El Nino Southern Oscillation shapes cholera in Africa

Five geographically coherent ENSO–cholera teleconnection groups in 30 African countries show distinct timing and strength of ENSO-linked effects on outbreak occurrence, duration, and incidence.

• Why it matters: Cholera is a climate-sensitive disease, but ENSO’s relationship to cholera in Africa has been poorly quantified despite most cholera deaths occurring there.
• What they did: Using 15 years of surveillance data across 30 African countries, the study applied novel statistical and simulation frameworks to identify five ENSO–cholera teleconnection groups.
• The result: For the unfolding major El Nino of 2026-27, projected cholera burden is two- to five-fold higher in Eastern and Horn of Africa than under ENSO-neutral conditions, supporting anticipatory action and dynamic attribution.

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