Cholera
is an acute epidemic infectious disease characterized by watery diarrhea,
extreme loss of fluid and electrolytes coupled with severe dehydration. It is
caused by the bacterium Vibrio cholera which contaminates water and food.
According to the study, ‘Cholera
– Pipeline Review, H2 2018’, each year cholera affects double the
number of people that typhoid affects. Cholera is easy to treat yet it claims a
significant number of lives each year.
Since
the disease is caused by the contamination of water and food, it appears that
regions around the world that do not have a strong hygienic base constitute the
core of the disease. In this respect Africa has garnered attention. The
worldwide cases reported to the WHO in 2016 seem to be aligned with these expectations.
A total of thirty-eight countries reported cholera cases out of which seventeen
were from Africa and twelve from Asia along with four each from Europe and the
Americas. Only one country from Oceania reported cholera cases. Further, more
than half of the total number of cases were reported from Africa, nearly
one-third from Hispaniola and more than one-tenth from Asia. Haiti, the
Democratic Republic of the Congo, Yemen, Somalia and the United Republic of
Tanzania have been recognized as the most severely affected when it comes to
cholera.
Many
other nations especially from Africa such as Ghana and Tanzania have begun
revolutionizing the distribution of clean water in the country. The authorities
of these countries have also started spreading awareness and warning the
general public about the harmful capacity of cholera. Both these nations have
previously been hit by cholera epidemics and have now been focusing on
vaccinesto combat cholera. Haiti too is expressing its concern regarding the
same.
It
is usually severe dehydration that leads to death from cholera so the most
important treatment is to give oral hydration solution (ORS). The mixture
consists of large volumes of water mixed with a blend of sugar and salts.
Packaged mixtures are commercially available in the market but widespread
distribution in developing countries is hindered by cost factors, so homemade
ORS recipes are often used with household ingredients. Severe cases require IV
fluid. Antibiotics are also used but not recommended due to the rising concern
for bacterial resistance. There are currently three cholera vaccines
recommended by WHO and are Dukoral, Shanchol and Euvichol.
Recent
studies done by the WHO reveal lots of interesting facts about ORS and its
effects. The WHO carried out an analysis to deal with widespread cholera. They
observed that the lethalness of the disease lies in its ability to kill healthy
adults within hours. Cholera has to be treated promptly and timely as this can
significantly reduce mortality. Its treatment should consist of prompt
rehydration of patients with ORS in certain mild to moderate cases. ORS has
been found to be extremely effective especially in epidemics. Research reveals
that it cannot influence the infectious process but corrects dehydration and
thus, saves lives. Numerous experiences with ORS have shown that it can be
given by nonmedical personnel. The critical state in cholera is that of
dehydration and thus, WHO recommends that ORS therapy should be initiated
immediately even before reaching proper medical establishments.
The
recent awareness about the lethalness of cholera has been brought out by the
findings of the WHO which claim that dehydration is the main killer and not the
infection itself. The importance of ORS is being realized and supplementary
measures are being promoted in nations that have recently been plagued by
epidemics of cholera. The sanitation and hygiene spectra of global regions
brings out the fact that until there is proper sanitation, diseases such as
cholera will persist in parts of the world that do not fare well in this
respect for instance, Africa.
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