THINGS YOU MUST KNOW ABOUT CHOLERA

By Jereaghogho Efeturi Ukusare

According to the WHO “Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.” An indicator of inequity and lack of social development, it is a global threat to public health. Many African countries lack social development as a result of under development. These countries do record cases of cholera yearly. And, in cases of outbreak, most times do not have the capacity to handle it. Researchers have estimated that every year, there are roughly 1.3 to 4.0 million cases, and 21 000 to 143 000 deaths worldwide due to cholera. Its control and prevention are however easy to implement.

The WHO says that “Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea.” Cholera typically takes between 12 hours to 5 days for symptoms to show after ingesting contaminated food or water. Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people.”

For the treatment of Cholera, the World Health Organisation has made recommendations which if followed should effectively arrest the situation. According to the world Health Organisation, “Cholera is an easily treatable disease. The majority of people can be treated successfully through prompt administration of oral rehydration solution (ORS). The WHO/UNICEF ORS standard sachet is dissolved in 1 litre (L) of clean water. Adult patients may require up to 6 L of ORS to treat moderate dehydration on the first day.

Severely dehydrated patients are at risk of shock and require the rapid administration of intravenous fluids. These patients are also given appropriate antibiotics to diminish the duration of diarrhoea, reduce the volume of rehydration fluids needed, and shorten the amount and duration of V. cholerae excretion in their stool.

Mass administration of antibiotics is not recommended, as it has no proven effect on the spread of cholera and contributes to increasing antimicrobial resistance.

Rapid access to treatment is essential during a cholera outbreak. Oral rehydration should be available in communities, in addition to larger treatment centres that can provide intravenous fluids and 24 hour care. With early and proper treatment, the case fatality rate should remain below 1%.

Zinc is an important adjunctive therapy for children under 5, which also reduces the duration of diarrhoea and may prevent future episodes of other causes on acute watery diarrhoea. Breastfeeding experts say should also be promoted.

The World Health Organisation says: “a multifaceted approach is key to control cholera and to reduce deaths. A combination of surveillance, water, sanitation and hygiene, social mobilisation, treatment, and oral cholera vaccines are used.”

The organisation’s recommendation for control is health education campaigns, adapted to local culture and beliefs which is expected to promote the adoption of appropriate hygiene practices such as hand-washing with soap, safe preparation and storage of food and safe disposal of the faeces of children. Oral cholera vaccines are also recommended by the WHO.

The WHO says: “there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral®, Shanchol™, and Euvichol®. All three vaccines require two doses for full protection.”

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