Prevention and Control of Cholera

New Delhi, September 11, 2019 :
Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. Researchers have estimated that every year, there are 1.3 to 4.0 million cases, and 21 000 to 143 000 deaths worldwide due to cholera.
Cholera is an extremely virulent disease that can cause severe acute watery diarrhoea with severe dehydration. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water. Cholera affects both children and adults and can kill within hours if untreated.
Most people infected with Vibrio cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people. Cholera is often predictable, preventable and can ultimately be eliminated where access to clean water and sanitation facilities, and satisfactory hygiene conditions are ensured and sustained for the whole population.
Measures for the prevention of cholera mostly consist of providing clean water and proper sanitation to populations who do not yet have access to basic services as well as vaccination with Oral Cholera Vaccines. Health education and good food hygiene are equally important. Communities should be reminded of basic hygienic behaviours, including the necessity of systematic hand-washing with soap after defecation and before handling food or eating, as well as safe preparation and conservation of food. In addition, strengthening surveillance and early warning systems greatly helps in detecting the first cases and put in place control measures.
A multi-sectoral, systems strengthening approach is key to prevent and control cholera, and to reduce deaths. The development and implementation of multi-sectoral cholera control plans can serve as a useful mechanism for bringing together all relevant sectors, and forging lines of communication and coordination that are valuable beyond cholera control.
Since the creation of the global stockpile in 2013, more than 50 million doses of oral cholera vaccines have been successfully used in various settings through mass campaigns. The use of Oral Cholera Vaccines (OCV) is an additional tool to the classic cholera control measures. It should be systematically considered in both endemic cholera hotspots as well as during outbreaks and emergencies.
OCV are safe and effective. OCV are just one tool in a much larger toolbox that includes sustainable safe water, sanitation, and hygiene (WASH), but it serves as a critical bridge to these longer-term efforts.

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