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Cholera cases on the rise: Dos and don’ts to stay safe

cholera

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. 

SYMPTOMS:

  • It takes between 12 hours and 5 days for a person to show symptoms
  • Severe acute watery diarrhea with severe dehydration
  • Most people infected with  cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1–10 days after infection

RISK FACTORS:

  • Inadequate access to clean water and sanitation facilities.
  • Typical at-risk areas include peri-urban slums

CURRENT SCENARIO IN NEPAL

Epidemiology and Disease Control Division (EDCD) has confirmed cholera in 17 people across the country till Monday. According to the EDCD, seven people in Lalitpur, three in Kathmandu, and seven in Dhangadhi have been diagnosed with cholera.

PREVENTION AND CONTROL

A multifaceted approach is key to control cholera, and to reduce deaths. These include:

  • surveillance,
  • water sanitation and hygiene,
  • social mobilization,
  • treatment, and
  • oral cholera vaccines

SURVEILLANCE

  • Rapid diagnostic tests (RDTs) can be useful tool to detect cholera outbreaks;
  • To confirm the diagnosis, stool samples are sent to a laboratory for confirmation of  cholerae O1 or O139 by culture or by polymerase chain reaction (PCR)

WATER AND SANITATION INTERVENTIONS

  • Provision of safe drinking water and basic sanitation.
  • Filtered and boiled drinking water

TREATMENT

  • ORS: The WHO/UNICEF ORS standard sachet is dissolved in 1 litre (L) of clean water. Adult patients may require up to 6 L of ORS to treat moderate dehydration on the first day. 
  • Severely dehydrated patients are at risk of shock and require the rapid administration of intravenous fluids. 
  • Antibiotics to diminish the duration of diarrhoea,
  • Zinc (reduces the duration of diarrhoea )

COMMUNITY ENGAGEMENT

  • Good hygiene practices including handwashing with soap,
  • Safe preparation and storage of food and
  • Safe disposal of the faeces of children.

ORAL CHOLERA VACCINES

There are 3 WHO pre-qualified oral cholera vaccines (OCV): Dukoral®, Shanchol™, and Euvichol-Plus®.

All 3 vaccines require 2 doses for full protection 

REFERENCES

World Health Organization, 2024
Epidemiology and Disease Control Division (EDCD), 29th July, 2024

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