Moreover, all the countries affected by confl ict shown in the Figure by cdc.gov/EID/content/13/11/1625-G. htm) have reported cholera outbreaks (2) (3) (4) . They are also among the poorest countries in the world; the latest statistics on human development (5) indicate that compared with all developing countries, on average they have higher rates of undernourishment, refugees, child deaths, and less adequate water and sanitation facilities. Thus, more information is needed about confl ict and cholera, especially in Africa. In Response: We agree with Kelly-Hope on the propensity for cholera outbreaks to occur in confl ict-affected countries and the need to monitor and respond more effectively to such events. In 2006, cholera was reported from 33 countries in Africa, and 88% of all reported cases were from confl ict-affected countries (1) .