World map. Source CDC
Perhaps one of the famous landmarks in London medical history is the handless pump that exists in Broadwick Street in Soho, London. In 1854, Dr John Snow discovered the connection between the sewage-contaminated water coming from the pump and the outbreak of cholera, which killed over 500 people. This discovery also elucidated the fact that cholera could also be water-borne disease rather than the prevailing theory, at the given time, that cholera was spread by miasma, a pollution of the atmosphere. This often led people to protect themselves by inhaling sweet scented things.
Oh John Snow, we owe you one.
Now we have the understanding that Cholera is caused by bacteria called Vibrio cholera and is rare in the industrialized developed countries, mainly due to improved hygiene, controlled water system and better living conditions. However, it has increased simultaneously since 2005 and is occurring in developing countries like Africa, Southeast Asia and Haiti1. It is an infection of intestine, which can be life-threatening in some cases but can be easily prevented and treated. Infection is often mild or no symptoms are seen but in some cases it can be severe. Around the world it’s been estimated that 3-5 million cases and over 100,000 deaths occur each year2. Reported cases of cholera have shown that the percentage of cholera death is higher in Africa than anywhere else. 1 in 10 infected people will have severe disease3 with symptoms of diarrhoea, vomiting and leg cramps, with such severe cases leads to dehydration and if untreated can lead to death.
People who have a very low immunity, malnourished children and people with HIV are the one that are high in risk of death if they get infected. In underdeveloped countries the main cause of this disease would be drinking water or food contaminated with cholera bacterium and poor sanitation. During epidemic this disease spreads rapidly in areas with inadequate treatment of drinking water and sewage. The infection doesn’t spread by casual contact with the infected person.
Good news for all is that, it can be successfully treated inexpensively by an immediate replacement of fluid and salts lost due to diarrhoea. These three key ingredients: salt, sugar and water, always found in your kitchen. With rehydration method only few than 1% of cholera patient die4. Along with rehydration method, antibiotic treatment and zinc treatment method are also practiced and has shown positive results.
Dukoral® and ShanChol® are the two oral cholera vaccines available currently prequalified by World Health Organization (WHO)5.