Cholera is an acute infection of the small intestine that can be life threatening if not detected and treated quickly. It is mainly endemic in developing nations, where there are large populations with poor access to good sanitation and water hygiene.

 

The condition can be prevented with improved sanitation and drinking water hygiene, factors which have been responsible for the eradication of the illness in England for over a century. In the United States, the last cholera outbreak was almost a century ago and for many of the developed nations cholera is no longer a major threat to people's health.

Prevention of cholera

To prevent cholera, the following recommendations are made:

• Good sanitation, since cholera is most commonly transmitted through drinking water that is contaminated with infected faeces. In addition to having access to good sanitation systems and clean drinking water, people should also wash their hands after using the toilet and before preparing and eating a meal.
• Surveillance and reporting of all cases of cholera. The identification, treatment and isolation of cholera prevents further spreading of the disease.
• Education of mass populations regarding good hygiene and safety practices. Such education can help contain the bacteria and prevent it from spreading.

Cholera vaccines

There are two oral cholera vaccines, Dukarol and Shanchol, that have been licensed for use in areas where cholera is endemic. Both vaccines contain whole-cell killed bacteria and reduce the chance of picking up cholera by more than 50% for two years in endemic regions. Dukoral can be used in all age groups to provide short-term protection of up to 85-90% against Vibrio cholerae 01 at 4-6 months following immunization. Shanchol provides longer-term protection against both Vibrio cholerae O1 and O139 in children aged less than five years.