The number of cases rose to 30,621, the highest number on record, as Malawi suffers its worst cholera outbreak in 20 years.

Malawi’s worst cholera outbreak, health minister Khumbes Chibunda said, has killed more than 1,000 people even as cases have reached 30,621.

The World Health Organization said Tuesday’s death toll is past a grim milestone and surpasses the largest outbreak on record, which killed 968 people between 2001 and 2002.

Chibunda called on people to be more careful when handling the bodies of cholera victims before funerals.

“People who die from cholera may be washed by family members who then prepare funeral feasts… Outbreaks of cholera usually follow these feasts,” the minister said on Wednesday.

She called on people to use proper disinfection procedures with chlorine-based and plastic body bags.

Most of the deaths occurred in two major cities, Lilongwe and Blantyre, where children have recently returned to class yet Schools opened late to try to contain the spread.

Cholera regularly strikes the South African country during the rains from November to March, and deaths usually hover around 100. But there was an unusual spike in pollution during and after the festive season in 2022.

In November 2022, Malawi received nearly three million doses of oral cholera vaccine from the United Nations to ramp up its immunization campaign, but case numbers continue to rise.

All doses have been used, health ministry spokesman Adrien Chicumbe told AFP.

“The fact that there is only one company manufacturing cholera vaccine worldwide makes it difficult to get the life-saving drug,” he added, creating competition between countries in need.

Cholera, which causes diarrhea and vomiting, is caused by a bacterium that is generally transmitted through contaminated food or water.

George Jobe, director of the nonprofit Malawi Health Network, told AFP that myths and misinformation circulating online were making an already dire situation worse.

“Most people don’t think we have cholera,” he told AFP. In addition, “some religions do not allow them [sick] members to go to the hospital.”

In September, the World Health Organization warned that after years of decline, the planet was seeing an “alarming uptick” in cholera outbreaks, with climate change adding to traditional factors such as poverty and conflict.

The disease affects between 1.3 million and four million people worldwide each year, and causes up to 143,000 deaths.

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