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The unending cholera outbreak which started in June 2014 has claimed 243 lives nationwide. The disease was recorded in 130 out of the 216 districts, representing 60% of all districts in the 10 regions of the country as of December 28, 2014. A total of 28,953 cases have been recorded within the period. The Greater Accra Region topped the list of deaths with 121, followed by Central with 60; Brong Ahafo at third position with 26; Upper East Region, nine; Volta, eight; and Western, seven. The rest are Eastern Region, six; Ashanti, three; Northern, two; and Upper West, one. The number of cases recorded per region from highest to the lowest are Greater Accra - 20,197 case in 27 districts; Central - 3,846 cases in 16 districts; Eastern -1,875 cases in 19 districts; Brong Ahafo - 1,056 cases in 16 districts; Volta - 651 cases in seven districts; and Western - 429 cases in 11 districts. The rest are Upper East - 294 cases in 10 districts; Ashanti - 287 cases in 27 districts; Northern - 282 cases in five districts; and Upper West - 36 cases in three districts. Dr Emmanuel K. Dzotsi, Public Health Specialist at the Disease Surveillance Department of the Ghana Health Service (GHS), who compiled the figures for The Finder, warned that the potential for the outbreak to re-occur or continue is high, considering the continuous existence of risk factors such as inadequate supply of safe water, street vending of water and food, poor liquid and solid waste disposal, and choked drains, urban slums and poor food and personal hygiene. He explained that the case incidence trend of the outbreak continues to decline despite protracted outbreak in the Greater Accra Region. However, he said the cholera outbreak in the Upper East, Upper West, and Eastern regions have been declared over. �As the case incidence of cholera cases has come down significantly, regions are requested to ensure that districts and facilities do laboratory tests for all suspected cases - Rapid Test for all cases and sampling if numbers are high for rectal swabs and stool culture,� he said. He said regions should further ensure that districts that have not recorded cases for at least 14 days following the last reported case declare the outbreak over, and write and share outbreak over reports. �Likewise, regions with all districts not reporting cases for 14 days should declare outbreak over. In this regard, new confirmed cases should be investigated as fresh outbreak,� he added. Dr Dzotsi appealed to the Ministry of Water Resources and the Ghana Water Company Limited to ensure supply of safe water to affected communities without water. He also suggested continuous Mass Community Education and social mobilisation with announcements on cholera prevention in the affected areas. He charged Metropolitan, Municipal and District Assemblies (MMDAs) and the Food and Drugs Authority (FDA) to ensure that food and water vendors provide hygienic food and water. The Public Health Specialist appealed to the Ministry of Local Government and the FDA to enforce by-laws on environmental sanitation, water and food safety. Dr Dzotsi asked the National Technical Co-ordinating Committee (NTCC), Regional and District Emergency Management Committees to bring on board other stakeholders and partners in the management of the outbreak and prevention of further outbreaks. History of cholera in Ghana Ghana has seen outbreaks of the disease since the 1970s. A total of 9,542 cholera cases with 100 deaths were reported in Ghana in 2012, but no deaths were recorded in 2013, despite some reported cases of the disease in the country. In 2011, 10,628 cholera cases with 105 deaths were reported. Between 1970 and 2012, Ghana recorded a total of 5,498 cholera deaths, according to data compiled by the World Health Organisation (WHO). According to the statistics, 1,546 deaths were recorded between 1970 and 1980 while 2,258 deaths were recorded between 1981 and 1990. Between 1991 and 1999, cholera claimed 1,067 lives, and between 2000 and 2012, 627 deaths were recorded.