Cholera
Zapobieganie i profilaktyka

Cholera, wywoływana przez Vibrio cholerae, jest ostrą chorobą zakaźną charakteryzującą się ciężką biegunką wodnistą i wymiotami, które mogą prowadzić do odwodnienia i śmierci. Profilaktyka opiera się na zapewnieniu bezpiecznej wody (butelkowanej, chlorowanej, przegotowanej lub filtrowanej), prawidłowej higienie rąk, bezpiecznych praktykach żywieniowych oraz odpowiedniej sanitacji i dezynfekcji. Szczepionki doustne, takie jak Dukoral (85-90% skuteczności przez 4-6 miesięcy), Euvichol-Plus, Euvichol-S i Shanchol, zapewniają ochronę przeciwko serotypom O1 i O139, a w USA dostępna jest żywa atenuowana szczepionka Vaxchora (CVD 103-HgR) z 90% skutecznością po 10 dniach i 80% po 3 miesiącach. Szczepienia zalecane są szczególnie dla osób narażonych na kontakt z cholerą, w tym personelu medycznego, wolontariuszy i podróżnych do obszarów endemicznych. Schemat szczepień różni się w zależności od wieku i rodzaju szczepionki, a szczepionki inaktywowane są bezpieczne w ciąży.

Cholera – Profilaktyka

Cholera to ostra choroba zakaźna wywoływana przez bakterię Vibrio cholerae, która może prowadzić do zagrażającej życiu biegunki wodnistej i wymiotów. Mimo że choroba ta jest potencjalnie śmiertelna, można jej łatwo zapobiegać i ją leczyć poprzez odpowiednie środki profilaktyczne i szybkie interwencje medyczne.12 W tym artykule skupimy się na skutecznych metodach zapobiegania cholerze, przeznaczonych dla personelu medycznego.

Podstawowe zasady profilaktyki cholery

Profilaktyka cholery opiera się na kilku kluczowych zasadach, które powinny być przestrzegane szczególnie w obszarach endemicznego występowania choroby lub podczas podróży do takich regionów:34

  • Bezpieczna woda – należy korzystać wyłącznie z wody butelkowanej, chlorowanej, przegotowanej lub filtrowanej do picia, mycia zębów, przygotowywania posiłków i przyrządzania napojów
  • Prawidłowa higiena rąk – regularne mycie rąk mydłem i bezpieczną wodą, szczególnie po skorzystaniu z toalety i przed przygotowywaniem lub spożywaniem posiłków
  • Bezpieczne praktyki żywieniowe – spożywanie tylko dokładnie ugotowanych i gorących posiłków, unikanie surowych owoców morza, jedzenie tylko samodzielnie obranych owoców
  • Prawidłowa sanitacja – korzystanie z toalet lub bezpiecznie zarządzanych urządzeń sanitarnych, prawidłowa utylizacja odchodów
  • Dezynfekcja – czyszczenie i dezynfekcja naczyń kuchennych i powierzchni do przygotowywania żywności przy użyciu mydła i bezpiecznej wody

345

Prosta zasada, którą warto się kierować, to: „Zagotuj, ugotuj, obierz, albo zapomnij” (ang. „Boil it, cook it, peel it, or forget it”).5

Szczepienia przeciw cholerze

Szczepionki przeciw cholerze stanowią ważne narzędzie w zapobieganiu chorobie, szczególnie w obszarach wysokiego ryzyka. Obecnie dostępnych jest kilka doustnych szczepionek przeciw cholerze (OCV), które są zatwierdzone przez Światową Organizację Zdrowia (WHO):67

  • Dukoral – szczepionka zawierająca inaktywowane całe komórki bakterii, zapewnia krótkoterminową ochronę na poziomie 85-90% przeciwko Vibrio cholerae O1 przez okres 4-6 miesięcy po immunizacji
  • Euvichol-Plus i Euvichol-S – szczepionki zapewniające dłuższą ochronę przeciwko Vibrio cholerae O1 i O139
  • Shanchol – zapewnia dłuższą ochronę przeciw Vibrio cholerae O1 i O139, także u dzieci poniżej 5 roku życia

678

W Stanach Zjednoczonych dostępna jest szczepionka Vaxchora (CVD 103-HgR), która jest żywą, atenuowaną szczepionką podawaną doustnie. W badaniach klinicznych skuteczności, dorośli w wieku 18-45 lat, którzy otrzymali Vaxchora, byli chronieni przed ciężką biegunką po doustnym podaniu V. cholerae O1 na poziomie 90% po 10 dniach i 80% po 3 miesiącach od szczepienia.910

