CHOLERA REPORTED  FROM KOTTAYAM DISTRICT !!!

TWO CASES OF CHOLERA HAS BEEN REPORTED FROM KOTTAYAM DISTRICT. ONE CASE AT ETTUMANOOR AND ONE CASE AT ATHIRAMPUZHA. EPIDEMIC ALERT AND EPIDEMIC PREDICTION HAS BEEN ALREADY GIVEN TO ALL INSTITUTIONS.

THIS IS A WARNING SIGNAL SO EVERYBODY SHOULD TAKE CARE AND INITIATE ALL POSSIBLE MEASURES TO PREVENT OCCURRENCE OF FURTHER CASES.

Cholera is an acute enteric infection caused by the ingestion of bacterium Vibrio cholerae present in faecally contaminated water or food. Primarily linked to insufficient access to safe water and proper sanitation.Cholera is characterized in its most severe form by a sudden onset of acute watery diarrhoea that can lead to death by severe dehydration. The extremely short incubation period - two hours to five days - enhances the potentially explosive pattern of outbreaks, as the number of cases can rise very quickly. About 75% of people infected with cholera do not develop any symptoms. However, the pathogens stay in their faeces for 7 to 14 days and are shed back into the environment, possibly infecting other individuals. Cholera is an extremely virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. Individuals with lower immunity, such as malnourished children or people living with HIV, are at greater risk of death if infected by cholera.

Diagnosis

The presence of V. cholerae in stools is confirmed through laboratory procedures. However, a new rapid diagnostic test (RDT), now available, allows quick testing at the patient's bedside.

Measures for the prevention of cholera mostly consist of providing clean water and proper sanitation.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.

Among people developing symptoms, 80% of episodes are of mild or moderate severity. The remaining 10%-20% of cases develop severe watery diarrhoea with signs of dehydration. Once an outbreak is detected, the usual intervention strategy aims to reduce mortality - ideally below 1% - by ensuring access to treatment and controlling the spread of disease.

Case management

Efficient treatment resides in prompt rehydration through the administration of oral rehydration salts (ORS) or intravenous fluids, depending of the severity of cases. Up to 80% of patients can be treated adequately through the administration of ORS (WHO/UNICEF ORS standard sachet). Very severely dehydrated patients are treated through the administration of intravenous fluids, preferably Ringer lactate. Appropriate antibiotics can be given to severe cases to diminish the duration of diarrhoea, reduce the volume of rehydration fluids needed and shorten the duration of V. cholerae excretion. For children up to five years, supplementary administration of zinc2 has a proven effective in reducing duration of diarrhoea as well as reduction in successive diarrhoea episodes.

Cholera vaccines

The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the high occurrence of severe adverse reactions. An internationally licensed oral cholera vaccine (OCV) is currently available on the market in limited stocks and is suitable for travellers. This vaccine was proven safe and effective and is available for individuals aged two years and above. It is administered in two doses 10-15 days apart.