There is a
cholera outbreak in the Nkomazi area, located in the Mpumalanga
province of South Africa. The affected area borders Mozambique,
where an epidemic of cholera has also been reported. As of
February 11, 179 cases and five deaths had been reported.
Cholera is an intestinal infection. The
bacterium is spread through food or water that has been
contaminated by the feces of an infected person. One to five days
after infection, patients develop severe, painless, watery
diarrhea, often called "rice-water" stools. Vomiting also occurs
in most patients. Usually, the symptoms are relatively mild and
respond to oral rehydratation.
Severe cases (10-20%) of cholera can cause life-threatening
dehydration. Treatment involves oral and/or intravenous fluid
replacement and antibiotics, which reduce the volume and duration
A cholera vaccine is available but is rarely
recommended. People who receive the vaccine only develop immunity
50% of the time, and even that immunity lasts for only a few
months. This vaccine is not available in the United States. A new,
more effective oral cholera vaccine has been licensed in Europe,
Canada, Australia and New Zealand. Medical personnel and relief
workers traveling to cholera-infected areas should consider taking
this oral vaccine.
If visiting an area infected with
cholera, drink only boiled or bottled water, water that has been
treated with chlorine or iodine, or carbonated beverages. Avoid
ice, as it may have been made with unsafe water. Choose food that
has been thoroughly cooked while fresh and is served hot. Avoid
street vendors, pre-peeled fruit or salad, fish and shellfish.
Fruit that you wash and peel yourself is safe.