Although cholera can be life-threatening, it is easily prevented and treated. Cholera is an acute, diarrhea illness caused by infection of the intestine with the bacterium Vibrio cholerae. The infection is often mild or without symptoms, but can be severe. Cholera is characterized by sudden abdominal cramps and severe watery diarrhea, vomiting, and leg cramps due to severe electrolyte imbalance. Rapid loss of body fluids leads to dehydration and shock as a person can lose ±15 to 20 litres of fluid in 24 hours. Without treatment, death can occur within hours.
How does a person get cholera?
A person may get cholera by drinking water, milk or eating food contaminated with the cholera bacterium. During epidemics, it is spread by ingestion of food, milk or water contaminated directly or indirectly by feces or vomit from i6f6cted persons. The disease can rapidly spread in areas with inadequate or poor treatment of sewage and -drinking water. The cholera bacterium may also live in the environment in brackish rivers and coastal waters for up to two days (salt does not kill the bacteria). The organism can grow well in certain foods such as raw shellfish, rice, etc; but will not grow or survive in very acidic foods, and is killed by heat. As the bacteria can live for ± seven days on raw vegetables, up to four weeks in dairy products, fish, meat, and in clear, 'clean' water, it is of the utmost importance to follow the suggestions below! The disease is not likely to spread from contact from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.
What should travelers do to avoid getting cholera?
The risk for travelers visiting the area is very low if simple precautions are observed:
- Drink only boiled or chlorine treated water. (Remember to make your ice from boiled / treated water as well.)
- Eat only food that has been thoroughly cooked and is still hot.
- Eat only fruit that you have peeled yourself.
- Avoid undercooked or raw fish or shellfish.
- Make sure that all vegetables are cooked; avoid salads made from uncooked vegetables.
- Good personal hygiene.
- Avoid foods and beverages from street vendors.
A simple rule of thumb is: "Boil it, cook it, peel it, or forget it."
Is a vaccine available?
A cholera vaccine is available but is not normally recommended as it only lasts for a short period and immunity is sometimes incomplete.
Can cholera be treated?
Cholera can be simply and successfully treated by immediate replacement of fluid and salt lost through diarrhea. Severe cases also require intravenous fluid replacement. With prompt rehydration, less than one per cent of cholera patients die!
Make your own effective, inexpensive Rehydration fluid: I litre boiled water that has been cooled down, 8 teaspoons sugar, 1/2 teaspoon salt. This solution may taste bland and may therefore be mixed with any cooldrink mixture. Drink as much as possible of the rehydration fluid - at least three litres in 24 hours. Antibiotics (tetracycline) shorten the course and diminish the severity of the illness, but are not as important as rehydration. Predicting how long the epidemic will last is difficult. A cholera epidemic may not be stopped immediately, especially in areas with inadequate sanitation.
Any person developing severe diarrhea and vomiting should seek medical attention promptly!