countries’ may refer to countries, territories, areas, or other jurisdictions of similar status. The designations employed, and the presentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries, territories, and areas are arranged under the administering WHO region. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted; the names of proprietary products are distinguished by initial capital letters.
Annex 2. Technical guidance and other resources
General
- Cholera fact sheet
- Ending Cholera, A Global Roadmap To 2030
- Global cholera strategic preparedness, readiness, and response plan 2023/24
- WHO’s Call for urgent and collective action to fight cholera
- Disease outbreak news Cholera – Multi-country with a focus on countries experiencing current surges
- Global Task Force on Cholera Control (GTFCC)
- AFRO Weekly outbreaks and emergency bulletin
- WHO Global Cholera and AWD Dashboard
- WHO AFRO Cholera Dashboard
- Cholera upsurge (2021-present) web page
Training
- GTFCC Laboratory training on Sample collection and testing with Rapid Diagnostic Tests for cholera for health care workers available in English, French, Arabic and Portuguese.
- GTFCC Laboratory job aids and fact sheets available in English, French, Arabic and Portuguese.
- GTFCC Cholera surveillance for health care workers. These courses are available in English and French.
- GTFCC Cholera surveillance for health authorities. These courses are available in English and French.
- Countries are encouraged to periodically self-assess their cholera surveillance systems using the GTFCC surveillance assessment method to identify priority activities for strengthening surveillance in line with GTFCC recommendations.
Technical guidance
- GTFCC fixed ORP interim guidance and planning
- Public health surveillance for cholera - Guidance document (2024), including tools and job aids. These recommendations are available in English, French, Arabic and Portuguese.
- GTFCC updated recommendations for cholera reporting to the regional and global levels, accompanied by an Excel reporting template, are available in English, French, Arabic and Portuguese.