Cholera, What you should know.

Cholera is an acute enteric infection caused by the bacteria Vibrio cholerae, which can be found in contaminated water or food. It is a highly contagious disease that can cause severe acute watery diarrhoea with high morbidity and mortality, and it can spread quickly depending on the frequency of exposure, the exposed population, and the setting. Cholera affects both children and adults and, if left untreated, can be fatal within hours. Poor sanitation and a lack of access to safe drinking water predisposes one to this disease. After consuming contaminated food or water, the incubation period ranges from 12 hours to five days. Cholera can also be transmitted when:

• Cooking and eating with utensils washed in contaminated water;
• Food becomes contaminated during or after cooking or preparation and allowed to remain at room temperature for several hours provide an excellent environment for the growth of?V. cholerae;

Most people infected with V. cholerae show no symptoms, despite the fact that the bacteria remain in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting others. The majority of people who develop symptoms have mild or moderate symptoms, while a small percentage develop severe forms of the disease with acute watery diarrhoea and vomiting, resulting in severe dehydration. Cholera is an easily treatable disease. Most people can be treated successfully through prompt administration of oral rehydration solution (ORS) and successful rehydration therapy can keep the CFR below 1%. Currently there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral?, Shanchol?, and Euvichol-Plus?. All three vaccines require two doses for full protection.

How to protect yourself?

• Be sure you drink and use safe water
• Wash your hands often with soap and safe water.
• Use toilets: avoid defecating close to water source
• Cook food well, keep it covered, eat it hot, and peel fruits and vegetables.
• Cook seafood, especially shellfish, until it is very hot all the way through.
• Avoid raw vegetables and fruits that cannot be peeled.
• Safe water collection, transport, handling and storage also need to be ensured and water quality monitored regularly to minimize the risk of microbial regrowth. To minimize the risk of contamination
• Treat your water with any of these methods: boiling, disinfection, chlorination and filtration.

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Outbreak of Cholera in Malawi

There is a current outbreak of cholera in Malawi. Since March 3, 2022, Malawi has been experiencing a widespread cholera outbreak, with 36 943 cases and 1210 associated deaths reported from all 29 districts. The current outbreak began in following tropical storm Ana (January 2022) and Cyclone Gombe (March 2022), both of which caused floods, displacing a population with low pre-existing immunity and a lack of access to safe water, sanitation, and hygiene. Until recently, the outbreak was mostly confined to flood-affected areas in the southern region. The outbreak was mainly limited to the flood-affected areas in the southern region until August 2022 when it spread to the northern and central parts of the country. There have been some interventions that have been put in place to mitigate the cholera outbreak in Malawi this includes:

WASH Interventions: Provision of mobile latrines in the cholera treatment camps and installation of prefabricated latrines in five camps. Households in the affected districts are being sensitized on WASH promotion including water treatment and hand hygiene. House-to-house chlorination is ongoing in affected communities in all the districts.

Rapid response team established in each districts continue to investigate cases. Data collection and analysis is ongoing, and situation reports are being produced and published regularly. Deep-dive epidemiological analysis of the cholera situation is ongoing.

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References

https://choleraoutbreak.org/book-page/section-8-reducing-spread-cholera-community

?https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON435

https://www.cdc.gov/cholera/preventionsteps.html