Wskazania do szczepień przeciw cholerze

Komitet Doradczy ds. Szczepień (ACIP) zaleca szczepionkę CVD 103-HgR zarówno dla pediatrycznych, jak i dorosłych podróżnych (w wieku do 64 lat) odwiedzających obszary aktywnej transmisji cholery.9 Szczepienie przeciw cholerze zalecane jest szczególnie w następujących przypadkach:1112

  • Wolontariusze, pracownicy organizacji humanitarnych i personel medyczny uczestniczący w akcjach pomocy podczas katastrof, gdzie istnieje ryzyko wystąpienia ognisk cholery
  • Osoby podróżujące do pracy w slumsach, obozach dla uchodźców, obszarach dotkniętych klęskami żywiołowymi lub krajach doświadczających ognisk cholery, gdzie trudno jest zachować higienę żywności i wody
  • Podróżni udający się do obszarów, gdzie występuje aktywne ognisko cholery lub gdzie woda nie jest bezpieczna do picia

1112

Należy podkreślić, że szczepionki przeciw cholerze nie zapewniają całkowitej ochrony, dlatego konieczne jest przestrzeganie podstawowych środków ostrożności nawet po szczepieniu.13 Szczepionka jest bezpieczna podczas ciąży.6

Schematy szczepień

Schemat szczepienia zależy od rodzaju szczepionki i wieku pacjenta:1415

  • Dzieci w wieku 2-6 lat: 3 dawki inaktywowanej szczepionki przeciw cholerze w odstępach 1-6 tygodni lub 1 dawka żywej atenuowanej doustnej szczepionki
  • Dorośli i dzieci >6 lat: 2 dawki szczepionki przeciw cholerze w odstępach 1-6 tygodni lub 1 dawka żywej atenuowanej doustnej szczepionki

1415

W przypadku utrzymującego się ryzyka zachorowania na cholerę, u osoby, której pierwotne szczepienie przeprowadzono inaktywowaną szczepionką przeciw cholerze, zaleca się pojedynczą dawkę przypominającą inaktywowanej szczepionki przeciw cholerze 6 miesięcy po zakończeniu podstawowego cyklu szczepień dla dzieci w wieku 2-6 lat.15

Przeciwwskazania do szczepień

Szczepionki przeciw cholerze są przeciwwskazane u osób, które doświadczyły anafilaksji po wcześniejszej dawce jakiejkolwiek szczepionki przeciw cholerze.16 Osoby z upośledzoną odpornością nie powinny otrzymywać żywej atenuowanej szczepionki przeciw cholerze.16 Kobiety w ciąży lub karmiące piersią mogą otrzymać inaktywowaną szczepionkę przeciw cholerze.16

Vaxchora jest przeciwwskazana u osób z historią ciężkiej reakcji alergicznej na składniki tej lub jakiejkolwiek innej szczepionki przeciw cholerze.9

Profilaktyka cholery w obszarach endemicznych

W obszarach, gdzie cholera występuje endemicznie, kluczowe znaczenie mają długoterminowe strategie profilaktyczne:117

Infrastruktura wodna i sanitarna

Długoterminowe rozwiązanie w zakresie kontroli cholery leży w rozwoju gospodarczym i powszechnym dostępie do bezpiecznej wody pitnej i odpowiednich warunków sanitarnych (WASH – Water, Sanitation and Hygiene).118 Inwestycje w systemy wodociągowe, systemy sanitarne i oczyszczalnie ścieków mają kluczowe znaczenie dla zapobiegania cholerze.19

W obszarach dotkniętych cholerą ścieki i osady fekalne muszą być skutecznie oczyszczane i zarządzane w celu zatrzymania rozprzestrzeniania się choroby poprzez ludzkie odchody.20 Właściwe usuwanie i przetwarzanie wszystkich materiałów, które mogły mieć kontakt z odchodami ofiar cholery (np. odzież, pościel) jest niezbędne.21

Nadzór epidemiologiczny i szybkie reagowanie

Czuły nadzór i szybkie raportowanie przyczyniają się do szybkiego opanowania epidemii cholery.1922 Identyfikacja, leczenie i izolacja przypadków cholery zapobiega dalszemu rozprzestrzenianiu się choroby.7

Światowa Organizacja Zdrowia zaleca, aby państwa członkowskie wzmacniały i utrzymywały nadzór nad cholerą w celu wczesnego wykrywania podejrzanych przypadków i zapewnienia odpowiedniego leczenia, aby zapobiec jej rozprzestrzenianiu się.23

Edukacja zdrowotna i świadomość społeczna

W obszarach endemicznego występowania cholery należy prowadzić masową edukację i działania zwiększające świadomość społeczną.20 Kampanie edukacji zdrowotnej, dostosowane do lokalnej kultury i przekonań, powinny promować przyjęcie odpowiednich praktyk higienicznych, takich jak mycie rąk mydłem, bezpieczne przygotowywanie i przechowywanie żywności oraz bezpieczne usuwanie odchodów dzieci.24

