  A substantial body of work supports a teleconnection between the El Ni\~no
Southern Oscillation (ENSO) and cholera incidence in Bangladesh. In particular,
high positive anomalies during the winter (Dec-Feb) in Sea Surface Temperatures
(SST) in the Tropical Pacific have been shown to exacerbate the seasonal
outbreak of cholera following the monsoons from Aug to Nov, and climate studies
have indicated a role of regional precipitation over Bangladesh in mediating
this long-distance effect. Thus, the current strong El Ni\~no has the potential
to significantly increase cholera risk this year in Dhaka, Bangladesh, where
the last five years have experienced low seasons of the disease. To examine
this possibility and produce a forecast for the city, we considered two models
for the transmission dynamics of cholera: a statistical model previously
developed for the disease in this region, and a process-based model presented
here that includes the effect of SST anomalies in the force of infection and is
fitted to extensive cholera surveillance record between 1995 and 2010.
Prediction accuracy was evaluated with 'out-of-fit' data from the same
surveillance efforts, by comparing the total number of cholera cases observed
for the season to those predicted by model simulations 8 to 12 months ahead,
starting in January each year. Encouraged by accurate forecasts for the low
risk of cholera for this period, we then generated a prediction for this coming
season. An increase above the third quantile in cholera cases is expected for
the period of Aug - Dec 2016 with 92% and 87% probability respectively for the
two models. This alert warrants the preparedness of the public health system.
We discuss the possible limitations of our approach, including variations in
the impact of El Ni\~no events, and the importance of this large, warm event
for further informing an early-warning system for cholera in Dhaka

Populations and Evolution