An outbreak of cholera that started in Haiti in October 2010 lay behind the surge in worldwide cholera cases in 2011. The reported total of some 600,000 cases - thought to greatly underrepresent the true number - was a two-decade high (see chart). By mid-August this year, Haiti's outbreak had calmed to fewer than 100 new cases a day. But Sierra Leone is seeing its biggest outbreak since 1996, with more than 10,000 cases and 180 deaths by 15 August. Its government has declared a state of emergency.
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