Masowe kampanie szczepień

W środowiskach endemicznych dla cholery, doustne szczepionki przeciw cholerze mogą być stosowane jako dodatkowe narzędzie zdrowia publicznego, w ramach długoterminowych planów kontroli cholery, w tym wzmocnienia nadzoru i potencjału diagnostyki laboratoryjnej oraz poprawy warunków WASH.18

W przypadku ognisk cholery WHO przydziela szczepionki z globalnych zapasów szczepionek doustnych przeciw cholerze (OCV) utworzonych w 2013 r., które są następnie podawane w ramach reaktywnej kampanii szczepień wdrażanej dodatkowo do wyżej wymienionych środków.8

Profilaktyka i kontrola ognisk cholery

W przypadku wystąpienia ogniska cholery kluczowe znaczenie ma szybka i skoordynowana odpowiedź:25

Zintegrowana odpowiedź wielosektorowa

Rozprzestrzenianie się choroby na danym obszarze można ograniczyć poprzez wczesne wykrycie i potwierdzenie przypadków, a następnie odpowiednią, dobrze skoordynowaną wielosektorową odpowiedź.25 Globalna Grupa Zadaniowa ds. Kontroli Cholery (GTFCC) zaleca, aby rozprzestrzenianie cholery można było zatrzymać, a zgony na cholerę znacząco zmniejszyć poprzez wdrożenie skoordynowanych wielosektorowych interwencji zgodnie z krajowym planem cholery.26

GTFCC synchronizuje wysiłki partnerów i inwestycje w celu wspierania skoordynowanego, wielosektorowego podejścia do kontroli i zapobiegania cholerze.27 Minimalne działania w odpowiedzi na wybuch ciężkiej biegunki powinny obejmować:28

  • Intensywne kampanie dotyczące kluczowych działań na rzecz cholery i/lub łagodzenia i zapobiegania biegunce
  • Dostęp do doustnego nawadniania przy użyciu doustnych płynów nawadniających (ORS) lub alternatyw
  • Chlorowanie całej wody pitnej (na odpowiednich etapach łańcucha wodnego)
  • Dystrybucja niezbędnych artykułów, takich jak mydło, pojemniki na wodę i środki do dezynfekcji wody w gospodarstwie domowym, jeśli to konieczne

28

Izolacja i leczenie przypadków

Cholera jest chorobą, która dobrze reaguje na leczenie medyczne.29 Pierwszym celem leczenia jest uzupełnienie płynów utraconych z powodu biegunki i wymiotów.29 Do 80% przypadków można leczyć poprzez wczesne podanie doustnych płynów nawadniających (ORS).29

Podawanie odpowiednich antybiotyków, szczególnie w ciężkich przypadkach, skraca czas trwania biegunki, zmniejsza objętość niezbędnych płynów nawadniających i skraca czas wydalania V. cholerae.2910

Przy odpowiednim leczeniu wskaźnik śmiertelności wynosi mniej niż 1%.29 W celu zapewnienia terminowego dostępu do leczenia w populacjach dotkniętych chorobą należy utworzyć ośrodki leczenia cholery.29

Dezynfekcja środowiska i materiałów

Profilaktyka pierwotna cholery w placówkach opieki zdrowotnej obejmuje odpowiednią sanitację potencjalnie zakażonych powierzchni i sprzętu w następujący sposób:30

  • 2% chlor – używany do dezynfekcji wymiocin, kału i zwłok
  • 0,5% chlor – używany do kąpieli stóp, czyszczenia podłóg, pościeli, latryn
  • 0,05% chlor – używany do kąpieli zanieczyszczonych pacjentów, mycia rąk, płukania naczyń, prania

30

Materiały, które mogły mieć kontakt z cholerą, muszą być dokładnie wyprane w gorącej wodzie; jeśli to możliwe, można zastosować wybielacz chlorowy.31 Wszystkie przedmioty używane przez pacjenta powinny być myte w gorącej wodzie z mydłem, a pomieszczenie dokładnie wyczyszczone po wyzdrowieniu pacjenta.32

Chemoprofilaktyka w cholerze

Chemoprofilaktyka odnosi się do podawania leków w celu zapobiegania chorobie lub zakażeniu. W przypadku cholery zdrowym osobom podaje się antybiotyki w celu ochrony przed chorobą, ograniczenia rozprzestrzeniania się choroby i powstrzymania epidemii.33

Stanowisko WHO w sprawie chemoprofilaktyki

WHO nie zaleca rutynowego leczenia społeczności antybiotykami ani masowej chemoprofilaktyki, argumentując, że nie ma to wpływu na rozprzestrzenianie się cholery, może mieć negatywne skutki poprzez zwiększanie oporności na środki przeciwdrobnoustrojowe i daje fałszywe poczucie bezpieczeństwa.336

