“Given the scale, severity, and interconnected nature of these outbreaks, the risk of further spread within and between countries is considered very high,” it said.

The UN health agency said the deteriorating outlook was “driven by conflict and poverty”, with rural and flood-affected areas especially vulnerable to the disease – an acute intestinal infection that spreads through food and water contaminated with bacteria, often from faeces.

Between Jan 1 and Aug 17, the WHO tracked 409,222 cases and 4,738 deaths reported globally.

While cases were down 20% on the same period last year, deaths were up 46%.

Cholera is gaining ground in several countries that had not reported substantial case numbers in years, like the Republic of Congo and Chad.

They are currently reporting the highest case fatality rates, at 7.7% and 6.8% respectively.

Cholera can kill within hours when not attended to, though it can be treated with simple oral rehydration, and antibiotics for more severe cases.

There has been a global increase in cholera cases, and their geographical spread, since 2021.