Cholera is a deadly disease caused by the bacteria Vibrio cholerae, associated with poor sanitation and limited access to clean water. But it has also been found in seemingly clean places, including wealthy neighborhoods, hotels and restaurants with poor hygiene practices, such as handling food with dirty hands and using contaminated water to wash utensils and prepare food.
Cholera outbreaks in Africa have affected 18 countries over the past two years. In southern and eastern Africa, more than 6,000 people have died and almost 350,000 cases have been reported since a series of outbreaks began in late 2021.
Samuel Kariuki, microbiologist and director of the Drugs for Neglected Diseases Initiative (East Africa) and former director of the Kenya Medical Research Institute, explains how the disease spreads, the symptoms, how to protect yourself and how it can be treated.
How does cholera spread?
Cholera can be spread directly or indirectly in several ways.
Contaminated water: Drinking or using water contaminated with the bacteria Vibrio cholerae is the most common way cholera spreads. Contamination can occur when wastewater and drinking water supplies mix.
Contaminated foods: Eating foods, especially raw or undercooked, that have been contaminated can lead to infection. Food can become contaminated if it is handled by someone who has the bacteria or if it is prepared with contaminated water.
Poor sanitation: The lack of adequate sanitation infrastructure creates a breeding ground for Vibrio cholerae, facilitating its rapid spread within communities.
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Person-to-person transmission: Although less common, cholera can be spread through direct contact with the feces or vomit of an infected person, or through indirect contact through contaminated surfaces or objects.
What are the symptoms?
Cholera symptoms can appear suddenly, between hours and five days after infection. Symptoms range from mild discomfort to serious, life-threatening conditions.
One of the main signs is severe diarrhea, often described as “rice water” stools, which causes rapid loss of fluid from the body and possible muscle cramps due to the loss of essential salts and minerals. Rice water is the starchy water left after soaking or cooking rice.
In addition to diarrhea, vomiting is common and can worsen dehydration.
Dehydration is the most concerning symptom, indicated by dry mouth, extreme thirst, reduced urination, sunken eyes and low blood pressure, which can progress to shock. If left untreated, it can be fatal within hours.
It is essential to recognize these symptoms promptly and seek medical help to prevent serious complications.
How do you protect yourself from cholera?
- Make sure you always use safe drinking water. Always use boiled or chemically treated water for drinking and preparing food, and avoid ice made from untreated water.
- Always practice hand hygiene. Wash your hands frequently with soap and safe water, especially after using the bathroom, after changing diapers, and before eating or preparing food. Washing your hands is one of the most effective ways to prevent the spread of many infectious diseases, including cholera.
- Avoid raw or undercooked foods. Eat well-cooked and still hot foods, and peel fruits and vegetables yourself after washing them with drinking water.
- Maintain good sanitation practices by ensuring bathrooms are thoroughly cleaned. In homes with young children who use potties, properly dispose of human waste and clean all surfaces thoroughly.
- Oral cholera vaccines are available and safe for both children and adults. These vaccines are valuable tools in cholera prevention, but must be used with all other preventive measures.
How can cholera be treated?
Timely and appropriate treatment of cholera is essential to prevent severe dehydration and deaths. Treatment focuses on rehydration and supportive care:
Rehydration: The main treatment for cholera is rapid rehydration using oral rehydration salts. It is a simple solution of sugar and salts that is mixed with clean water. It is very effective in replacing lost fluids and electrolytes and can be administered at home or in a healthcare facility.
Intravenous fluids: In severe cases where dehydration is extreme, intravenous fluids may be necessary. This can quickly restore fluid levels and is vital for patients who cannot keep oral fluids down because they are vomiting.
Antibiotics: Rehydration is the cornerstone of cholera treatment, but antibiotics can reduce the duration and severity of symptoms. They are particularly useful in severe cases and for patients at high risk of spreading the infection.
Zinc supplements: These supplements can reduce the duration and severity of diarrhea, especially in children. Zinc is an essential mineral that supports immune function and gut health. The correct dosage must be prescribed by a doctor.
Cholera can be prevented and treated. Stay informed, take preventive measures and contribute to a healthier, cholera-free world.
Celestine Wairimu of the Microbiology Research Center contributed to this article.
Samuel Kariuki, Chief Investigator and Director of the Microbiology Research Centre, Kenya Medical Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.