Cholera Epidemic: facts about disease

Cholera Epidemic: facts about disease

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Posted to the web: 24/11/2008 08:25:31
What is cholera?

Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. The infection is often mild or without symptoms, but sometimes it can be severe.

Approximately one in 20 infected persons has severe disease characterised by profuse watery diarrhoea, vomiting, and leg cramps. In these persons, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

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How does a person get cholera?

A person may get cholera by drinking water or eating food contaminated with the cholera bacterium. In an epidemic, the source of the contamination is usually the faeces of an infected person. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water.

The cholera bacterium may also live in the environment in brackish rivers and coastal waters. Shellfish eaten raw have been a source of cholera. The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.
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What should travelers do to avoid getting cholera?

The risk for cholera is very low for travellers visiting areas with epidemic cholera. When simple precautions are observed, contracting the disease is unlikely.

All travellers to areas where cholera has occurred should observe the following recommendations:

• Drink only water that you have boiled or treated with chlorine or iodine. Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice.

• Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself.

• Avoid undercooked or raw fish or shellfish.

• Make sure all vegetables are cooked and avoid salads.

• Avoid foods and beverages from street vendors.

• Do not carry perishable seafood back to your country of residence.

A simple rule of thumb is "Boil it, cook it, peel it, or forget it.”
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Is a vaccine available to prevent cholera?

A recently developed oral vaccine for cholera is licensed and available in other countries (Dukoral from SBL Vaccines). The vaccine appears to provide somewhat better immunity and have fewer adverse effects than the previously available vaccine. Further information about Dukoral can be obtained from the manufacturers:

Dukoral ®
SBL Vaccin AB,
SE-105 21 Stockholm, Sweden
telephone +46-8-7351000,
e-mail: info@sblvaccines.se
website: www.sblvaccines.se
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Can cholera be treated?

Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhoea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts. This solution is used throughout the world to treat diarrhoea. Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1% of cholera patients die.

Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as rehydration. Persons who develop severe diarrhoea and vomiting in countries where cholera occurs should seek medical attention promptly.
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How long will the current epidemic last?

Predicting how long a cholera epidemic will last is difficult. In areas with inadequate sanitation, a cholera epidemic cannot be stopped immediately. Major improvements in sewage and water treatment systems are needed to contain the current and prevent future epidemic cholera.

(Source:Centers for Disease Control and Prevention)
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