Dostęp społeczności do ORS jest niezbędny podczas epidemii cholery. Masowe podawanie antybiotyków w celu zapobiegania cholerze (chemoprofilaktyka) nie jest zalecane, ponieważ nie ma udowodnionego wpływu na rozprzestrzenianie się cholery i może przyczynić się do oporności na środki przeciwdrobnoustrojowe.6

Celowana chemoprofilaktyka

Mimo oficjalnego stanowiska WHO, w niektórych sytuacjach stosowano selektywną chemoprofilaktykę antybiotykową. Celowana chemoprofilaktyka antybiotykowa jest zalecana w zamkniętych warunkach instytucjonalnych, takich jak więzienia lub sierocińce, gdzie ze względu na charakter obiektów prawdopodobne jest znaczne narażenie w krótkim czasie.34

Chemoprofilaktykę należy podać jednocześnie wszystkim osobom tak szybko, jak to możliwe po rozpoznaniu pierwszego przypadku. Profilaktyczna dawka antybiotyku jest taka sama jak dawka terapeutyczna.34

Selektywną chemoprofilaktykę można rozważyć jako dodatkowy środek do kontroli cholery w takich warunkach, ale nie zastępuje ona innych środków kontroli.34

Skuteczność chemoprofilaktyki

Badania systematyczne sugerują, że chemoprofilaktyka ma działanie ochronne wśród domowników osób chorych na cholerę, ale wyniki oparte są na badaniach z wysokim ryzykiem błędu. Istnieje potrzeba odpowiednich wiarygodnych badań, które pozwolą zrównoważyć korzyści i szkody poprzez ocenę skutków chemoprofilaktyki.3536

Długoterminowe strategie zapobiegania cholerze

Długoterminowe rozwiązanie w zakresie kontroli cholery leży w rozwoju gospodarczym i powszechnym dostępie do bezpiecznej wody pitnej, podstawowej sanitacji i dobrych praktyk higienicznych.1 Interwencje WASH pomagają zapobiegać wielu chorobom przenoszonym przez wodę, w tym cholerze, i przyczyniają się do realizacji Celów Zrównoważonego Rozwoju.1

Globalne inicjatywy kontroli cholery

Globalna Grupa Zadaniowa ds. Kontroli Cholery (GTFCC) to partnerstwo organizacji rządowych i pozarządowych, agencji ONZ i instytucji akademickich, których wspólną misją jest zmniejszenie globalnego obciążenia cholerą.6

Globalna strategia kontroli cholery ma na celu zmniejszenie liczby zgonów z powodu cholery o 90% i wyeliminowanie choroby w 20 krajach do 2030 roku.37 GTFCC zapewnia krajom narzędzia, wsparcie w zakresie budowania potencjału i pomoc w opracowywaniu Krajowych Planów Cholery (NCP) oraz ich skutecznym wdrażaniu.27

Program WHO ds. cholery działa w celu zwiększenia świadomości na temat cholery i promowania jej kontroli na całym świecie.6 Ustanawia i podtrzymuje normy i standardy dla wysiłków na rzecz kontroli cholery poprzez Techniczne Grupy Robocze GTFCC: Zarządzanie Przypadkami, Epidemiologia, Laboratorium, Doustna Szczepionka Przeciw Cholerze (OCV), Woda, Sanitacja i Higiena (WASH).38

Narodowe plany kontroli cholery

Zaleca się, aby państwa opracowywały krajowe plany cholery i politykę, kierując się planem cholery GTFCC z 2020 roku.26 Narodowe plany cholery powinny obejmować:39

  • Zintegrowane podejście społeczności do kontroli cholery
  • Systemy nadzoru i wczesnego wykrywania przypadków
  • Strategie poprawy dostępu do wody, sanitacji i higieny
  • Plany kampanii szczepień OCV
  • Protokoły zarządzania przypadkami i leczenia

39

Skuteczne wdrożenie ram zapobiegania i kontroli cholery wymaga silnego zaangażowania rządu i własności, wzmocnionych systemów opieki zdrowotnej oraz zwiększonych inwestycji w długoterminowe środki kontroli cholery.40

Innowacyjne podejścia do kontroli cholery

Ostatnie innowacje w kontroli cholery obejmują:4142

  • Interwencje celowane w obszarach przypadków (CATI) – coraz częściej stosowane do powstrzymania rozprzestrzeniania się cholery
  • Nowe suplementy żywnościowe – pochodzące z immunoglobulin, które wiążą się z toksyną cholery i zapobiegają zakażeniu jelit
  • Leki przeciwbiegunkowe – nowe podejścia do leczenia cholery i innych poważnych ostrych chorób biegunkowych poprzez powstrzymanie samej biegunki

