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Cholera: Outbreak in Yemen

Cholera: Outbreak in Yemen

Yemen is located south of Saudi Arabia and is separated from Africa by the Red Sea and Gulf of Aden. The population is over 26 million people and the average life expectancy for males is 64, and for females, 67. On June 8, 2017 a press release was issued by the World Health Organization (WHO) notifying the world of the cholera epidemic that is ravaging the country. The suspected number of cases is over 140,000. As of June 15, 2017, 989 people have died.

Cholera was first recorded in 1563, but is believed to have existed long before. In the U.S., there were 4 separate epidemics: 1832, 1849, 1866, and the late 1870's. At that time, American citizens believed it to be caused by the stench of illness and death, filthy living conditions, or by the wrath of God. For each outbreak, deaths totaled 5-10% of the population.

An abundance of information on cholera now exists. Cholera is a sudden illness caused by the presence of vibrio cholera, a bacterium that is found in the intestine.

A person can get cholera by drinking water or eating food contaminated with the cholera bacterium. In an epidemic, the source of the contamination is usually the feces (poop) of an infected person that contaminates the water and/or food source. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water, poor sanitation, and inadequate hygiene. The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.

Cholera infection is often mild or without symptoms, but can sometimes be severe. Approximately 1 in 10 infected persons will have severe disease, characterized by profuse watery diarrhea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

To test for cholera, a stool sample or a rectal swab is sent to a laboratory to look for the cholera bacterium.

Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Severe cases require intravenous fluid replacement. With prompt re-hydration, fewer than 1% of cholera patients die. Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as receiving re-hydration

The risk for cholera is very low for people visiting areas with epidemic cholera. All people in areas where cholera is occurring or has occurred should observe the following recommendations:

·         Drink only bottled, boiled, or chemically treated water and bottled or canned carbonated beverages. Avoid tap water, fountain drinks, and ice cubes

·         Wash your hands often with soap and clean water

·         If no water and soap are available, use an alcohol-based hand cleaner. Clean your hands especially before you eat or prepare food and after using the bathroom

·         Use bottled, boiled, or chemically treated water to wash dishes, brush your teeth, wash and prepare food, and make ice

·         Eat foods that are packaged or that are freshly cooked and served hot. Do not eat raw and under-cooked meats and seafood or unpeeled fruits and vegetables

·         Dispose of feces in a sanitary manner to prevent contamination of water and food sources

For Traveler information https://wwwnc.cdc.gov/travel/

For more information of cholera, visit https://www.cdc.gov/cholera/general/index.html

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