12 September 2018

Zimbabwe: Cholera Alert

Cholera is an acute epidemic infectious disease characterised by watery diarrhoea, extreme loss of fluid and electrolytes, and severe dehydration.

Due to severe dehydration, fatality rates are high when untreated, especially among children and infants.

Death can occur in otherwise healthy adults within hours. Those who recover usually have long-term immunity against reinfection.

Diarrhoea is the key symptom of cholera.


They typically include:

Large volumes of explosive watery diarrhoea, sometimes called "rice water stools" because it can look like water that has been used to wash rice

i) Vomiting

ii) Leg cramps

A person with cholera can quickly lose fluids, up to 20 litres a day, so severe dehydration and shock can occur.

Signs of dehydration include:

I. loose skin

II. sunken eyes

III. dry mouth

IV. decreased secretion, for example, less sweating

V. fast heart beat

VI. low blood pressure

VII. dizziness or light-headedness

VIII. rapid weight loss

Shock can lead to collapse of the circulatory system. It is a life-threatening condition and a medical emergency.


Cholera is more common where there is overcrowding and poor sanitation.

Cholera bacteria enter the body through the mouth, often in food or water that has been contaminated with human waste, due to poor sanitation and hygiene.

They can also enter by eating seafood that is raw or not completely cooked.

Poorly cleaned vegetables irrigated by contaminated water sources are another common source of infection.

In situations where sanitation is severely challenged, such as communities with highly limited water resources, a single affected victim can contaminate all the water for an entire population.


It is normally dehydration that leads to death from cholera, so the most important treatment is to give oral hydration solution (ORS), also known as oral re-hydration therapy (ORT).

The treatment consists of large volumes of water mixed with a blend of sugar and salts.

Severe cases of cholera require intravenous fluid replacement. An adult weighing 70 kilogrammes will need at least 7 litres of intravenous fluids.

Antibiotics can shorten the duration of the illness, but the WHO does not recommend the mass use of antibiotics for cholera, because of the growing risk of bacterial resistance.

Anti-diarrhea medicines are not used because they prevent the bacteria from being flushed out of the body.

With proper care and treatment, the fatality rate should be around 1 percent.


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