Friday, May 29, 2015


I have previously compiled information on Thyphoid Fever. If you missed it just go on Google.

Let us talk about cholera.  This one has killed more than 30 people in Tanzania in refugee camps and apparently from refugees running out of Burundi for their lives.  This is something that can easily be treated or prevented if we all pay attention.  Since the refugees have been arriving in #Uganda, I feel obligated to talk about it.  Below is some information about this preventable and yet killer illness.

Cholera often breaks out when there is overcrowding and inadequate access to clean water, trash collection and proper toilets. It causes profuse diarrhea and vomiting which can lead to death by intense dehydration, sometimes within a matter of hours.  Cholera is a serious risk in the aftermath of emergencies, like the Haiti earthquake of 2010, but can strike anywhere. The situation can be especially problematic in rainy seasons when houses and latrines flood and contaminated water collects in stagnant pools.  According to the World Health Organization (WHO), cholera affects three to five million people worldwide and causes between 100,000 and 130,000 deaths per year.

MSF’s water and sanitation engineers and logisticians play a vital role in the prevention of cholera. The disease is treatable and, in many situations, MSF teams have limited the death rate to less than one percent.

Cholera causes profuse diarrhea and vomiting
Caused by poor sanitation, overcrowding, war and famine.
A patient undergoing treatment can lose over 50 litres of fluid.
MSF has developed cholera treatment kits to provide rapid assistance.
MSF teams are able to limit the case fatality rate to less than one percent.
What Causes Cholera?

Cholera is caused by an infection of the intestine with the bacterium Vibrio cholerae. The bacterium causes the cells lining the intestine to produce large amounts of fluid, leading to profuse diarrhea and vomiting.  The infection spreads when someone ingests food or water contaminated with the feces or vomit of someone carrying the disease.   Contaminated food or water supplies can cause massive outbreaks in a short period of time, particularly in overcrowded areas such as slums or refugee camps.

Symptoms of Cholera
Typically, symptoms of cholera appear within two to three days of infection. However, it can take anywhere from a few hours to five days or longer for symptoms to appear.  A cholera infection is often mild or without symptoms but can sometimes be severe, resulting in profuse watery diarrhea, vomiting and leg cramps.  The patient rapidly losses body fluids, leading to dehydration and shock. Without treatment, they may die within hours.

Diagnosing Cholera
Cholera can be diagnosed by examining stool samples or rectal swabs but, due to the fast-acting nature of the disease there is often little time to do so. 
In epidemic situations, a diagnosis is often made by taking a patient history and conducting a brief examination, with treatment given before there is time for a laboratory to confirm the diagnosis.

Treating Cholera
Cholera can be treated simply and successfully by immediately replacing the fluids and salts lost through vomiting and diarrhea—with prompt rehydration, less than one percent of cholera patients die.

Cholera victims are always treated with oral rehydration solutions—prepackaged mixtures of sugars and salts that are mixed with water and drunk in large amounts. Severe cases will need these fluids to be replaced intravenously via a drip, and antibiotics are sometimes administered.

MSF has treated cholera outbreaks in Algeria, Angola, Cameroon, theDemocratic Republic of Congo, Haiti, India, Kenya, Pakistan, Papua New Guinea, Somalia, South Sudan, Uganda and Zimbabwe.

Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium calledVibrio cholerae.

Cholera was prevalent in the U.S. in the 1800s, before modern water and sewage treatment systems eliminated its spread by contaminated water. Only about 10 cases of cholera are reported each year in the U.S. and half of these are acquired abroad. Rarely, contaminated seafood has caused cholera outbreaks in the U.S. However, cholera outbreaks are still a serious problem in other parts of the world. At least 150,000 cases are reported to the World Health Organization each year.

The disease is most common in places with poor sanitation, crowding, war, and famine. Common locations include parts of Africa, south Asia, and Latin America. If you are traveling to one of those areas, knowing the following cholera facts can help protect you and your family.

Cholera Causes
Vibrio cholerae, the bacterium that causes cholera, is usually found in food or water contaminated by feces from a person with the infection. Common sources include:

Municipal water supplies
Ice made from municipal 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
When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea.   It is not likely you will catch cholera just from casual contact with an infected person.

Cholera Symptoms
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 waterydiarrhea accompanied by vomiting, which can quickly lead todehydration. 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:
Rapid heart rate
Loss of skin elasticity (the ability to return to original position quickly if pinched)
Dry mucous membranes, including the inside of the mouth, throat, nose, and eyelids
Low blood pressure
Muscle cramps
If not treated, dehydration can lead to shock and death in a matter of hours.

Do the right thing. Boil all your drinking water including the water you use for brushing your teeth.  Avoid eating in places which are suspect of not keeping proper hygiene.  Watch out for common symptoms which can progress into really serious things.  Beware.  Prevention is better than cure.  READ and keep reading.  It could save your life or the life of a loved one.

Martha Leah Nangalama
Moncton, Canada

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