Around 14,000 people from wards 11,12 and 13 of the Kathmandu Metropolitan City who were administered the first dose of the cholera vaccine missed the second dose.

According to the Epidemiology and Disease Control Division, over 37,000 people from the said wards were administered with first doses of the vaccine in May first week.

“Of them, only 23,473 people have taken the second dose of the vaccine,” said Bhola Adhikari, an official at the division. “The remaining others might be migrants and we guess they were not in the Valley at the time of administration of the second dose.”

The division had planned to administer the oral cholera vaccine to over 95,000 people above one-year-old from wards 11,12 and 13 of the Kathmandu Metropolitan City. Officials say that during the second round of vaccination, 18,000 people took their first doses.

“This shows that less than half the target population took the vaccine in the first round,” said Sajina Maharjan, an official at the Kathmandu Metropolitan City. “Thousands of people who took the vaccine in the first round did not come for their second doses.”

Health officials say that low uptake of vaccines, whether they are routine vaccines or Covid vaccines or those against cholera, is not a new thing in the Kathmandu Valley, especially in the Kathmandu Metropolitan City which does not even have a record of migrant population. Officials have also found many children in Kathmandu have not received even a single dose of routine vaccines.

The cholera vaccination campaign aims to lessen the risk of an outbreak of the deadly contagion and severity of infection in the upcoming monsoon, officials say.

Authorities had urged everyone above one year of age in the said wards to take the cholera vaccine.

Health Ministry officials say wards 11,12 and 13 were selected for vaccination against cholera, as they have been considered high-risk wards of the metropolis owing to poor drinking water and sanitation conditions.

Last year, the Kathmandu Valley witnessed a massive cholera outbreak in which at least 77 cases were confirmed. Hundreds of people suffered from the diarrheal infection that continued for months.

Vibrio cholera 01 Ogawa serotype was confirmed in stool samples of the victims at the time.

Cholera is a highly infectious disease that causes severe diarrhoea and vomiting, and leads to dehydration and even death within a few hours if left untreated.

Cases of cholera were reported at Bagbazar, Dillibazar, Balaju, Balkhu, Sanepa, Kapan, Naikap, Kageshwari Manohara, Bhaktapur, and Jaisidewal areas in the Valley.

Public health experts had said the number of reported cases could be just the tip of the iceberg, as only around 10 percent of the people infected with cholera develop severe symptoms such as watery diarrhoea and vomiting.

Along with vaccination, health authorities have also been running water, sanitation and hygiene programmes with the support of the World Health Organisation, Unicef and other agencies. They had also been collecting drinking water samples for testing.

A study carried out by the health ministry following the outbreak last year showed that nearly 70 percent of drinking water samples in Kathmandu Valley were found to have been contaminated with E coli and faecal coliform.

The cholera outbreak was blamed on contaminated water with the increase in rainfall and disruption in garbage collection in Kathmandu Valley. Several other factors, including the condition of supply pipes, water storage, and pollution in water sources affected the quality of water supplied to households, officials said.

Due to poor sanitation and hygiene conditions, Nepal is highly vulnerable to water-borne diseases, including diarrhoea, dysentery, typhoid, hepatitis, and cholera, with thousands of people falling sick every year.

In October 2021 also, a cholera outbreak in several local units of Kapilvastu killed at least six, including three minors and infected hundreds of people. Health authorities had launched a ring vaccination programme in the affected areas.

Doctors say launching awareness drives against water-borne diseases and ensuring safe drinking water are the only ways to save people from dying from water-borne diseases, including cholera. A combination of surveillance, water and sanitation measures, hygiene practices, social mobilisation, and treatment are required to contain the spread of the infection, according to them.

The World Health Organisation says cholera is a global threat to public health and a multifaceted approach is key to controlling the disease and reducing deaths.