Cholera: what you need to know

Samuel Kariuki, a microbiologist, explains how cholera is transmitted, its symptoms, how to protect yourself, and the available treatments.

Cholera is a life-threatening disease caused by the bacterium Vibrio cholerae, often linked to poor sanitation and lack of access to clean water. However, outbreaks have also occurred in seemingly well-maintained environments, such as upscale neighborhoods, hotels, and restaurants where hygiene practices are inadequate, such as handling food with dirty hands or using contaminated water for washing utensils and preparing meals.

Cholera has had devastating effects across Africa. In the past two years, outbreaks in 18 African countries have resulted in over 6,000 deaths, with nearly 350,000 cases reported in southern and eastern Africa alone since late 2021.

How is cholera spread?

Cholera spreads both directly and indirectly through several channels:

1. Contaminated water: Drinking or using water tainted with Vibrio cholerae bacteria is the most common way the disease spreads. Contamination can occur when sewage mixes with water sources.
2. Contaminated food: Eating food that has come into contact with the bacteria, particularly raw or undercooked items, can cause infection. Food can become contaminated through contact with infected individuals or by being prepared with unclean water.
3. Poor sanitation: Inadequate sanitation systems allow Vibrio cholerae to thrive, making it easier for the disease to spread in communities.
4. Person-to-person contact: Although less common, cholera can spread through direct contact with the feces or vomit of an infected person, or indirectly through contaminated surfaces and objects.

What are the symptoms of cholera?

Cholera symptoms typically appear within hours to five days after exposure, ranging from mild to severe. Key symptoms include:

• Severe diarrhea: Often described as “rice-water” stools, this is a hallmark of cholera and can result in rapid fluid loss.
• Vomiting: Frequently accompanies diarrhea, further accelerating dehydration.
• Dehydration: The most dangerous symptom, dehydration is characterized by extreme thirst, dry mouth, sunken eyes, reduced urination, and low blood pressure. Without timely treatment, dehydration can lead to shock and death within hours.

How can you protect yourself from cholera?

Preventing cholera requires a combination of good hygiene and sanitation practices:

1. Drink safe water: Always use boiled or chemically treated water for drinking, cooking, and preparing food. Avoid ice made from untreated water.
2. Handwashing: Wash your hands regularly with soap and clean water, particularly after using the bathroom, changing diapers, and before handling food. This simple practice is one of the most effective ways to prevent cholera.
3. Eat thoroughly cooked food: Consume food that is properly cooked and still hot. Peel fruits and vegetables yourself after washing them with safe water.
4. Maintain sanitation: Keep toilets and all surfaces clean, especially in homes with young children. Properly dispose of human waste and disinfect affected areas.
5. Vaccination: Oral cholera vaccines are safe and effective for both children and adults. Although they don’t replace other preventive measures, they provide additional protection against the disease.

How is cholera treated?

Early and appropriate treatment is essential to prevent fatalities from cholera. The focus is on rehydration and supportive care:

1. Oral rehydration salts (ORS): The primary treatment is rehydration using a solution of sugar and salts mixed with clean water. ORS helps replace lost fluids and electrolytes, and can be administered at home or in a healthcare setting.
2. Intravenous fluids: In severe cases, where dehydration is extreme, IV fluids may be necessary to quickly restore fluid levels, especially for patients unable to keep down oral fluids due to vomiting.
3. Antibiotics: While rehydration is the main treatment, antibiotics may be used to shorten the duration and severity of symptoms, particularly in severe cases.
4. Zinc supplements: For children, zinc supplements can help reduce the length and intensity of diarrhea. These should be taken under medical supervision.

Cholera is both preventable and treatable. By staying informed, taking necessary precautions, and seeking timely medical attention, we can reduce the spread of cholera and help create a healthier world.

SOURCE: Samuel Kariuki

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