Cholera outbreak in a fishing community with inadequate water, sanitation, and hygiene infrastructure: A descriptive investigation at Kasensero Landing Site, Uganda

Introduction: On 26 April 2024, Kyotera District health officials reported suspected cholera cases at Kasensero Landing Site, a fishing community along Lake Victoria with known water, sanitation and hygiene (WASH) vulnerabilities. We investigated the outbreak to confirm its existence, characterize cases by person, place and time, assess WASH conditions, and evaluate the response. Methods: We conducted a descriptive outbreak investigation reviewing outpatient records at Kasensero Health Center II from 1 April to 14 May 2024. Standard case definitions were applied where suspected (acute watery diarrhoea ± vomiting in persons ≥2 years, or acute watery diarrhoea with some or severe dehydration in children <2 years); confirmed (Vibrio cholerae O1/O139 isolated by culture or detected by rapid diagnostic test). Data were analyzed descriptively using Microsoft Excel. Field observations assessed WASH infrastructure and response efforts using the WHO Five Pillars framework. Results: We identified 52 suspected cases, of which 14 (26.9%) were laboratory-confirmed. The epidemic curve was consistent with common-source exposure. Confirmed cases were geographically clustered in Kimwanyi Cell 5 (92.9%; 95% CI: 66.1% – 99.8%) and predominantly working-age adults (78.6% aged 21-60 years) with equal sex distribution. Field observations revealed heavy reliance on untreated lake water, inadequate latrine coverage, open defecation, and absent handwashing facilities. Conclusion: This outbreak was consistent with common-source exposure in a high-risk WASH setting. Preventing future outbreaks requires sustained investment in safe water supply, sanitation facilities, hygiene promotion, oral cholera vaccination, and strengthened laboratory diagnostics for fishing communities along Lake Victoria.