The African Great Lakes have been an endemic area for cholera since the late 1970s. We focused on the Katana health zone, bordering Lake Kivu, as during outbreaks, this is, (together with the Kalemie health zone located along the west coast of the Tanganyika lake) the health zone in which the first cases of Cholera are usually observed, and the highest number of cases are also usually reached in this area. The persistence of this aquatic bacillus, usually associated with warm and salty waters, led us to formulate the hypothesis that the geothermal springs supplying Lake Kivu, mainly from the Nyiragongo volcano, should control the physico-chemical characteristics of the lake and promote the persistence of the bacillus. The lake would thus be a reservoir of the pathogen, which could contaminate local residents through the consumption of water and fish. Over the 2007-2012 period, we demonstrated a long-term unidirectional relationship between volcanic activity and cholera cases in the Katana health Zone. Contamination of the lake’s water and fish was also correlated to the lake characteristics. The activity of the volcano can thus be used for predicting epidemic risks. A more comprehensive approach to the Kivu-Tanganiyka chain of lakes is underway to determine how the volcano tectonic and hydrogeological functioning of the area governs the epidemic dynamics on both sides of the Rift. The question of the role of food webs in the survival of the bacillus during inter-epidemic periods is also a problem that we would like to address.