Cholera is a diarrhoeal disease caused by infection of the intestine with the bacterium Vibrio cholerae. In developing countries cholera remains a serious problem for people living without access to adequate water and sanitation systems.
In most cases, infection causes only mild diarrhoea or no symptoms at all. Some patients can develop very severe watery diarrhoea and vomiting from 6 hours to 5 days after exposure to the bacterium. In these cases, the loss of large amounts of fluids can rapidly lead to severe dehydration. In the absence of adequate treatment, death can occur within hours.
How does a person get cholera?
A person can become infected by drinking water or eating food contaminated by the bacterium. Common sources of food borne infection include raw or poorly cooked seafood, raw fruit and vegetables, and other foods contaminated during preparation or storage. Bacteria present in the faeces of an infected person are the main source of contamination. The bacterium can also live in the environment in brackish rivers and coastal waters. The disease can thus spread rapidly in areas where sewage and drinking water supplies are inadequately treated.
Where do outbreaks occur?
Cholera remains an ever present risk in many countries. New outbreaks can occur sporadically in any part of the world where water supplies, sanitation, food safety, and hygiene are inadequate. We are uncertain about the presence of cholera in Uzbekistan.
Can cholera be prevented?
Yes. People living in high risk areas can protect themselves by following a few simple rules of good hygiene and safe food preparation. These include scrupulous washing of hands, especially before food preparation and eating, thorough cooking of food and consumption while hot, boiling or treatment of drinking water, and use of sanitary facilities.
- Drink only water that has been boiled or disinfected with chlorine, iodine or other suitable products. Products for disinfecting water are generally available in pharmacies. Beverages such as hot tea or coffee, wine, beer, carbonated water or soft drinks, and bottled or packaged fruit juices are usually safe to drink.
- Avoid ice, unless you are sure that it is made from safe water.
- Eat food that has been thoroughly cooked and is still hot when served. Cooked food that has been held at room temperature for several hours and served without being reheated can be an important source of infection.
- Avoid raw seafood and other raw foods. The exceptions are fruits and vegetables that you have peeled or shelled yourself.
- Boil un-pasteurized milk before drinking it.
- Ice cream from unreliable sources is frequently contaminated and can cause illness. If in doubt, avoid it.
- Be sure that meals bought from street vendors are thoroughly cooked in your presence and do not contain any uncooked foods.
What treatments are available?
The most important treatment is re-hydration, which consists of prompt replacement of the water and salts lost through severe diarrhoea and vomiting. Early re-hydration can save the lives of nearly all cholera patients. Most can be re-hydrated quickly and easily by drinking large quantities of a solution of oral re-hydration salts. Patients who become severely dehydrated may need to receive fluid intravenously.
What about antibiotics and other drugs?
In individual cases of severe cholera, an effective antibiotic can help shorten illness, though re-hydration remains the mainstay of treatment. Anti-diarrhoeal medicines, such as loperamide, are not recommended and should never be given.