Volume 94, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



In 1998, a cholera epidemic in east Africa reached the Comoros Islands, an archipelago in the Mozambique Channel that had not reported a cholera case for more than 20 years. In just a little over 1 year (between January 1998 and March 1999), Grande Comore, the largest island in the Union of the Comoros, reported 7,851 cases of cholera, about 3% of the population. Using case reports and field observations during the medical response, we describe the epidemiology of the 1998–1999 cholera epidemic in Grande Comore. Outbreaks of infectious diseases on islands provide a unique opportunity to study transmission dynamics in a nearly closed population, and they may serve as stepping-stones for human pathogens to cross unpopulated expanses of ocean.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. Mengel MA, Delrieu I, Heyerdahl L, Gessner BD, , 2014. Cholera outbreaks in Africa. Curr Top Microbiol Immunol 379: 117144. [Google Scholar]
  2. World Health Organization, 2008. Global Task Force on Cholera Control Cholera Country Profile: Comoros. Available at: http://www.who.int/cholera/countries/ComorosCountryProfile2008.pdf. Accessed May 19, 2015. [Google Scholar]
  3. Piarroux R, Bompangue D, Tibayrenc M, , 2007. Needs for an integrative approach of epidemics: The example of cholera. , ed. Encyclopedia of Infectious Diseases. Hoboken, NJ: John Wiley and Sons, 639654.[Crossref] [Google Scholar]
  4. Ministère de la Santé Publique et de la Population, Direction de la Population, 1997. République fédérale islamique des Comores, Projet FNUAP/BIT/COI/95/PO2/UPP. Geneva: Organisation Internationale du Travail. [Google Scholar]
  5. Anselin L, , 1995. Local indicators of spatial association—LISA. Geogr Anal 27: 93115.[Crossref] [Google Scholar]
  6. Moran PAP, , 1950. Notes on continuous stochastic phenomena. Biometrika 37: 1723.[Crossref] [Google Scholar]
  7. Kulldorff M and Information Management Services, Inc., 2015. SaTScan™ v9.4: Software for the spatial and space-time scan statistics. Available at: http://www.satscan.org/.
  8. Kulldorff M, , 1997. A spatial scan statistic. Commun Stat Theory Methods 26: 14811496.[Crossref] [Google Scholar]
  9. Gaudart J, Rebaudet S, Barrais R, Boncy J, Faucher B, Piarroux M, Magloire R, Thimothe G, Piarroux R, , 2013. Spatio-temporal dynamics of cholera during the first year of the epidemic in Haiti. PLoS Negl Trop Dis 7: e2145.[Crossref] [Google Scholar]
  10. Bompangue Nkoko D, Giraudoux P, Plisnier PD, Tinda AM, Piarroux M, Sudre B, Horion S, Tamfum JJ, Ilunga BK, Piarroux R, , 2011. Dynamics of cholera outbreaks in Great Lakes region of Africa, 1978–2008. Emerg Infect Dis 17: 20262034. [Google Scholar]
  11. Piarroux R, Barrais R, Faucher B, Haus R, Piarroux M, Gaudart J, Magloire R, Raoult D, , 2011. Understanding the cholera epidemic, Haiti. Emerg Infect Dis 17: 11611168.[Crossref] [Google Scholar]
  12. Xia Y, Björnstad ON, Grenfell BT, , 2004. Measles metapopulation dynamics: a gravity model for epidemiological coupling and dynamics. Am Nat 164: 267281.[Crossref] [Google Scholar]
  13. World Health Organization, 1998. Cholera in 1997. Wkly Epidemiol Rec 73: 201208. [Google Scholar]
  14. World Health Organization, 1999. Cholera in 1998. Wkly Epidemiol Rec 74: 257264. [Google Scholar]
  15. The World Health Organization, 1998. 1998—Cholera in the Comoros Islands—Update. Available at: http://www.who.int/csr/don/1998_02_20a/en/. Accessed May 19, 2015. [Google Scholar]
  16. IRIN, 2007. Comoros: An Uninvited Wedding Guest. Available at: http://www.irinnews.org/report/73706/comoros-an-uninvited-wedding-guest. [Google Scholar]
  17. Parola P, Gazin P, Pradines B, Parzy D, Delmont J, Brouqui P, , 2004. Marseilles: a surveillance site for malaria from the Comoros Islands. J Travel Med 11: 184186.[Crossref] [Google Scholar]
  18. International Federation of Red Cross and Red Crescent Societies, 2008. Comoros: Cholera. DREF operation no. MDRKM001. Available at: http://www.ifrc.org/docs/appeals/07/mdrkm001fr.pdf. Accessed 19 May 2015. [Google Scholar]
  19. Bengtsson L, Gaudart J, Lu X, Moore S, Wetter E, Sallah K, Rebaudet S, Piarroux R, , 2015. Using mobile phone data to predict the spatial spread of cholera. Sci Rep 5: 8923.[Crossref] [Google Scholar]
  20. Martin S, Lopez AL, Bellos A, Deen J, Ali M, Alberti K, Anh DD, Costa A, Grais RF, Legros D, Luquero FJ, Ghai MB, Perera W, Sack DA, , 2014. Post-licensure deployment of oral cholera vaccines: a systematic review. Bull World Health Organ 92: 881893.[Crossref] [Google Scholar]
  21. Rebaudet S, Sudre B, Faucher B, Piarroux R, , 2013. Cholera in coastal Africa: a systematic review of its heterogeneous environmental determinants. J Infect Dis 208 (Suppl 1): S98S106.[Crossref] [Google Scholar]
  22. Duval P, Champetier de Ribes G, Ranjalahy J, Quilici ML, Fournier JM, , 1999. Cholera in Madagascar. Lancet 353: 2068.[Crossref] [Google Scholar]

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  • Received : 28 May 2015
  • Accepted : 08 Sep 2015
  • Published online : 06 Jan 2016

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