Overview:
Cholera is an acute infection that causes diarrhea and is caused by eating food or drinking water contaminated with Vibrio cholerae bacteria. Cholera remains a global public health threat and an indicator of inequality and lack of social development.
Symptoms:
- Cholera causes severe acute watery diarrhea, and severe forms of the disease can lead to death within hours if left untreated.
- Most people infected with Vibrio cholerae bacteria may have no symptoms, although the bacteria are present in their stool for 1 to 10 days after infection, and are then dispersed back into the surrounding environment, potentially infecting other people.
- Most people who become infected with the disease have mild or moderate symptoms. It takes between 12 hours and 5 days for a person to develop symptoms. A minority of patients develop severe watery diarrhea accompanied by severe dehydration.
Disease prevention and control:
A multifaceted approach is essential to combat cholera and reduce deaths. A combination of surveillance, water, sanitation and hygiene, social mobilization, treatment and oral cholera vaccines are used.
treatment:
- Most people can be treated successfully if they are given oral rehydration solutions quickly. The WHO/UNICEF standard sachet containing the oral rehydration solution is dissolved in 1 liter of clean water. Adult patients may require up to 6 L of oral rehydration solution to treat moderate dehydration on the first day.
- Those suffering from severe dehydration are at risk of shock and must be quickly administered intravenous fluids. These patients are given appropriate antibiotics in order to reduce the duration of diarrhea, limit the amount of necessary rehydration fluids, and shorten the amount and duration of V. cholerae excretion in their stool.
- All patients should begin eating regular, properly prepared local food as soon as they are able to do so safely.
- Breastfeeding should also be encouraged.
- Zinc is an important adjuvant treatment for children under the age of five, as it also reduces the duration of their diarrhea and may prevent future attacks due to other causes of acute watery diarrhea.
- Administration of antibiotics in large quantities is not recommended as they have no proven effect on controlling the spread of cholera and may contribute to increased antimicrobial resistance.
Rapid access to treatment is essential during a cholera outbreak. Oral rehydration solutions should be made available in communities, including at designated oral rehydration points, as well as larger treatment centers capable of giving patients intravenous fluids and caring for them around the clock. The case fatality rate should remain less than 1% thanks to early administration of appropriate treatment.
Community participation:
Community participation means that people and communities are part of the process of developing and implementing programmes. Cultural practices and local beliefs are central to promoting actions such as good hygiene practices, including hand washing with soap and water, safe food preparation and storage, and safe disposal of children faeces. Funeral practices for individuals who die from cholera may need to be adapted to prevent infection rows of attendees.
Community engagement continues during outbreak response with increased reporting on potential risks, symptoms of cholera, precautions to take to avoid infection, when and where to report cases, and seeking treatment immediately when symptoms appear. Communities should be part of the programming process to address needs, including where they can seek treatment and when.
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