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Health Alert - CHOLERA

April 12, 2010

In Ho Chi Minh City, there were four patients confirmed positive to cholera bacterium last week, and another three people admitted to the hospital with typical symptoms of this disease. The Health Public Authority worries that an outbreak of cholera is potentially happening in HCMC as it is in the northern areas of the country.

• The transmission of cholera occurs through direct fecal-oral contamination or through ingestion of contaminated water and food.
• Vibrio Cholerae bacteria stays in patient’s feces for 07 to 14 days, are shed back into the environment, potentially infecting other individuals.
• Incubation period from two hours to five days enhances potential outbreaks, as the number of cases can rise very quickly.

• Severe watery diarrhea.
  • Diarrhea has fishy odor.
  • Stool looks like water with flecks of rice in it.
• Nausea and vomiting: Occurring in both the early and later stages of cholera; vomiting may persist for hours.
• Muscle cramps: These result from the quick loss of salts such as sodium, chloride and potassium.
  • Dehydration: This can develop within hours after the onset of cholera symptoms.
  • Depending on how much body fluids have been lost, dehydration can range from mild to severe.
• Signs of cholera dehydration: irritability, sunken eye, dry mouth, thirsty, dry and shriveled skin, low blood pressure and irregular heartbeat.
• Fever.
• Shock.

• Cholera can be simply and successfully treated with oral rehydration solution (ORS): a package mixture of sugar and salts to be mixed with water and drunk in large amounts. This solution is used throughout the world to treat diarrhea.
• Severe cases may also require intravenous fluids replacement.
• Antibiotics may be considered by physicians to shorten the course and diminish the severity of the disease.

• Drink only boiled water or safe beverages such as tea and coffee made with boiled water and carbonated; bottled beverages with no ice.
• Eat only foods that are thoroughly cooked or fruits that you have peeled yourselves.
• Avoid undercooked, raw fish or shellfish.
• Make sure all vegetables are cooked, avoid salads.
• Avoid foods and beverages from street vendors.

• The use of cholera vaccine has not been recommended by World Health Organization (WHO) due to its low protective efficacy and the high occurrence of severe side-effects.

• You develop severe watery diarrhea.
• You have signs of dehydration: dry mouth, dry skin, sunken eyes, rapid pulse, thirst, reduce or no urine…

References:
http://www.nlm.nih.gov/medlineplus/ency/article/000303.htm
http://www.who.int/mediacentre/factsheets/fs107/en/
http://www.mayoclinic.com/health/cholera/DS00579
http://www.thanhniennews.com/2010/Pages/20100411162423.aspx

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