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Strategy, Demand, Management, and Costs of an International Cholera Vaccine Stockpile

The cholera outbreak still ongoing in Haiti has caused >530 000 clinical cases affecting >5% of the country’s total population. About half of the patients have required
hospitalization, and about 7 000 cholera patients have died [1]. The Haitian outbreak is the most recent in a series of cholera epidemics over the last 5 years to strike large populations with high mortality. According to World Health Organization (WHO) reporting, the majority of recognized cholera outbreaks occur in sub-Saharan Africa. A 15-month outbreak in Angola during 2005– 2006 caused >85 000 cases and >3200 deaths [2, 3]. Another 11-month outbreak in Zimbabwe caused 98 000 hospitalizations and 4300 deaths [4]. These are likely underestimates of the magnitude of the outbreaks, owing to inadequate surveillance.