Key facts about cholera

• Health Castilla-La Mancha detects the first case of cholera in Spain since 1979

The case of cholera detected in a young woman from Madrid who was infected last week on a farm in Toledo has brought to the present a disease that has been occurring in Spain since 1979 (later there have been some imported cases).

These are some keys about cholera, a problem that usually occurs in places where there are poor sanitation, overcrowding, war and starvation.

What is cholera?

It is an infectious-contagious, acute and diarrheal disease caused by the bacterium

.

and has few symptoms, although it can sometimes be serious.

It is estimated that one in 20 infected people may have relevant symptoms, characterized by severe diarrhea, vomiting, and malaise.

Fluid loss can lead to

.

The seriousness of the picture is that this dehydration can occur in a few hours.

How is it transmitted?

The spread of the disease occurs by drinking water or eating food contaminated with cholera bacteria.

During an epidemic, the source of contamination is the

, which is full of bacteria.

The disease can spread quickly when the sewage system is not adequate, or the methods to make the water drinkable are not correct.

can

also live in rivers with salt water or in the sea.

Sometimes raw oysters (and undercooked seafood) are the vehicle of transmission of infection.

Transmission from person to person is exceptional

, especially if basic hygienic measures are taken, such as hand washing after going to the bathroom (again, hand hygiene is essential).

How long does it take to incubate and how is it diagnosed?

The time from contact with the bacteria to the appearance of symptoms can be very short, even hours, although the average is two or three days.

(up to 30-40 stools a day), which can look similar to rice washing water, and is often very foul-smelling.

.

It is usually diagnosed by symptoms, although in the case of epidemics it is of interest to

to be sure that it is the cause that has produced the outbreak.

Once the germ is identified, it is not necessary to study all those affected.

For the diagnosis,

.

Bacteria can be seen under the microscope, with a gram stain.

They can also be detected by antibody staining.

The bacterium can be cultured, and for epidemiological purposes the presence of antibodies can be tested in the blood of individuals suspected of having the disease.

Which is the treatment?

Treatment is

of the individual.

If possible, try oral rehydration (more accessible in the third world);

it can also be done intravenously or subcutaneously.

.

,

since it seems that they only serve to reduce the duration of diarrhoea, the liquid requirements and the period of elimination of the bacteria in the faeces.

Tetracyclines, quinolones, trimethoprim/sulfamethoxazole can be used.

How can it be prevented?

Improvements in water supply, sanitation, food hygiene, and community awareness of preventive measures are the best means of preventing cholera.

, which are given orally and are made from killed bacteria, which

, but since protection is not complete, basic hygienic precautions should still be observed.

The role of mass vaccination as a public health strategy to protect populations at risk against cholera is being studied.

The advice given by the WHO to avoid contagion that could be highlighted (and which are summarized in 'boil it, cook it, peel it... or discard it') are:

-Drink only water previously boiled or disinfected with chlorine, iodine or other appropriate products, which can usually be easily obtained in pharmacies.

Beverages such as hot tea or coffee, wine, beer, soft drinks and sparkling water, as well as bottled or packaged fruit juices, are generally safe.

-Avoid ice unless you are sure it was made from potable water.

-Eat only foods that are well cooked and still hot when served.

Cooked foods that are kept at room temperature for several hours and served without reheating are a common cause of infections.

-Avoid raw fish and shellfish and other raw foods.

Fruits and vegetables peeled by yourself are excepted.

-Boil unpasteurized milk before drinking it.

-Ice creams of uncertain provenance are often contaminated and can cause illness.

If in doubt, avoid them.

-Make sure foods purchased from street vendors have been thoroughly cooked in your presence and do not contain uncooked food.

cholera in the world

Cholera

in India, Europe and America, most of them in the 19th century.

But also in the 1990s there was an outbreak in several South American countries that spread rapidly.

The disease has been

.

thanks undoubtedly to the improvement of sanitation and drinking water networks.

It is estimated that climate change and sea level rise will increase the presence of this disease.

No country requires proof of vaccination against cholera as a condition for entry, and the international certificate of vaccination no longer reserves a space to record vaccination against that disease.

According to data from the European Center for Disease Prevention and Control (ECDC), several countries in Africa and Asia have reported

.

Major ongoing outbreaks are being reported from Afghanistan, Bangladesh, Cameroon, the Democratic Republic of the Congo, and Nigeria.

Since the last update on April 29, 2022, approximately

.

The countries that have reported new cases since the previous update are Afghanistan, Cameroon, Democratic Republic of the Congo, Malawi, Nigeria, South Sudan, Pakistan, Tanzania, and Zambia.

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