Community Mobilization Against Cholera

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Cholera is a diarrhoeal disease caused by infection of the intestine with the bacterium Vibrio cholera, either type O1 or O139. Both children and adults can be infected. About 20% of those who are infected develop acute, watery diarrhoea; 10 – 20% of these individuals develop severe watery diarrhoea with vomiting (Lindström and Salutogenesis 2005; 59(6):440-442). If these patients are not promptly and adequately treated, the loss of such large amounts of fluid and salts can lead to severe dehydration and death within hours. The case-fatality rate in untreated cases may reach 30–50%. Treatment is straightforward (basically rehydration) and, if applied appropriately, should keep case-fatality rate below 1%. Cholera is usually transmitted through faecally contaminated water or food and remains an ever-present risk in Zambia (and many other countries). New outbreaks can occur sporadically in any part of the world where water supply, sanitation, food safety, and hygiene are inadequate. The greatest risk occurs in over-populated communities and refugee settings characterized by poor sanitation, unsafe drinking-water, and increased person-to-person transmission. Because the incubation period is very short (2 hours to 5 days), the number of cases can rise extremely quickly (Lindström and Salutogenesis 2005; 59(6):440-442). It is impossible to prevent cholera from being introduced into an area – but spread of the disease within an area can be prevented through early detection and confirmation of cases, followed by appropriate response. Because cholera can be an acute public health problem – with the potential to cause many deaths, to spread quickly and eventually internationally, and to seriously affect travel and trade – a well-coordinated, timely, and effective response to outbreaks is paramount. Response activities should always be followed by the planning and

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