South Asia

Assessing the risk of cholera in Nepal following the earthquake

David A. Sack, MD

Professor | Johns Hopkins Bloomberg School of Public Health
Tents in Lalitpur, Nepal after the recent earthquakes. Photo: Lorenz Von Seidlein (2015).

Tents in Lalitpur, Nepal after the recent earthquakes. Photo: Lorenz Von Seidlein (2015)

Will the earthquake in Nepal be followed by a massive cholera outbreak and can this risk be reduced if oral cholera vaccine is introduced?  These are some of the questions that led Dr. Lorenz von Seidlein, from the DOVE Project ( to travel to Nepal to help assess the risk in collaboration with Anuj Bhattachan from the International Vaccine Institute (, along with Deepak C. Bajracharya and Shyam Raj Upreti  from the Group for Technical Assistance, Kathmandu, Nepal (, a partner of DOVE Project. The assessment was requested by the Ministry of Health which was concerned about the risk of enteric diseases, including cholera.  In this PLOS Blog post, Dr. von Seidlein provides his perspective on the risks of cholera and the potential for OCV in Nepal.

Understanding Cholera in Nepal

Alfred Pach, PhD

Senior Social Scientist | International Vaccine Institute (IVI)

Anuj Bhattachan, MD

Associate Research Scientist | International Vaccine Institute (IVI)

Nepal is a land-locked country with geographical and socio-cultural proximity to the Gangetic plain and the Bhramputra River basins of West Bengal and Bangladesh. The latter is known as the ‘homeland of cholera’ for its critical relation to six of the seven recent cholera pandemics (1).  Nepal too battles with cholera, and a complex set of factors set the cholera scene in this Himalayan country.

Cost of illness for cholera in a high risk urban area in Bangladesh: an analysis from household perspective

Article published in BMC Infectious Diseases on 04-Nov-2013 by Sarker, A. R. et al.


Cholera poses a substantial health burden to developing countries such as Bangladesh. In this study, the objective is to estimate the economic burden of cholera treatments incurred by households. The study was carried out in the context of a large vaccine trial in an urban area of Bangladesh.

5 Year efficacy of a bivalent killed whole-cell oral cholera vaccine in Kolkata, India: A cluster-randomised, double-blind, placebo-controlled trial

Article published in The Lancet on 17-Oct-2013 by Bhattacharya, S. K. et al.


Efficacy and safety of a two-dose regimen of bivalent killed whole-cell oral cholera vaccine (Shantha Biotechnics, Hyderabad, India) to 3 years is established, but long-term efficacy is not. We aimed to assess protective efficacy up to 5 years in a slum area of Kolkata, India.