WHAT IS CHOLERA?
Cholera is an acute, diarrheal illness caused by infection of the intestine with the toxigenic bacterium Vibrio cholerae serogroup O1 or O139. This bacterial disease causing severe diarrhoea and dehydration, usually spread in water or food. Researchers have estimated that each year there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to cholera. The infection is often mild or without symptoms, but can be severe. Approximately 1 in 10 people who get sick with cholera will develop severe symptoms such as watery diarrhea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
The cholera bacterium is usually found in water or in foods that have been contaminated by feces (poop) from a person infected with cholera bacteria. Cholera is most likely to occur and spread in places with inadequate water treatment, poor sanitation, and inadequate hygiene. Cholera bacteria can also live in the environment in brackish rivers and coastal waters. Shellfish eaten raw have been a source of infection.
A person can get cholera by drinking water or eating food contaminated with cholera bacteria. In an epidemic, the source of the contamination is usually the feces of an infected person that contaminates water or food. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The infection is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk factor for becoming ill.
RISK FACTORS ASSOCIATED WITH CHOLERA
Cholera can be endemic or epidemic. A cholera-endemic area is an area where confirmed cholera cases were detected during the last 3 years with evidence of local transmission (meaning the cases are not imported from elsewhere). A cholera outbreak/epidemic can occur in both endemic countries and in countries where cholera does not regularly occur.
In cholera endemic countries an outbreak can be seasonal or sporadic and represents a greater than expected number of cases. In a country where cholera does not regularly occur, an outbreak is defined by the occurrence of at least 1 confirmed case of cholera with evidence of local transmission in an area where there is not usually cholera.
Cholera transmission is closely linked to inadequate access to clean water and sanitation facilities. Typical at-risk areas include peri-urban slums, and camps for internally displaced persons or refugees, where minimum requirements of clean water and sanitation are not been met.
The consequences of a humanitarian crisis – such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded houses and camps – can increase the risk of cholera transmission, should the bacteria be present or introduced. Uninfected dead bodies have never been reported as the source of epidemics.
The number of cholera cases reported to WHO has continued to be high over the last few years. Health authorities in Cameroon’s Southwest region said on Wednesday 23 March 2022, that at least 12 people have died within 72 hours and over 400 cases were reported in a cholera epidemic that is sweeping across the region.
The chief town of the region, Buea and the touristic seaside resort town of Limbe have been particularly affected, according to officials.
“Hospitals are overwhelmed with patients. Some are lying in the corridors of the hospital and we are trying to set up makeshift structures to host more patients. The situation is critical,” Samuel Rinyu, medical personnel working in one of the hospitals hosting patients in the region said.
On Wednesday afternoon, the region’s governor Bernard Okalia Balai held a crisis meeting in Limbe as residents panicked after the news of the cholera outbreak went viral.
SIGNS AND SYMPTOMS OF CHOLERA
Approximately 1 in 10 people who get sick with cholera will develop symptoms such as
- Watery diarrhea,
- Leg and stomach cramps.
- Rapid loss of body fluids leading to dehydration and shock.
- Sunken eyes
- A dry mouth
- Extreme thirst
- Dry and shriveled skin that’s slow to bounce back when pinched into a fold
- Little or no urinating,
- Low blood pressure
- Irregular heartbeat
NB. After a person is infected with the cholera bacteria, it usually takes 2-3 days for the symptoms to appear and without treatment, death can occur within hours
Who is most likely to get cholera?
Persons living in places with unsafe drinking water, poor sanitation, and inadequate hygiene are at the highest risk for cholera.
What to do if you have the symptoms
If you think you or a member of your family might have cholera, seek medical attention immediately. Dehydration can be rapid so fluid replacement is essential.
WHAT IS THE TREATMENT FOR CHOLERA?
Cholera can be treated successfully by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution (ORS), a prepackaged mixture of sugar and salts that is mixed with 1 liter of water and drunk in large amounts. This solution is used throughout the world to treat diarrhea. Severe cases also require intravenous fluid replacement.
Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as rehydration. Persons who develop severe diarrhea and vomiting in countries where cholera occurs should seek medical attention promptly.
Should I be worried about getting cholera from others?
The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk factor for becoming ill.
HOW CAN I AVOID GETTING SICK WITH CHOLERA?
All visitors or residents in areas where cholera is occurring or has occurred should follow recommendations to prevent getting sick:
- Drink only bottled, boiled, or chemically treated water and bottled or canned beverages. When using bottled drinks, make sure the seal has not been broken. Carbonated water may be safer than non-carbonated water.
- Avoid tap water, fountain drinks, and ice cubes.
- Wash your hands often with soap and clean water, especially before you eat or prepare food and after using the bathroom.
- Use bottled, boiled, or chemically treated water to wash dishes, brush teeth, wash and prepare food, and make ice.
- Eat foods that are packaged or that are freshly cooked and served hot.
- Dispose of feces in a sanitary manner to prevent contamination of water and food sources.
- Do not eat raw or undercooked meats and seafood, or raw or undercooked fruits and vegetables unless they are peeled
- Also used an alcohol-based hand sanitizer with at least 60% alcohol if no water or soap are available.
SUMMARY FACTS ABOUT CHOLERA
- Cholera is an acute diarrheal disease that can kill within hours if left untreated.
- There are many serogroups of V. cholerae, but only two – O1 and O139 – cause outbreaks
- Researchers have estimated that each year there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to cholera
- Most of those infected will have no or mild symptoms and can be successfully treated with oral rehydration solution.
- Severe cases will need rapid treatment with intravenous fluids and antibiotics.
- Provision of safe water and sanitation is critical to prevent and control the transmission of cholera and other waterborne diseases.
- Oral cholera vaccines should be used in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in areas known to be high risk for cholera.