4142

Wraz z przyspieszeniem ukierunkowanego, szybkiego zapobiegania wybuchom cholery, ulepszenie zarządzania przypadkami byłoby mile widzianym osiągnięciem w dążeniu do celu zmniejszenia zachorowalności i śmiertelności z powodu cholery o 90% do 2030 roku.41

Zalecenia dla podróżnych do obszarów występowania cholery

Ryzyko cholery dla większości podróżnych jest bardzo niskie, nawet w krajach, gdzie występują aktywne ogniska cholery, o ile przestrzegane są odpowiednie środki zapobiegawcze.435 Wszyscy podróżni do obszarów, gdzie występowała cholera, powinni przestrzegać następujących zaleceń:544

  • Higiena wody:
    • Pić tylko wodę, która została przegotowana lub poddana działaniu chloru lub jodu
    • Inne bezpieczne napoje to herbata i kawa przygotowane z przegotowanej wody oraz gazowane napoje butelkowane bez lodu
    • Używać butelkowanej lub przegotowanej wody do mycia zębów
  • Higiena żywności:
    • Jeść tylko dokładnie ugotowane i nadal gorące potrawy lub owoce, które samodzielnie obrano
    • Unikać niedogotowanych lub surowych ryb lub owoców morza, w tym ceviche
    • Unikać surowych owoców i warzyw (w tym sałatek), których nie umyto w butelkowanej lub przegotowanej wodzie
    • Unikać pokarmów i napojów od ulicznych sprzedawców
  • Higiena osobista:
    • Regularnie myć ręce mydłem i czystą wodą, szczególnie po skorzystaniu z toalety i przed przygotowywaniem żywności lub jedzeniem

544

Jeśli planujesz odwiedzić obszar, o którym wiadomo, że występują w nim epidemie cholery, powinieneś podjąć odpowiednie środki, aby chronić się.45 Odwiedź lekarza lub klinikę podróży, aby porozmawiać o szczepieniu przeciw cholerze, jeśli udajesz się do obszaru, gdzie cholera jest obecna, lub gdzie woda i żywność są niebezpieczne do picia i jedzenia.3

Zapobieganie cholerze – kompleksowe podejście

Zapobieganie i kontrola cholery wymaga wieloaspektowego podejścia łączącego nadzór, poprawę wody, sanitacji i higieny, zwiększenie komunikacji ryzyka i zaangażowania społeczności, poprawę dostępu do leczenia i wdrażanie kampanii doustnych szczepionek przeciw cholerze.1

Kluczowe elementy skutecznej profilaktyki cholery obejmują:4647

  • Bezpieczna woda i sanitacja – zapewnienie czystej wody i odpowiednich warunków sanitarnych społecznościom endemicznym dla cholery
  • Edukacja zdrowotna – dotycząca higieny osobistej i bezpieczeństwa żywności
  • Szczepienia – stosowanie doustnych szczepionek przeciw cholerze wraz z innymi strategiami zapobiegania i kontroli
  • Nadzór i raportowanie – wszystkich przypadków cholery
  • Szybkie i odpowiednie leczenie – przypadków cholery, wzmocnienie laboratoriów, szkolenie pracowników służby zdrowia
  • Skoordynowane podejście wielosektorowe – obejmujące służbę zdrowia, sektor wodny i sanitarny, edukację

4647

CDC wymieniło pięć podstawowych komunikatów dotyczących zapobiegania cholerze. Obejmują one: picie i używanie bezpiecznej wody; mycie rąk mydłem i bezpieczną wodą; korzystanie z latryn lub odpowiednich metod sanitarnych; właściwe gotowanie żywności, przykrywanie jej i jedzenie na gorąco; właściwe czyszczenie miejsc używanych do kąpieli i prania ubrań.46

Globalna Grupa Zadaniowa ds. Kontroli Cholery (GTFCC) oraz Światowa Organizacja Zdrowia pracują nad zwiększeniem świadomości na temat cholery i promowaniem jej kontroli na całym świecie, dążąc do celu zmniejszenia liczby zgonów z powodu cholery o 90% do 2030 roku.637

