Читать книгу (101 things to know when you go) ON SAFARI IN AFRICA - Patrick Brakspear - Страница 59

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. Epidemics of cholera have occurred over the centuries but have been largely eliminated from countries with safe water supplies & proper sanitation although infrequent local outbreaks do occur in Africa from time to time.

Cholera is spread by water and food contaminated with the germ by unhygienic handling, or by flies. Sudden, large outbreaks are usually caused by a contaminated water supply. The germ can survive in fresh water for days or even a few weeks. Unless conditions are particularly unhygienic direct person-to-person transmission is rare.

Most infected people do not become ill although the bacterium can be detected in the faeces for 1 to 2 weeks. When illness does occur more than 90% of cases have mild to moderate diarrhoea indistinguishable from other causes such as simple traveller's diarrhoea. Less than 10% develop the dramatic & frightening disease with copious, painless diarrhoea quickly leading to severe dehydration & death within hours or days, if treatment is not promptly given.

Prevention - boiling water will kill the cholera organism as will filtered water treated with iodine or chlorine. Sealed bottled water with an identifiable label is safe. Do not trust any ice. Food that is thoroughly cooked & comes to you piping hot is safe. It is best to avoid shellfish. Avoid raw fruits & vegetables unless you can peel them or you are certain that they have been adequately washed. Avoid food that is likely to have been standing around & contaminated by flies. These are simple & time-tested precautions that will prevent cholera (and other water-borne diseases).

An effective 2 dose oral vaccine is now available, and this can provide good protection, up to 80%, for 2-3 years. Currently, no country requires proof of cholera vaccination as a condition for entry.