* Prices may differ from that shown
Cholera was once widely spread in developed countries including England during the time when there wasn't proper sewage and water systems. Due to the implementation of these cholera has pretty much been eradicated - but poorer countries are not so lucky. --- What it is --- Cholera is caused by a bacterial toxin which affects the absorption of water in the small intestine. The bacteria which enters the gut does not really cause the symptoms, but it is rather the build-up of toxins in the intestines. It usually enters the body through drinking contaminated water but also through contaminated food, mainly raw or poorly cooked fish and raw fruits and vegetables. In areas without proper sewage systems spread is increased because the bacteria remains in the faeces. --- Risk Areas --- Areas at risk, as previously mentioned, are those with poor sanitation, overcrowded areas and with poor food hygeine. At the moment there have been outbreaks of cholera in east Africa and some areas of South Asia including India. Before traveling you should always discuss the risk of cholera with your GP. The WHO will also have up-to-date information on it's spread. --- Prevention --- The best means of prevention is being cautious when you have reached your destination country, particularly when there has been a recent cholera case or outbreak. Drink only water that is bottled, boiled or disinfected unless your travel agent/tour guide tells you it is safe. You should also check food is properly cooked and avoid raw foods. The main thing if you are ever in doubt of the hygiene then avoid it! The local people in the area tend to have a resistance to a lot of the bugs which makes us ill so they probably aren't reliable when asking about the safety of water sources. There is an oral cholera vaccine currently available on prescription from your GP. If you're entitled to free prescriptions then it qualifies for this, otherwise I think you have to pay the standard fee of around £8. Don't leave collecting it till the last minute though as most pharmacies won't regularly have it in so you may have to wait a few days for delivery. The vaccine is a somewhat fizzy raspberry flavoured drink which surprisingly doesn't taste that bad! What you do is mix a powder in with some water and then drink. You have to take two doses - I can't remember what the difference is between the two doses though. I think you take the second anytime after 1 week. --- Symptoms --- The incubation period is between 2 and 5 days so you can still have cholera when you've returned home. The infection may start as usual diarrhea but then worsen to a fever, stomach cramps, severe diarrhea and vomiting. --- Treatment --- The most important thing if you have any of these symptoms is to drink plenty of water as the main cause of death from this disease is dehydration. The Net Doctor suggests including salt and sugars in this mixture - I'm not completely sure of the technicalities of this suggestion. When you have received medical attention they may give you antibiotics to combat the infection further.
Cholera makes Swine Flu look like a summer cold. I remember living in Nigeria in the early 1970s when there was a cholera outbreak. There was plenty of public information about the outbreak. This was the only safeguard, as there is no public health service, poor sanitation and overcrowding. These are perfect conditions for an outbreak to turn into an epidemic. About 23,000 people caught it, nearly 3,000 died a horrible death. Cholera spread like wildfire, rumours and misinformation spread even faster. Everyone knew which areas it had spread to, so that they could give them a very wide berth. Neither food nor people went in or out. We all knew or thought we knew what signs and symptoms to look out for, so anyone who had sickness and diarrhoea would find themselves surrounded by a very wide empty circle as everyone stampeded in the opposite direction. I can't help contrasting this with the current outbreak of swine flu that is threatening, and it would appear spreading around the country with no ne really batting an eyelid. No mass hysteria no voluntarily imposed quarantines. We are really fortunate in having a National Health service and decent public housing. If Cholera were to spread her from India or Africa where outbreaks commonly occur, it's progress would be largely controlled by the ready availabilty of medical attention, by the fact that however creaky , we do have a reasonable sewerage system and we are not all crowded into close proximity.