What you should know about cholera

After the flu, the pandemic word nowadays is cholera. The word has especially been linked to areas of natural disaster starting with Pakistan and now Haiti.

But what do we really know about this disease aside from being a word in the title of Nobel Prize winning author Gabriel García Márquez’s famous novel “Love in the Time of Cholera” (Spanish: El amor en los tiempos del cólera)?

Cholera is a gastrointestinal infection caused by the bacterium Vibrio cholera. It is “the most feared epidemic diarrheal disease because of its severity.”

The World Health Organization (WHO) gives the following basic facts on cholera:

• Cholera is an acute diarrhoeal disease that can kill within hours if left untreated.
• There are an estimated 3–5 million cholera cases and 100 000–120 000 deaths due to cholera every year.
• Up to 80% of cases can be successfully treated with oral rehydration salts.
• Effective control measures rely on prevention, preparedness and response.
• Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases.
• Oral cholera vaccines are considered an additional means to control cholera, but should not replace conventional control measures.

What causes cholera?

Cholera is transmitted through poor hygiene and sanitation. It is no wonder that areas of natural disasters that result in disruption of water and sanitation systems are major outbreak areas of cholera. Other hotspots for cholera outbreaks are overcrowded refugee camps where displaced human populations are temporary accommodated and urban slums. These facilities, too, have inadequate clean water and sanitation system.

Strangely enough, it is not the infection itself that usually kills cholera victims but rather the dehydration resulting from severe diarrhea and vomiting.

The Haitian capital city Port-au-Prince is a classic example of an urban area where cholera can break out.

Pandemic cholera

Like the flu, cholera has also caused pandemics in the past. WHO gives the following historical background:

During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India. Six subsequent pandemics killed millions of people across all continents. The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries.

How is cholera treated?

Cholera can actually be treated rather easily. Up to 80% of cases are treated successfully through immediately rehydration. Rehydration may be taken orally (electrolytes) or intravenously in severely dehydrated patients. Antibiotics may also be prescribed in severe cases.

Oral cholera vaccines are also available.