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Cholera is a severe diarrheal disease that can be fatal within hours if not treated. Quick access to treatment is crucial. […] Populations access to safe water, basic sanitation and hygiene (WASH) is essential to prevent cholera. […] The oral cholera vaccine (OCV) can help prevent and control cholera. […] Preventing and controlling cholera involves a combination of strengthening surveillance, improving water, sanitation and hygiene, increasing risk communication and community engagement, improving access to quality treatment and implementing oral cholera vaccine campaigns. […] The long-term solution for cholera control lies in economic development and universal access to safe drinking water, basic sanitation and good hygiene practices. WASH interventions help prevent many waterborne illnesses, including cholera, and contribute to the Sustainable Development Goals.
  • #2 Cholera: Causes, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/16636-cholera
    Cholera can be fatal if left untreated. Start drinking plenty of fluids if you have diarrhea. Go to the emergency room if you have severe diarrhea, severe vomiting or signs of dehydration. […] Drinking water thats been sanitized and washing your hands with clean water and soap are the best ways to reduce your risk of cholera. Drink and cook with bottled water if youre unsure whether the water where you are is safe to consume. […] If you live in or are traveling to a place where youll be at higher risk for cholera, there are oral vaccines available. They can help reduce your risk of getting sick, but don’t eliminate your risk entirely. […] On a larger scale, the best way to prevent cholera is for people to have access to clean drinking water and toilet facilities. This requires global humanitarian and public health efforts.
  • #3 Preventing Cholera: Five Basic Steps | Cholera | CDC
    https://www.cdc.gov/cholera/prevention/index.html
    People can get cholera from drinking water or eating food containing cholera bacteria. […] Cholera can cause life-threatening watery diarrhea and vomiting. […] Take steps to reduce your risk of getting cholera if you’re going to an area where the disease is present. […] In addition to these five prevention measures, visit a doctor or travel clinic to talk about cholera vaccination if you’re going to an area where cholera is present, or where the water and food are unsafe to drink and eat. […] Use bottled, chlorinated, boiled, or filtered water. […] Use bottled water with unbroken seals to drink, brush your teeth, wash and prepare food, and make ice or beverages. If bottled water is not available, use water that has been properly chlorinated, boiled, or filtered. […] If a chlorine treatment product isn’t available, boiling is an effective way to make water safe. Bring water to a rolling boil for 1 minute.
  • #4 Preventing Cholera – MN Dept. of Health
    https://www.health.state.mn.us/diseases/cholera/prevention.html
    The risk for cholera is very low for U.S. travelers visiting areas with epidemic cholera. When simple precautions are observed, contracting the disease is unlikely. […] All travelers to areas where cholera has occurred should observe the following recommendations: […] Drink only water that you have boiled or treated with chlorine or iodine. […] Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice. […] Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself. […] Avoid undercooked or raw fish or shellfish, including ceviche. Make sure all vegetables are cooked avoid salads. […] Avoid foods and beverages from street vendors. […] A simple rule of thumb is „Boil it, cook it, peel it, or forget it.”
  • #4 Preventing Cholera: Five Basic Steps | Cholera | CDC
    https://www.cdc.gov/cholera/prevention/index.html
    Wash your hands often with soap and safe water. […] Use toilets or safely managed sanitation facilities to get rid of poop. […] Clean and disinfect kitchenware and areas where you prepare food with soap and safe water. Allow them to dry completely. […] To prevent cholera, you should wash your hands often and take steps to ensure your food and water are safe. […] Cholera can be life-threatening, but it is easily prevented and treated.
  • #5 Preventing Cholera – MN Dept. of Health
    https://www.health.state.mn.us/diseases/cholera/prevention.html
    The risk for cholera is very low for U.S. travelers visiting areas with epidemic cholera. When simple precautions are observed, contracting the disease is unlikely. […] All travelers to areas where cholera has occurred should observe the following recommendations: […] Drink only water that you have boiled or treated with chlorine or iodine. […] Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice. […] Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself. […] Avoid undercooked or raw fish or shellfish, including ceviche. Make sure all vegetables are cooked avoid salads. […] Avoid foods and beverages from street vendors. […] A simple rule of thumb is „Boil it, cook it, peel it, or forget it.”
  • #6
    https://www.who.int/news-room/fact-sheets/detail/cholera
    Community access to ORS is essential during a cholera outbreak. Mass administration of antibiotics to prevent cholera (chemoprophylaxis) is not recommended, as it has no proven effect on the spread of cholera and may contribute to antimicrobial resistance. […] Currently, three WHO pre-qualified oral cholera vaccines (OCV) are available: Dukoral, Euvichol-Plus, and Euvichol-S. […] OCV is safe during pregnancy. […] The Global Task Force on Cholera Control (GTFCC) is a partnership of governmental and nongovernmental organizations, UN agencies and academic institutions with a common mission to reduce the global cholera burden. […] The WHO cholera programme works to increase awareness of cholera and advocate for its control globally.
