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Medical Alerts

South Africa    February 25, 2004 10:16 GMT


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.

The Disease
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 of diarrhea.

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.

Preventive Measures
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.

SOS Analysis

Risk for Travelers
Cholera tends to occur in large epidemics, especially in areas where sanitary conditions have deteriorated (such as refugee camps and war zones). With the exception of health and relief workers, cholera rarely infects travelers who avoid unsanitary conditions.

Medical personnel and relief workers traveling to cholera-infected areas should consider getting the cholera vaccination.

For more information:

  • See the SOS Country Guide on South Africa
  • See "Cholera" in the "Diseases and Prevention" dropdown on SOS Country Guides
  • Contact any SOS Alarm Center