As the monsoon season sweeps across the country, bringing with it the much-needed respite from the scorching summer heat, it also ushers in a host of health challenges. Among these, cholera stands out as a particularly dangerous threat. This acute diarrheal disease, caused by the ingestion of food or water contaminated with the bacterium Vibrio cholerae, can lead to severe dehydration and, if untreated, can be fatal within hours. The monsoon's heavy rains and flooding create the perfect breeding ground for this pathogen, making it crucial to understand the causes and adopt effective prevention measures.
To understand the symptoms, causes, and ways of preventing cholera, OnlyMyHealth interacted with Dr Kiran Dhake, Corporate Wellness Physician, Mumbai. Explaining the disease, he said, “Cholera is a water-borne disease that leads to sudden illness caused by a bacterial infection of the intestine. The bacteria causing the infection are known as Vibrio cholerae. The spectrum of symptoms is variable, often mild or without symptoms, but can sometimes be catastrophic.”
Sources of Cholera Infection
Cholera is primarily caused by consuming food or water contaminated with Vibrio cholerae. Citing sources, Dr Dhake said, “This often occurs through municipal water supplies, ice made from such water, street food, and vegetables irrigated with contaminated water. Areas experiencing famine are particularly vulnerable due to the scarcity of safe food and water. Poor sanitation practices, including inadequate water treatment, overcrowded living conditions, and insufficient hygiene, also contribute to the spread of cholera.” Additionally, eating raw or undercooked seafood, especially shellfish from contaminated tropical reefs and salty rivers, can lead to infection.
Also read: From Cholera To Dengue: Understanding Major Epidemic Diseases In India
Symptoms of Cholera
According to Dr Dhake, most people infected with cholera do not develop symptoms or may have mild symptoms. “It takes between 12 hours and 5 days for a person to show symptoms. The bacteria remain in their feces for 1–10 days after infection, potentially infecting others,” he said listing some common symptoms of cholera.
- Severe acute watery diarrhea ("rice water stools")
- Vomiting
- Rapid loss of body fluids leading to intense thirst, dehydration, and shock
- Leg cramps
- Restlessness and irritability
- Fast heart rate, loss of skin elasticity, dry mucous membranes, low blood pressure (late symptoms)
- Progressive dehydration can be fatal if not treated early
Preventive Measures to Curb Cholera Infection During Monsoon
Cholera becomes more pronounced during monsoon and post-monsoon seasons due to waterlogging and overflowing drains contaminating water bodies. A multifaceted approach is required to control cholera and reduce complications, including surveillance, water, sanitation and hygiene, social mobilization, and treatment. Below are some measures recommended by Dr Dhake to prevent cholera.
1. Water Intervention: Access to Safe Water
The long-term solution for cholera control lies in universal access to safe drinking water. Dr Dhake advised, “Use boiled, filtered, properly chlorinated, bottled, or canned water for drinking purposes. Avoid drinking piped water or water/drinks sold in plastic mugs, cups, bags, or broken bottles.” Use water that has been properly chlorinated, boiled, filtered, or bottled with unbroken seals for drinking, brushing teeth, washing and preparing food, and making ice or beverages.
2. Sanitation Intervention
Sanitation standards should be adhered to at the individual and community level to reduce the incidence of cholera and other waterborne diseases. Dr Dhake strongly recommended to use toilets or latrines with optimal sanitation facilities, ensuring that drainage or disposal of feces does not leak into water sources. “If toilet facilities are unavailable, defecate at least 30 meters away from water bodies and dispose of the fecal matter by burying it or in plastic bags. Bags should be disposed of in a pit away from water bodies,”he said.
Hand Hygiene: Wash hands with soap and water:
- Before, during, and after food preparation
- Before and after feeding children
- After using the toilet
- After cleaning a child’s bottom
- After nursing someone sick with diarrhea
Food Sanitation:
- Eat foods that have been thoroughly cooked and are still hot and steaming.
- Consume fruits and vegetables that you have peeled yourself. Avoid uncooked or undercooked food, especially seafood.
Cleanliness Standards:
- Clean and disinfect kitchenware and areas with soap and water where food is prepared. Allow the area to dry completely.
- Bathe and wash clothes or diapers at least 30 meters (100 feet) from drinking water sources.
- Periodically clean and disinfect toilets and surfaces contaminated with fecal matter. Use a solution of 1 part household bleach to 9 parts water for disinfection.
4. Vaccination
“Oral cholera vaccines are available and can provide protection in endemic areas, during humanitarian crises, and during cholera outbreaks. Vaccination should always be combined with other prevention and control strategies,”Dr Dhake said.
5. Early Recognition and Immediate Treatment
- Reversing dehydration is the mainstay of cholera treatment. Immediate replacement with oral rehydration solutions and IV fluids should be undertaken.
- Supportive treatment may include antibiotics, zinc, or validated probiotics for cholera.
Conclusion
Cholera remains a global threat to public health and an indicator of inequity and lack of social development. Along with early detection and quick response, public health measures such as promoting preventive strategies, constant surveillance, education about water sanitation and hygiene standards, oral vaccination, and implementing infection control practices should be actively pursued, especially in cholera-prone regions globally.