Each year, between 1.3 and 4 million people are infected with cholera around the world. The disease is highly contagious and deadly. In some cases, fatalities can occur within hours of infection.
Most people infected with the diarrheal disease exhibit only mild symptoms. But for about 20% of those who pick up this bug, severe watery diarrhea and vomiting lead to dehydration and death if left untreated.
Cholera is usually encountered in high-density areas of the developing world where water quality is at risk. The world has experienced 6 cholera pandemics, with the first recorded mass illness recorded in the 19th century. This first cholera epidemic was spawned in India's Ganges delta. It then spread through Southeast Asia and the Middle East through trade routes.
Today, cholera is treatable but still claims hundreds of thousands of lives each year. Vaccines do exist for the Vibrio cholerae bacteria that cause the disease, but they are rare and not always issued to travellers.
In the following article, we'll discuss cholera symptoms and how you avoid the disease.
Cholera is a bacterial infection caused by Vibrio cholerae microbe. The bacteria live in brackish waters along warm coastal areas. However, it thrives in places like estuaries or stagnant, salty river waters.
Since the bacteria is naturally occurring, it is often passed on to humans by eating raw shellfish. These bivalves are filter feeders, so what they eat gets passed on to you.
Once you've become infected, the bacteria begin to produce a toxin. The poison causes the cells located in your intestine to produce excessive amounts of water. This water is then passed on in the form of diarrhea.
You'll lose a lot of water and electrolytes through this severe diarrhea. In many cases, this ends in extreme dehydration.
You spread the bacteria through your body waste, and if proper sanitary or sewage isn't in place, your community runs the risk of exposure and more infections. Treatment for mild cases takes about 3 to 6 days of a steady oral or intravenous rehydration treatment.
This will include replenishing nutrient-rich salts and plenty of clean water. In the worst cases, antibiotics are also administered. It may take up to two weeks for the cholera bacteria to completely leave your body.
History is ripe with cholera epidemics because it was not clear how the disease spread. Experts believe the first pandemic in 1817 was spread throughout Southeast Asia through contaminated rice.
Infections continued to spread for another 6 years and reached as far as England and Russia. While it is not fully known why this pandemic came to an end, some believe the cold winter of 1823-24 helped end the global outbreak.
During an especially deadly outbreak in 1854, Dr. John Shaw in England used the first modern techniques to plot and track the root causes of disease. Through detailed mapping, he tracked the epidemic to a water pump.
After much wrangling with government officials, Shaw argued for the public pump's handle to be removed. Subsequently, the infected area experienced a dramatic drop in cholera cases.
The episode not only cemented Shaw's place as a forefather in epidemiology but demonstrates the importance of isolating the source of the contamination as soon as possible to dampen infection.
Eighty percent of the people infected with cholera show no or mild symptoms, which helps fuel the spread of the disease. However, the other 20 percent will have cholera symptoms of profuse watery diarrhea, vomiting, and cramps. These dehydration-related cramps are often localized in the large muscles of the legs.
As extreme dehydration sets in, the sufferer will develop a blue tint to their skin and lips. Also, the victim will have sunken eyes, cold skin, and wrinkled skin on their hands and feet. At this level of dehydration, death is likely for the patient within hours.
Oral and intravenous fluid replacement is the best way to help cholera suffers. And while antibiotics are useful in helping people fight the disease, they are not useful in stopping the spread.
There are several vaccines for Cholera, but they all have some drawbacks. In many cases, the vaccines only are 65% to 85% effective. The Public Health Agency of Canada recommends the Dukoral vaccine for people travelling to high-risk areas like Haiti, Dominican Republic, Cuba, and Tanzania.
Cholera vaccines tend to lose their effectiveness the further away from inoculation you are. For example, Dukarol has an 85% efficacy rate after four to six months; at a year, the rate decrease to 62%. For this reason, a booster is recommended.
The initial vaccine is administered in two oral doses. You take the first six weeks prior to your trip and the second dose about a week before. Because the efficiency rate does drop over time, a booster is suggested every six weeks to protect against cholera and diarrhea.
The two doses of Dukurol costs $90, and the booster runs around $50. The vaccine for cholera does require a prescription. However, there is an over-the-counter version of Dukoral that is suggested for anyone concerned with contracting diarrhea or a stomach bug while travelling overseas.
Currently, no country requires a cholera vaccine before entering.
Since outbreaks are sporadic and unpredictable, cholera risks are hard to judge. Local governments prohibit travel to cholera-infected areas. No government currently requires a cholera vaccine as a requirement of admittance.
The best way to avoid a cholera infection while travelling is to ensure that the food you eat is properly prepared and thoroughly cooked.
Other tips include:
Also, only use sources of water you know are properly treated and sourced.
While diseases like cholera continue to infect locals and travellers worldwide, the best way to stay safe is to exercise caution.
A great way to do this is with the proper amount of travel insurance. This way protects not only your health but also your finances and your peace of mind.
Learn more about what precautions you should take and contact one of our specialists today.