A vicious intestinal infection caused by the Vibrio cholerae, cholera could kill a healthy adult within hours if not checked in time.1 And the 2.9 million cases and 95,000 deaths across the world every year confirm that cholera can’t be taken lightly.2 This diarrheal disease is rampant in places that lack proper water supply or sewage systems or where the infrastructure has broken down, be it through war or conflict, or natural disasters like hurricanes and floods. While cholera episodes are rare in the United States, international travel, infected seafood, or outbreaks in neighboring countries have been known to be triggers.
[pullquote]Young children, the elderly, people living in extreme poverty, and immunocompromised individuals are at high risk. A mild infection may not cause any symptoms but, typically, around 10% of infected people have a severe infection which results in extremely watery diarrhea, leg cramps, and vomiting. This can quickly lead to loss of bodily fluids and, consequently, dehydration and shock.[/pullquote]
The bacteria that cause cholera can be transmitted via food or water which has been contaminated by fecal matter from a person who has this disease. They may also be found in coastal waters and brackish waters and have also been known to spread through the consumption of undercooked or raw shellfish.3 4 If you are traveling to or are in a place where basic water and sanitation infrastructure is compromised or you suspect a cholera outbreak, taking measures to protect yourself from cholera may even mean the difference between life and death. Here are a few simple but effective measures that can help prevent this disease:5
1. Wash Your Hands
[pullquote]While caring for any sick person, wear gloves and wash your hands after every interaction. Bathe more frequently as well.[/pullquote]
It’s important to wash your hands regularly with water and soap to avoid transferring the bacteria which cause cholera to your mouth through them. Make sure you wash your hands before preparing food, after using the toilet, after cleaning your baby’s bottom, and before feeding children or eating. Just simple but frequent washing with soap and water can be even more effective than other means like using sanitizers.
2. Consume Safe And Clean Water
Ensure you use clean water from safe and uncontaminated sources when preparing or washing food, cleaning areas used for preparing food, cleaning dishes, brushing your teeth, and making ice. Usually, this isn’t a challenge when you are at home and in familiar surroundings.
When you are in unknown environs, explore options for drinking water and find out about local practices. For instance, in many parts of the world, water cannot be drunk straight off the tap. You will need to purify or boil this water before it can be consumed. When in doubt, opt for bottled water where possible. Always make sure the seal is intact and check labeling to rule out a spurious brand.
[pullquote]Don’t contaminate drinking water sources: make sure you bathe and wash clothes and nappies at least 30 meters away from a source of drinking water.[/pullquote]
If you are in a situation where you don’t have access to bottled water, suspect the water is contaminated but are forced to use it, take measures to ensure your water’s safe.
- As a first step, collect water and let it sit till all solid particles have settled.
- You can now use a sand and charcoal filter or a clean fabric to filter the water.
- Once this is done, you need to disinfect the water.
You could boil water or treat it with agents that decontaminate it. If you are boiling the water, make sure it boils fully for at least a minute. Bleaching agents like chlorine, lime, or lemon are other options. While lime or lemon isn’t a foolproof method, it is considered a better option than not decontaminating at all and have been known to prevent cases of cholera. A juice of lemon or lime can be added to a liter of water to kill germs.
If you are using household bleach, you need to add about 2 drops to a liter of water. Chlorine products that you buy will have further instructions on how they need to be used.6 You also need to make sure your water containers are clean and you never put your hands into drinking water.
3. Eat Only Food That’s Properly Cooked
Like water, you need to be wary about food as well when you are caught in a strange or unfamiliar environment.
- As much as possible, eat food that’s been thoroughly cooked and eat it while it is hot. This especially applies to shellfish such as crayfish and crabs – ensure they have been cooked properly all the way through.
- Don’t mix raw and cooked food with raw foods such as salads and relishes. If you do have uncooked vegetables or fruits, say in a salad, be sure it is from a reliable source. Or peel and prepare it yourself using only clean, treated water.
- It is best to avoid ice cream and ice if you aren’t certain that they were made with clean water.
- Avoid eating from a shared plate or container to minimize exposure to germs.
4. Dispose Of Poop Safely
Use a latrine or chemical toilets to defecate. Clean surfaces contaminated with poop using household bleach diluted with water in the proportion of 1:9. In case you don’t have access to a toilet, make sure you are at least 30 meters away from water bodies when you defecate and bury your poop. A half meter deep pit or trench can function as a temporary toilet. After every use, a layer of soil should be used to cover the trench. If the area is cholera-prone, health authorities also ask that a layer of lime be used to line the trench every day.
5. Get Vaccinated
[pullquote]Oral rehydration solutions can help replace salts and fluid lost through diarrhea due to cholera. With immediate rehydration, less than 1% of people affected by this disease die. Severe cases of dehydration may need fluids to be given intravenously.7[/pullquote]
Several vaccines endorsed by the WHO are available against cholera. In the United States, an FDA-approved vaccine for cholera is usually recommended if you are traveling to places where this disease is common and you won’t be able to access medical facilities. This can, however, protect against only certain strains of the cholera bacteria and only for some months. It is still important to follow the other preventive measures mentioned here even if you have been vaccinated.