The Manica Post

Cholera alert: Be cautious

- Dr Tendai Zuze

CHOLERA is an infectious disease that causes severe watery diarrhoea, which can lead to dehydratio­n and death if untreated.

It is caused by eating food or drinking water contaminat­ed by a bacterium called Vibrio cholerae. This disease is most common in places with poor sanitation, crowding, war, and famine.

The bacteria that causes cholera is usually found in food or water contaminat­ed by faeces from a person with the infection.

Common sources include: ◆ Some municipal water supplies ◆ Ice made from contaminat­ed water ◆ Foods and drinks sold by street vendors

◆ Vegetables grown with water containing human wastes

◆ Raw or undercooke­d fish and seafood caught in waters polluted with sewage

◆ Unsafe water sources including rivers and wells

When a person consumes the contaminat­ed food or water, the bacteria release a toxin in the intestines that produces severe diarrhoea.

It is not likely you will catch cholera just from casual contact with an infected person.

Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. Often symptoms are mild. But sometimes they are very serious.

About one in 20 people infected have severe painless, profuse watery diarrhoea accompanie­d by vomiting, which can quickly lead to dehydratio­n. Although many infected people may have minimal or no symptoms, they can still contribute to spread of the infection.

Signs and symptoms of dehydratio­n include: a rapid heart rate, loss of skin elasticity, low blood pressure, excessive thirst, muscle cramps and dry mucous membranes including the inside of the mouth, throat, nose and eyelids.

If not treated, dehydratio­n can lead to shock and death in a matter of hours.

Although there is a vaccine against cholera, the World Health Organizati­on don't normally recommend it because it may not protect up to half of the people who receive it and it lasts only a few months.

However, you can protect yourself and your family by using only water that has been boiled, water that has been chemically disinfecte­d or bottled water from a reputable source. Provision of safe water, proper sanitation, and food safety are critical for preventing occurrence of cholera.

Be sure to use bottled, boiled, or otherwise clean water for the following purposes: ◆ Drinking

◆ Preparing food or drinks ◆ Making ice

◆ Brushing your teeth ◆ Washing your face and hands ◆ Washing dishes and utensils that you use to eat or prepare food ◆ Washing fruits and vegetables To disinfect your own water, boil it for one minute or filter it and add two drops of bleach or one-half of an iodine tablet per litre of water.

You should also avoid raw foods, including the following: ◆ Unpeeled fruits and vegetables ◆ Unpasteuri­sed milk and milk products

◆ Raw or undercooke­d meat or shellfish

◆ Fish caught in contaminat­ed water If you develop severe, watery diarrhoea and vomiting — particular­ly after traveling to a region where cholera is epidemic — seek medical help immediatel­y.

Cholera is highly treatable, but because dehydratio­n can happen quickly, it's important to get cholera treatment right away.

Hydration is the mainstay of treatment for cholera. Depending on how severe the diarrhoea is, treatment will consist of oral or intravenou­s solutions to replace lost fluids.

Start taking salt and sugar solution as soon after the onset of diarrhoea as possible. Antibiotic­s, which kill the bacteria, are not part of emergency treatment.

They reduce the duration of diarrhoea by half and also reduce the excretion of the bacteria, thus helping to prevent the spread of the disease.

If you suspect you, or someone you know has cholera, please report to your nearest health facility.

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