A Risk Assessment of Possible Post-Earthquake Cholera Outbreak in Nepal
Based on our assessment, the risk of a cholera outbreak is alarmingly high in several earthquake-
affected districts. The prevailing conditions limited access to clean water, inadequate sanitation,
and poor hygiene create an environment conducive to cholera transmission. This risk is further
underscored by repeated outbreaks in past years.
The 2015 earthquake has significantly amplified the threat, as infectious cholera strains continue
to circulate, as documented in multiple reports from both Kathmandu and regions beyond the
valley. Moreover, the health system’s ability to contain outbreaks has been severely
compromised due to infrastructure damage, resource constraints, and logistical challenges. As a
result, the probability of a large-scale, if not catastrophic, outbreak has escalated similar to the
cholera outbreak that followed Haiti’s 2010 earthquake.
However, unlike Haiti, some individuals in Nepal may have partial immunity due to prior
exposure to cholera. Yet, given that immunity is not lifelong, a substantial susceptible population
has likely accumulated in the high-risk northern districts most affected by the earthquake. The
impending monsoon season further compounds these concerns, as heavy rains can exacerbate
waterborne disease transmission while simultaneously straining an already fragile public health
system particularly in remote villages.