Cholera primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Although cholera can be life-threatening, it is nearly always easily prevented, in principle, if proper sanitation practices are followed. In the United States and Western Europe, because of advanced water treatment and sanitation systems, cholera is no longer a major threat. The last major outbreak of cholera in the United States was in 1911. However, everyone, especially travelers, should be aware of how the disease is transmitted and what can be done to prevent it. Good sanitation practices, if instituted in time, are usually sufficient to stop an epidemic.
Primary prevention
Steps to take in case of suspected cholera outbreak
- Inform and ask for help (supervisor, other centers)
- Treat patients promptly specially patients presenting as some or severe cholera symptoms (as they may deteriorate frequently)
- Protect the community (prevent spread to others)
Checklist for medical professional in case of suspected outbreak
In case of suspected cholera in community medical professionals and hospitals should check the supplies to treat the patients.
- IV fluids (Ringer Lactate is the best, in case of nonavailability of ringer lactate cholera saline or normal saline)
- Oral Rehydration Salt (ORS)
- Antibiotics (doxycycline, erythromycin, tetracycline)
- Drips
- Nasogastric tubes
- Soap
- Chlorine or bleaching powder
- Rectal swabs and transport medium (Cary Blair or TCBS) for stool samples
- Safe water is needed to rehydrate patients and to wash clothes and instruments
Steps to protect the community
- Disinfect water sources with chlorine
- Promote water disinfection at home using chlorine
- Stool and vomit are highly contagious
- Wash your hands with soap after using toilets and latrines, before preparing food, before eating
- Boil or disinfect the water with chlorine solution
- Only eat freshly cooked food
- Do not defecate near the water sources
- Use latrines and keep them clean
- Isolate the severe cases
- Provide information on how to avoid cholera through simple messages on the outbreak
Precautions for funerals
- Disinfect corpses with chlorine solution (2%)
- Fill mouth and anus with cotton wool soaked with chlorine solution
- Wash hands with soap after touching the corpse
- Disinfect the clothing and bedding of the deceased by stirring them in boiling water or by drying them thoroughly in the sun