  • #7 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cholera-Prevention.aspx
    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. […] 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.
  • #8 Cholera : symptoms, treatment, prevention – Institut Pasteur
    https://www.pasteur.fr/en/medical-center/disease-sheets/cholera
    Improved access to drinking water and general hygiene measures are vital in tackling cholera. […] In the event of an outbreak, a comprehensive public health response is essential, and health education needs to be developed in countries with regular cholera outbreaks. […] During a cholera outbreak, WHO allocates vaccines from the global stockpile of oral cholera vaccines (OCVs) created in 2013, which are then administered as part of a reactive vaccination campaign implemented in addition to the above-mentioned measures. […] This global stockpile of vaccines now needs to be increased to accommodate increasing demand with restrictions on supplies likely to last until 2025. […] Two oral vaccines are currently prequalified by WHO: […] Dukoral (not included in the global stockpile), used mainly for travelers.
  • #9 Cholera | Yellow Book | CDC
    https://www.cdc.gov/yellow-book/hcp/travel-associated-infections-diseases/cholera.html
    Travelers who consistently observe safe food, water, sanitation, and hand hygiene precautions have virtually no risk of infection. […] The Advisory Committee on Immunization Practices recommends the CVD 103-HgR vaccine for the prevention of cholera in adults traveling to high-risk settings. […] Travelers should follow safe water and food precautions and frequently wash hands. Antibiotic chemoprophylaxis is not recommended. […] The Advisory Committee on Immunization Practices recommends CVD 103-HgR vaccine for both pediatric and adult travelers (264 years old) visiting areas of active cholera transmission. […] CDC provides a list of countries with active cholera transmission. […] In clinical efficacy trials, adults aged 1845 years who received Vaxchora were protected against severe diarrhea after oral V. cholerae O1 challenge at 10 days (vaccine efficacy 90%) and at 3 months (vaccine efficacy 80%) after vaccination. […] The safety and efficacy of revaccination with CVD 103-HgR have not been established. […] Vaxchora is contraindicated in people with a history of severe allergic reaction to the ingredients of this or any other cholera vaccine.
  • #10 Cholera Medication: Antibiotics, Vaccines
    https://emedicine.medscape.com/article/962643-medication
    Antimicrobial therapy for cholera is an adjunct to fluid therapy and is not an essential therapeutic component. However, an effective antibiotic can reduce the volume of diarrhea in patients with severe cholera and shorten the period during which Vibrio cholerae O1 is excreted. […] Travelers to cholera-affected regions should receive a cholera vaccine. The cholera vaccine Vaxchora is the only one approved by the FDA for cholera prevention. It is a live, weakened vaccine administered as a single, oral liquid dose of about three fluid ounces at least 10 days before travel to a cholera-affected region. […] The only other existing cholera-prevention vaccines require 2 doses, according to the Centers for Disease Control and Prevention (CDC). A single-dose vaccine is especially beneficial to a person who needs to travel to a cholera-affected region on short notice.
  • #11 Cholera – Fit for Travel
    https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/cholera
    Cholera is an infection spread mainly through food and water that can cause acute watery diarrhoea. […] Prevention is focused on food and water precautions and practising good hand and personal hygiene, particularly in countries where cholera is more common or where outbreaks occur (see individual country pages). […] A vaccine is available to protect against cholera but as the risk to most travellers is very low, it is only recommended in the following circumstances: […] Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks are likely. […] Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible. […] The risk of disease for most travellers is low. […] Fluid replacement is the mainstay of treatment. Antibiotic therapy may be used in severe illness.
  • #12 Prevention of cholera – Canada.ca
    https://www.canada.ca/en/public-health/services/diseases/cholera/prevention.html
    You can lower your risk by: […] There is a vaccine that protects against cholera for those at high risk. This includes aid or humanitarian workers or those who must travel to high-risk affected areas. […] Your health care provider may recommend the vaccine depending on your risk factors, such as:
  • #13 Cholera: How It Spreads and Tips for Prevention
    https://www.verywellhealth.com/cholera-overview-1958786
    Basic cholera safety practices include the following: Only use water that has been bottled, chlorinated, boiled, or filtered for drinking, brushing your teeth, prepping food, and making ice or other beverages, Wash your hands regularly using soap and safe water, Use a toilet or bury waste at least 30 meters (100 feet) away from any body of water, Avoid eating raw foods that cannot be peeled, Use safe cleaning practices. […] The CDC recommends that anyone living in or traveling to places where cholera is found should drink boiled, chlorinated, or bottled beverages. […] The CDC recommends that you get a cholera vaccine if you are going to an area where there is a cholera outbreak or where the water is not safe to drink. […] Cholera vaccines do not provide complete protection, so it’s vital to follow basic safety precautions even if you’ve been vaccinated. […] Cholera prevention tips include drinking only water that has been bottled, chlorinated, or boiled and regular hand washing.
  • #14 Cholera | The Australian Immunisation Handbook
