Cholera is an infectious disease that produces severe watery diarrhea and, if left untreated, dehydration and death.
It is contracted by consuming food or water infected with the bacteria Vibrio cholerae.
Cholera continues to be a worldwide public health issue as well as a sign of injustice and a lack of social development.
Researchers estimate that 1.3 to 4.0 million cases of cholera are reported each year, with 21 000 to 143 000 fatalities globally.
Symptoms
Cholera is a highly contagious illness that causes severe watery diarrhoea.
After consuming infected food or drink, symptoms might appear anywhere from 12 hours to 5 days later.
Cholera affects both children and adults, and if left untreated, illness can kill within hours.
The germs are present in their feces for 1-10 days after infection and are shed back into the environment, potentially infecting other individuals. Most persons infected with V. cholerae do not exhibit any symptoms.
The majority of those who develop symptoms have mild or moderate symptoms, but a small percentage suffer acute watery diarrhoea and severe dehydration.
If left untreated, this might result in death.
Cholera: Diagnosis and Treatment
If you have cholera symptoms, see your doctor very away.
By detecting germs in a stool sample, a doctor can confirm that you have cholera.
The following are some of the most common cholera treatments:
Oral rehydration salts (which are mixed with water)
Intravenous fluid rehydration
Antibiotics
Zinc supplements
Source: Meredith Goodwin (Healthline)
Zinc is an essential supplementary therapy for children under the age of five, since it decreases the length of diarrhoea and may prevent subsequent bouts of acute watery diarrhoea from other causes.
Breastfeeding should be encouraged as well.
Prevention and control
Controlling cholera and reducing fatalities requires a comprehensive strategy.
Surveillance, water, sanitation, and hygiene, as well as social mobilization, treatment, and oral cholera vaccinations, are all employed.
Surveillance
Cholera monitoring should be part of a larger disease monitoring strategy that incorporates local feedback as well as worldwide information exchange.
Patients with severe acute watery diarrhoea are diagnosed with cholera based on clinical suspicion. The suspicion is subsequently verified when V. cholerae is found in stool samples from people who have been infected.
Rapid diagnostic tests (RDTs) can help in detection, with one or more positive samples triggering a cholera alarm.
The samples are forwarded to a lab for culture or PCR confirmation.
An efficient surveillance system and the planning of control actions need local ability to detect (diagnose) and monitor (collect, assemble, and analyze data) cholera incidence.
Countries with cholera epidemics are urged to improve disease surveillance and national preparedness in order to detect and respond to outbreaks quickly.
All cases of cholera are no longer required to be reported under the International Health Regulations.
However, public health occurrences involving cholera must always be evaluated against the rules’ requirements to determine if formal reporting is required.
Water and sanitation interventions
Economic development and universal access to safe drinking water and appropriate sanitation are the long-term solutions to cholera control.
Implementing appropriate long-term sustainable WASH solutions to ensure the use of safe water, basic sanitation, and good hygiene practices in cholera hotspots is one of the environmental actions.
In addition to cholera, such initiatives help to avoid a variety of other water-borne diseases while also helping to achieve poverty, hunger, and education goals.
The cholera WASH solutions are in line with the Sustainable Development Goals (SDG 6).
Hygiene promotion and social mobilization
Adoption of proper hygiene practices such as hand-washing with soap, safe food preparation and storage, and safe disposal of children’s feces should be promoted through health education programs tailored to local culture and beliefs.
To minimize transmission among attendance, funeral rituals for cholera victims must be modified.
During outbreaks, public awareness campaigns should be organized, and the community should be informed about the dangers and symptoms of cholera, how to avoid cholera, when and where to report cases, and how to seek prompt treatment if symptoms arise.
It’s also a good idea to disclose the locations of relevant treatment facilities.
Long-term behavioral changes and cholera management require community involvement.
Oral cholera vaccines
Currently, three WHO-approved oral cholera vaccines (OCVs) are available: Dukoral®, ShancholTM, and Euvichol-Plus®.
For complete protection, all three vaccinations require two doses.
Dukoral® is given with a buffer solution that needs 150 mL of clean water for adults.
Dukoral can be administered to anybody over the age of two.
Each dose must be separated by a minimum of 7 days and a maximum of 6 weeks.
A third dosage is required for children aged 2 to 5.
Dukoral® is mostly used by tourists.
Two doses of Dukoral® offer two years of cholera protection.
The vaccination formulas for ShancholTM and Euvichol-Plus® are the identical, although they are made by two separate companies. They don’t need a buffer solution to be administered. They are distributed to all people above the age of one year.
Each dosage of these two vaccinations must be separated by at least two weeks.
Two doses of ShancholTM and Euvichol-Plus® give at least three years of cholera protection, whereas one dosage provides only short-term protection.
ShancholTM has been prequalified for use in a Controlled Temperature Chain, a new method to vaccine management that allows vaccines to be stored at temperatures outside of the usual cold chain range of +2°C to +8°C for a limited time under monitored and controlled circumstances.
More information on Control Temperature Chain can be found here
More information on Cholera Vaccines can be found here
References
https://www.who.int/news-room/fact-sheets/detail/cholera
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