Ingesting food or water contaminated with the Vibrio cholerae bacterium, which disrupts the small intestine, can result in cholera, an acute diarrheal infection. It is a waterborne disease that has plagued humanity for centuries, causing widespread outbreaks and significant mortality. While cholera might be rare in developed countries, it remains a major public health concern in many parts of the world, particularly in areas with inadequate sanitation and limited access to clean water.
Cholera can be life-threatening, but it is easily preventable and treatable with the right measures and by creating awareness for the public. This comprehensive guide aims to shed light on cholera, its transmission, symptoms, and, most importantly, the key strategies to prevent its occurrence and spread.
What is Cholera?
Cholera is a waterborne disease primarily transmitted through contaminated water or food. Direct contact with an infected person’s feces can also spread the disease. The Vibrio cholerae bacterium thrives in aquatic environments, and once ingested, it multiplies rapidly in the small intestine. This triggers the production of a toxin that causes the intestines to release vast amounts of fluid, leading to profuse, watery diarrhea, a hallmark symptom of cholera.
Mode of transmission
Cholera is primarily transmitted through the fecal-oral medium, a process by which the Vibrio cholerae bacteria responsible for causing cholera are excreted in the feces of an infected person. When people consume contaminated food or water as a result of poor sanitation practices, such as improper sewage disposal or untreated drinking water, they run the risk of contracting cholera.
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- Contaminated Water: The most common mode of transmission is through drinking water contaminated with the Vibrio cholerae bacterium. This can occur when sewage mixes with drinking water sources, or when people use untreated water for drinking, cooking, or washing.
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- Contaminated Food: Food washed or prepared with contaminated water can also transmit cholera. Raw or undercooked seafood, particularly shellfish, can harbor bacteria if harvested from contaminated waters.
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- Poor Hygiene: Inadequate handwashing after using the toilet or handling contaminated items can facilitate the transfer of bacteria from hands to mouth, leading to infection.
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- Flies can act as mechanical vectors in some cases, carrying bacteria from feces to food.
Symptoms of cholera
The incubation period for cholera, which is the time between infection and the onset of symptoms, typically ranges from a few hours to five days. The severity of symptoms can vary widely, from mild diarrhea to severe dehydration. The most common symptoms of cholera include the following:
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- Profuse Watery diarrhea: This is the hallmark symptom of cholera. People often describe diarrhea as “rice-water stool” because of its pale, milky appearance and flecks of mucus.
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- Vomiting: Vomiting may occur, often without nausea, and can contribute to fluid loss and dehydration.
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- Dehydration: Rapid and severe dehydration is a major concern in cholera. Signs of dehydration include thirst, dry mouth, sunken eyes, decreased urine output, lethargy, and wrinkled skin.
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- Muscle Cramps: Muscle cramps, particularly in the legs, can result from excessive loss of electrolytes or electrolyte imbalances caused by dehydration.
Some cases of cholera can result in hypovolemic shock, which is a disease that poses a significant risk to the patient’s life and is characterized by extremely low blood volume and pressure. If left untreated, the effects of cholera can be lethal within a few hours.
Cholera outbreak in Nigeria:
The cholera outbreak in Nigeria continues to be a concern, with a significant number of cases and fatalities reported across multiple states. The Nigeria Centre for Disease Control and Prevention (NCDC) has been regularly releasing situation reports based on the latest available information.
As of January 1 to June 11, 2024, 96 local government units in 30 states of the federation recorded a total of 1,141 suspected cases, 65 confirmed cases, and 30 fatalities from cholera, according to the agency. Mr. Idris signed the statement on Thursday, June 13, 2024.
The NCDC named Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos as the 10 states that accounted for 90% of the cholera cases. At that time, the Lagos State Ministry of Health reported that it had identified 350 probable instances of the illness in 29 wards across many LGAs, with 17 cases verified. Severe dehydration brought on by a delayed presentation was the cause of 15 fatalities, the ministry claimed.
Despite reports of cases in 30 states, the high number of cases and fatalities in Lagos State warrant particular concern. Heavy downpours and flooding in Lagos State have exacerbated the situation, potentially contaminating water sources and contributing to the spread of the disease. Read more here.
How to prevent cholera:
Preventing cholera involves a multi-faceted approach that focuses on improving sanitation, ensuring access to clean water, and promoting proper hygiene practices. The following are the key strategies to prevent cholera:
Improving Water Quality: Treating water sources through chlorination, filtration, or boiling to kill any harmful bacteria.
Good Hygiene Practices: Promoting good hygiene practices is crucial to preventing the spread of cholera. This includes:
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- Handwashing: washing hands thoroughly with soap and clean water after using the toilet, before handling food, and after changing diapers.
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- Safe Food Handling: Cooking food thoroughly, washing fruits and vegetables with clean water, and avoiding raw or undercooked seafood.
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- Proper Waste Disposal: To prevent contamination of the environment, dispose of waste properly, including garbage and human waste.
Cholera Vaccination: Oral cholera vaccines (OCVs) are available and can provide significant protection against cholera. These vaccines are recommended for people living in or traveling to areas with a high risk of cholera.
Health Education: Educating communities about cholera, its transmission, and prevention measures is essential in empowering individuals to take proactive steps to protect themselves and their families. This includes raising awareness about the importance of safe water, sanitation, and hygiene practices.
Early Detection: Meticulous monitoring for cholera cases and outbreaks is critical in identifying high-risk areas and implementing prompt control measures. Early detection and treatment of cases can prevent the spread of the disease.
Emergency Preparedness: Putting plans and resources in place to respond to cholera outbreaks is crucial to minimizing the impact of the disease. This includes stockpiling essential supplies such as oral rehydration salts (ORS) and antibiotics, training healthcare workers, sensitizing the public, and establishing treatment centers.
How to Treat Cholera
Prompt treatment of cholera is essential to prevent severe dehydration and complications. The mainstays of treatment include:
Rehydration: Rehydration is the most crucial aspect of cholera treatment. It can be achieved through:
- Oral Rehydration Salts (ORS): ORS is a simple, inexpensive, and effective solution that replenishes lost fluids and electrolytes. It is readily available in most communities and can be prepared at home.
- Antibiotics: Antibiotics can shorten the duration and severity of cholera symptoms. They are particularly beneficial for severe cases and vulnerable individuals, such as children, pregnant women, and the elderly.
Zinc Supplements: Zinc supplements can help reduce the duration and severity of diarrhea in children.
With prompt and appropriate treatment, most people with cholera can recover fully.
Conclusion
Cholera remains a significant public health challenge in many parts of the world. However, we can effectively prevent and control cholera with a comprehensive approach that addresses water safety, sanitation, hygiene, and healthcare. By investing in these essential interventions, we can protect countless lives and move closer to a world where cholera is no longer a threat. Governments, international organizations, and communities must work together to prioritize these efforts and ensure that everyone has access to safe water, sanitation, and the knowledge to protect themselves from this preventable disease.
Disclaimer: This article contains information solely for informational and educational purposes. The written or published article does not aim to diagnose, treat, or cure any disease and should not be considered as such.
References and Further Readings:
Nigeria Centre for Disease Control and Prevention NCDC.com
Punch news PunchNews.com
World Health Organization WHO
