HEALTH MATTERS with DR JOE
AS WE are facing a cholera outbreak as a nation, there is no more befitting moment to start discussing health matters than now.
To kick the ball rolling let us delve into the medieval disease that is currently causing havoc in our country and the region Cholera. Cholera is an infectious disease that is caused by the bacteria vibrio cholerae. This bacteria mainly infects our small intestines resulting in the classic presentation of profuse watery diarrhea that may be coupled with vomiting and abdominal pain.
The incubation period, i.e. the time it takes for one to develop symptoms after being infected by the cholera bacteria, ranges from two hours to five days. What this means is you can contract cholera now as you are reading this article and by the time you finish reading the sports section you could actually be having diarrhoea.
Which means the incubation period can be that short. And generally the longest you will take before symptoms surface is five days. It is quite embarrassing for us to still be talking about cholera in the twenty-first century especially if you are to know its mode of transmission. In the first world countries they no longer look at cholera as a life-threatening condition because they have managed to curtail it.
In Europe, for example, their last cholera outbreak was before World War 1, which is more than a century ago. So, simply put, we are about a hundred years back if we are still dealing with cholera outbreaks. Now to the mode of transmission of cholera, which is one of those discussions that every time I talk about especially when I am giving a speech in public, people develop goose bumps and generally get embarrassed at the same time. I always prefer calling a spade a spade when it comes to this.
So cholera is spread by what we term “the direct faecal oral route”. What this means in simple terms is what most people get uncomfortable to hear; it means that when someone suffers from cholera they would have ingested some faeces. Yes, I need you to get this clearly, if someone is suffering from cholera it means they have eaten some human excreta.
Now that we know how people get to suffer from cholera, let us avoid eating faeces so that we do not suffer from cholera. Now what makes this direct faecal oral route mode of transmission of cholera are what we call the risk factors.
Poor water and sewer reticulation systems are one of the top causes of cholera outbreaks. If you look at the three outbreaks we have had as a country -2008, 2017 and the current one-you will see that they mainly occur in high density areas.
This is not because people living in high density areas are less hygienic compared to their counterparts in the low density areas, NO. It is mainly because of poor water and sewer reticulation systems in the high-density areas.
Overcrowding is the next risk factor associated with cholera. Because of overcrowding in our high density residential areas we see an increase in burst sewer pipes with faecal matter flowing in the streets, which in turn go on to contaminate our water sources that are our wells and also our community boreholes.
Limited supply of clean running tap water is the other risk factor that makes it difficult for people to avoid contracting cholera. The most important thing you need to do to minimise your chances of contracting cholera is to make sure you break the faecal oral route chain.
And how do you do that at a personal and family level? The first thing you need to do is to make sure that all your water sources are clean and free from cholera. For you to make sure that your water sources are clean from cholera, you can do one of the following simple steps.
Firstly, you can boil your water before using it. Vibrio Cholerae, the cholera bacteria will definitely die once water is boiled. Secondly you can use chlorine containing agents such as water guard to rid your drinking water of cholera.
Once you do one of the two simple steps outlined above then your water is now safe to use. It therefore means that you can wash your fruits and vegetables using your clean drinking water. You can safely wash your hands with the clean water before touching any food stuff.
You can safely drink the water and not contract cholera. You can safely bathe in the water; especially children, without contracting cholera. Yes children tend to drink a bit of the bathing water as you are bathing them so they can actually contract cholera whilst bathing.
As such, it is imperative that we bath them in water that is free from vibrio cholerae. If you unfortunately contract cholerae or even suspect you have contracted it, the first and most important thing you need to do before you even go to the hospital is to prepare salt and sugar solution or buy oral rehydration solution from the nearest pharmacy and start drinking it as soon as possible.
Please note you have to start taking the salt and sugar solution whilst still at home and on your way to the hospital. Salt and sugar solution is very important to minimise your chances of getting dehydrated. Dehydration is the main cause of complications from kidney damage to electrolyte imbalances and ultimately death.
As such, we implore anyone who is having diarrhoea to please start taking salt and sugar solution as soon as possible. If your child is still breastfeeding, please breastfeed as frequently as possible to minimise dehydration if you suspect they have cholera. Let us not wait to get to the hospital or clinic before we start taking salt and sugar solution or giving it to the affected child.
Yes we will give you antibiotics to kill the cholera bacteria, but without rehydration it is difficult to win the war against cholera. If you are to remember anything remember to take salt and sugar solution as soon as you suspect you have cholera and above all, remember a healthy you, a healthy me to a healthy world.
Chiripanyanga is an experienced Harare-based medical doctor with a passion for educating the public on health issues who is contactable on joechiripanyanga@gmail.com, +263719395231, @drjoe263 and www.drjoe263.com)