WVU professor working to predict, prevent a major cholera outbreak in Yemen

Antar Jutla, associate professor of civil and environmental engineering at West Virginia University, is part of a British-led humanitarian team that is working to predict and prevent a major outbreak of cholera in war-torn Yemen.

Cholera is a waterborne disease that can cause severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholera. The Centers for Disease Control and Prevention estimate that more than 2.9 million cases of cholera occur worldwide on an annual basis and is responsible for about 95,000 deaths each year.

Working with NASA satellite data, Jutla, along with researchers from the University of Maryland, have developed a model to predict the distribution of pathogenic cholera bacteria. The model looks at the interactions between cholera bacteria and things like temperature, precipitation, organic matter and salinity in water through the lens of civil infrastructure. Jutla's research is funded by NASA's Applied Sciences Program/Health and Air Quality Applications program.

In 2017, in proof of performance testing, the model was proven to have a high accuracy rate at a district level in areas identified as high risk of a cholera outbreak in Yemen.

In an effort designed to turn theory to reality, aid experts at the United Kingdom's Department for International Development are using Jutla's model in tandem with one of the world's most powerful supercomputers at The Met Office, the UK's national weather service, to predict where and when cholera will spread.

Last year, Yemen suffered the worst cholera outbreak in its history with more than 1 million suspected cases. Starting in March 2018, DFID began using this data to work with UNICEF to prevent the spread of the disease ahead of the rainy season. This allowed for the targeted delivery of such items as hygiene kits, clean water, cholera treatment kits and medical equipment to areas predicted to be at greatest risk.

The effort is working.

During the last week of June, there were 2,597 suspected cases and three deaths, down from 50,825 suspected cases and 179 deaths at the same time last year. Despite the predicted risk of cholera in Ibb – a governorate on the frontline of the conflict – being just as high this year as last year, there were only 672 suspected cases of cholera in July 2018 compared to 13,659 in July 2017.

"There aren't a lot of us doing this type of work yet," Jutla said. "But we have an opportunity to understand how these different factors create conditions favorable for the proliferation of water-related diseases like cholera and what their impact will be on society.

"If we can ensure safe drinking water and sanitation facilities, we can control this disease."

Julta has earned a prestigious CAREER award from the National Science Foundation for his research.

While officials note there are a number of other factors that could have contributed to a lower number of suspected cholera cases this year, i.e., a later rainy season, greater immunity against cholera and a change in national guidance for the recording of suspected cholera cases, it is clear that the new actions taken as a result of the predictions are saving lives and reducing suffering.

"The conflict in Yemen is the worst humanitarian crisis in the world, with millions of people at risk of deadly but preventable diseases such as cholera," said DFID Chief Scientist Charlotte Watts. "DFID has brought together experts from around the world to predict where the risk of cholera is highest so that aid workers can act before it's too late. By working joining up international expertise with those working on the ground, we have, for the very first time, used these sophisticated predictions to help save lives and prevent needless suffering for thousands of Yemenis."​