South Africans were shocked to hear and read about the cholera outbreak in various places in South Africa. Many people have already died in Zimbabwe and South Africa. Even areas like Gauteng were not spared.

1. What is cholera?
The cholera bacterium was identified in 1883 by the well known German bacteriologist Robert Koch. Cholera is a waterborne disease caused by the gram negative bacteria Vibrio cholerae which is ingested by drinking contaminated water. Vibrio cholerae secrete an enterotoxin which promotes secretion of fluids and electrolytes by the small intestine. This results in the production of watery diarrhoea which, if not treated timeously and effectively, will cause death from severe dehydration and shock.

2. How is cholera transmitted?
Vibrio cholerae is spread via the faecal-oral route. It is mostly disadvantaged people who depend on streams and rivers for sanitation who are affected. People drink and wash their food with water contaminated with faeces. Personal hygiene plays an important roll, especially where there is poor sanitation, over-crowding or famine. Incubation period can be from a few hours up to five days.

3. What are the symptoms of cholera?
Vibrio cholerae is a human pathogen en sensitive to the low pH of the stomach. When people do get infected the diarrhoea is profuse, painless and watery and has a fishy odour. Other symptoms include nausea and vomiting, muscle cramps, dehydration and shock.

4. How can cholera be prevented?
Personal hygiene is of the utmost importance. Consuming of uncooked shellfish, vegetables and untreated water in affected areas must be avoided. Do not eat food or drink beverages from street vendors unless the origin and preparation method is known. Drinking water should be boiled for at least 15-20 minutes. Human excretions should be disposed of hygienically without contaminating water sources. Breeding places of flies must be identified and eliminated. Houseflies (Musca domestica) can spread up to 100 different pathogens, i.a. cholera, typhoid fever, tuberculosis, anthrax, E. coli and parasitic worms. Chlorine is also an effective and inexpensive water disinfectant. Unfortunately dead bacteria remain in boiled and chlorinated drinking water. It is also a well known fact that chlorine has adverse health effects. Trihalomethanes (THMs) are formed as a by-product when chlorine is used to purify water for drinking. These by-products could have adverse health effects and 2 many governments set limits on the amount in drinking water.

In emergencies water can be sterilised as follows:
1. Filtrate cloudy water through a clean cloth.
2. Boil water for 15-20 minutes and leave to cool.
3. To improve the taste of boiled water it can be air-rated by pouring it from one glass to another a few times.
4. If water can not be boiled chemicals can be used to sterilise water:
4.1 Add 1 teaspoon Jik or Javel to 25 litres and shake well. Let it stand for at least 2 hours.
4.2 Add 5 drops Jik or Javel to 1 litre water and shake well. Let it stand for at least 30 minutes.
4.3 Add 2 ml Milton to 1 litre water and shake well. Let it stand for at least 30
minutes.

One of the most effective means to get rid of bacteria and viruses is to use a reverse osmosis membrane. Reverse osmosis or crossflow membrane technology is the most advanced technology in water purification. The size of the membrane pores are 0,0001 micron. A Vibrio cholerae bacteria measures only 3x0,5 micron. Bacteria and viruses are separated and drained away. At the same time the membrane also gets rid of toxic heavy metals, agricultural,industrial and mining wastes that pollute our dams, rivers and boreholes.

For more information about Cholera and treatment solutions, please contact us.

Sources:
Gillies R R en Dodds T C (1973). Bacteriology Illustrated. Churchill Livingstone, London.Internet: Lancet Laboratories – Newsletter.
www.allafrica.com
www.wikipedia
Rochon, K (1998). Persistence and Significance of E.coli in Houseflies (Musca domestica) andStable Flies (Stomoxys calcitrans). University of Lethbridge, Canada.National Department of Health (June 2001). Guidelines for Cholera Control. Pretoria.