Cholera

Nov 1, 2012
2012 / November 2012

Cholera is an acute infection caused by the bacterium Vibrio cholerae that results in diarrhea and severe dehydration. Left untreated, cholera can be fatal in a matter of hours to even healthy individuals. An estimated 3 to 5 million cases and more than 100,000 deaths occur each year around the world.

Most often spread by ingesting contaminated food or water, cholera occurs in places with poor sanitation or overcrowding; impoverished countries; refugee camps; and areas devastated by war, natural disaster or famine. Water may be contaminated by the feces of an infected person or by untreated sewage. Food may be contaminated by water containing the bacteria or by being handled by a person with cholera. The disease is not likely to spread directly from person to person, so casual contact with an infected person is not a risk. A type of cholera is associated with infected shellfish, especially raw oysters.

In the United States, incidence due to contaminated food is low, but there has been a cholera pandemic in Asia, Africa and Latin America for the last four decades. Sierra Leone is experiencing its worst outbreak in 15 years, with more than 19,000 cases and 274 deaths as of Sept. 19. Outbreaks have been ongoing in Haiti and the Dominican Republic for two years, with more than 140,000 cases in Port-au-Prince alone, though the number of cases decreased recently. This year saw the first outbreak in Cuba in more than a century, with 236 confirmed cases and three deaths as of July 31.

Symptoms of cholera include abdominal cramps, dry mucous membranes, dry skin, excessive thirst, glassy or sunken eyes, lack of tears, lethargy, low urine output, nausea, rapid dehydration, rapid heart rate, unusual sleepiness or tiredness, leg cramps and watery diarrhea that starts suddenly and has a fishy odor. Children have the same symptoms as adults but may also experience fever and convulsions. In infants, the soft spot (fontanel) on the top of the baby’s head will appear sunken.

Inform your physician if you are returning from a country where cholera occurs. Cholera infection is often asymptomatic or results in mild gastroenteritis. Severe cholera is characterized by acute, profuse watery diarrhea described as “rice-water stools” and often vomiting. Dehydration from cholera can be rapid, leading to shock and death within hours.

Cholera is confirmed through a stool specimen or rectal swab. The best treatment is oral rehydration with fluids containing salts; intravenous fluids are used when necessary. Antibiotics shorten the course of the disease and diminish the severity but are not as important as rehydration. The World Health Organization developed oral rehydration salts (powder that can be reconstituted with bottled water) that are cheaper and easier to administer than typical IV fluid. Up to 80 percent of cases can be successfully treated with ORS.

Most U.S. travelers are not at high risk of getting cholera. However, travelers to an area with a known outbreak should take steps to avoid getting sick. The Centers for Disease Control believe the two oral cholera vaccines currently available abroad offer incomplete protection for a relatively short time, so they are not available in the United States. For information about these vaccines, contact your health care provider or local public health office. No country requires immunization against cholera as a condition of entry.

The best way to avoid getting sick is to follow water and food safety precautions. Use bottled or canned water or carbonated beverages with unbroken seals. Use safe water to brush your teeth, wash, prepare food and make ice. Clean food preparation areas and utensils with soap and safe water and let dry completely before reuse. Piped water sources, ice and drinks sold in cups or bags may not be safe; boil or treat all water for drinking or making ice.

Wash your hands often with soap and safe water, especially before eating, preparing food and feeding children; and after using the bathroom, changing diapers or taking care of someone who has diarrhea. In lieu of soap, use hand sanitizer containing at least 60 percent alcohol. Wash yourself, your children, diapers and clothes at least 100 feet away from drinking water sources.

Do not defecate in any body of water. Use toilets, latrines or chemical toilets. Clean toilets and surfaces with a solution of one part household bleach to nine parts water.

WATER SAFETY

• Boil unbottled water for at least one minute.

• Or treat with purification tablets.

• Or treat with household bleach (eight drops/gallon of water; two drops/liter) and let stand 30 minutes.

• Store treated water in clean, covered containers.

FOOD SAFETY

• Boil it, cook it, peel it or leave it.

• Peel fruits and vegetables.

• Handle and store raw and cooked food separately.

• Eat cooked food hot.

• Cook shellfish thoroughly.

• Avoid raw foods except fruits and vegetables you have peeled.

Introducing

FX Excursions

FX Excursions offers the chance for once-in-a-lifetime experiences in destinations around the world.

Daily
Sep 20, 2019

Catch Autumn at the Arboretum in Dallas

Attend one of the most acclaimed fall events, Autumn at the Arboretum, in Dallas. In its 14th year, the annual event is known as one of the best pumpkin festivals in the country, with its creative displays featuring more than 90,000 pumpkins, gourds and squash. The event takes place at Dallas Arboretum, Sept. 21 –Oct. 31. Alongside thousands of pumpkins, guests glimpse 150,000 autumn flowers across the 66-acre space.

The Island of the Knights

Welcome to Rhodes, a medieval treasure beautifully preserved throughout the centuries. Rhodes is the capital of the Dodecanese, an island ideal not only for those who want to relax, but also for those looking for an action-packed holiday! With its bright green hills, rich green valleys and uninterrupted line of golden beaches, Rhodes is truly a blessed place. “The sun island” has more sunshiny days and milder temperatures throughout the year than any other location in Greece. It is, after all, one of the country’s easternmost places and among the first to welcome summer on its impressive beaches. Add in the excellent facilities for tourism, the island’s special blend of cosmopolitan and traditional, and numerous cultural and archaeological sites, the most important being the Medieval (Old) Town, a UNESCO World Heritage site, and you’ve got the perfect holiday destination. While on Rhodes, don’t miss a daytrip to nearby Sými. An island of sponge divers and seamen, Sými used to have 30,000 inhabitants before the Second World War and was the richest island in the Dodecanese, despite its small size. Today, Sými attracts many visitors thanks to its beautifully preserved Neo-Classical buildings and the famous Archangel Michael monastery at Panormitis.

Feature
Sep 19, 2019

Wilderness Safaris Reopens Jao Camp

Following a complete renovation, Wilderness Safaris’ Jao Camp reopened in Botswana’s Okavango Delta.

News
Sep 19, 2019

Best U.S. Cities for Oktoberfest Celebrations

WalletHub compared the 100 largest U.S. cities across 24 key metrics to determine the best destinations for an upcoming Oktoberfest celebration. The brand’s study found the estimated cost for an American to attend Oktoberfest in Munich, Germany, is $5,000. Munich boasts a $1.43 billion annual economic impact on Munich. During Oktoberfest, nearly 2 million gallons of beer are consumed and more than 510,000 whole roast chickens eaten.

TAP Air Portugal Adds 15 Flights Each Week From U.S., Canada

TAP Air Portugal is adding 15 new weekly flights from the United States and Canada by summer 2020,  a new record for the carrier of 71 weekly flights between North America and Portugal.

Feature
Sep 19, 2019

Qantas Will Start Using a Dreamliner on Santiago–Sydney Route

Qantas will start using a Boeing 787-9 Dreamliner on its Sydney–Santiago route starting in late June 2020.

eFlyer News
Sep 18, 2019

New Luxury Hotel Set to Open in China

A new hotel is slated to open in the capital of China’s Guangxi Province.

To New Heights

United Airlines announces a number of new routes.

eFlyer News
Sep 18, 2019

LOT Polish Airlines Adds New Route to Delhi

LOT Polish Airlines is offering travellers more options for travel between Asia and Europe.