    https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/cholera
    Cholera vaccine is recommended for children (≥2 years of age) and adult travellers who: […] Cholera vaccination is only available in Australia as an oral vaccine against serogroup O1. […] Cholera vaccination is recommended for travellers who have a high risk of exposure to cholera. These include humanitarian aid workers deployed to regions where there is endemic cholera or an outbreak of cholera. […] Cholera vaccination is also recommended for people travelling to areas where cholera exists who have a higher risk of severe or complicated diarrhoeal disease. […] Either the inactivated cholera vaccine, Dukoral, or the live cholera vaccine, Vaxchora, can be used. […] Children aged 2–6 years are recommended to receive 3 doses of inactivated cholera vaccine with an interval of 1–6 weeks between each dose, or 1 dose of live attenuated oral cholera vaccine.
  • #15 Cholera | The Australian Immunisation Handbook
    https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/cholera
    Adults and children aged >6 years are recommended to receive 2 doses of cholera vaccine with an interval of 1–6 weeks between each dose, or 1 dose of live attenuated oral cholera vaccine. […] If there is an ongoing risk of cholera, in a person whose primary vaccination was with inactivated cholera vaccine, a single booster dose of inactivated cholera vaccine is recommended: 6 months after finishing the primary course for children aged 2-6 years. […] If the interval between primary immunisation and the booster dose is greater than these specified intervals, the primary course should be repeated. […] Travellers can receive the inactivated oral cholera vaccine before, with, or after other parenteral travel vaccines. […] People receiving inactivated oral cholera vaccine and oral live attenuated typhoid vaccine should have the vaccines at least 8 hours apart.
  • #16 Cholera | The Australian Immunisation Handbook
    https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/cholera
    People receiving live attenuated oral cholera vaccine and oral live attenuated typhoid vaccine should have the vaccines at least 2 hours apart. […] Cholera vaccines are contraindicated in people who have had: anaphylaxis after a previous dose of any cholera vaccine. […] People who are immunocompromised should not receive the live attenuated cholera vaccine. […] Women who are pregnant or breastfeeding can receive the inactivated cholera vaccine. […] The cholera vaccines marketed in Australia do not protect against infection with Vibrio cholerae serogroup O139.
  • #17 An assessment of the progress made in the implementation of the regional framework for cholera prevention and control in the WHO African region | BMJ Global Health
    https://gh.bmj.com/content/10/1/e016168
    High-burden cholera outbreaks, spreading beyond the traditional cholera-endemic countries, have been reported since 2021 in the WHO African region. […] To track progress towards this goal, WHO-African countries adopted a regional cholera prevention and control framework in 2018. […] Effective implementation of the cholera prevention and control framework anchored on strong government commitment and ownership is essential to curb the current trend of cholera outbreaks and improve the likelihood of cholera elimination by 2030 in Africa. […] Effective implementation of the WHO-AFRO cholera prevention and control framework is essential if the region is to control and eliminate cholera in line with the 2030 global elimination target. […] The assessment of the first 5 years of the framework implementation revealed that the region was not on track to eliminate cholera by 2030.
  • #18
    https://www.who.int/activities/preventing-and-controlling-cholera-in-endemic-countries
    The long-term solution for cholera control lies in economic development and universal access to safe drinking water and adequate sanitation. […] Cholera prevention and control measures mainly rely on the implementation of adapted WASH solutions to ensure use of safe water, basic sanitation and good hygiene practices. […] In cholera endemic settings, oral cholera vaccines can be used as an additional public health tool, as part of a longer-term cholera control plans, including reinforcement of surveillance and laboratory diagnostic capacity and improving WASH conditions.
  • #19
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6838734/
    Surveillance and prompt reporting is very important in the control and prevention of cholera because it allows rapid containment of cholera epidemics. […] A number of safe effective oral vaccines for cholera is available. […] Political will on the part of the government is needed to create a legal basis for fighting cholera, for instance, by investing in drinking water systems, sanitation system and sewage treatment plants. […] Ensure water is well boiled and treated before drinking; also, bottled water must be properly sealed. […] Personal hygiene should be constant and paramount. […] Ensure all food is well cooked before consumption. […] Avoid open defecation and indiscriminate refuse dumping and ensure proper disposal of waste and clearing of sewage. […] Upon any signs and symptoms of cholera such as sudden watery diarrhea, a health care facility should be visited immediately. […] A multifaceted approach of political will on the part of the government, surveillance, water purification and hygiene, community sensitization, and oral cholera vaccination are vital to prevent, control, and to reduce the rate of deaths from cholera.
  • #20
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6838734/
    In cholera-affected areas, sewage and fecal sludge need to be treated and managed carefully in order to stop the spread of this disease via human excreta as provision of sanitation and hygiene is an important preventative measure. […] Massive sensitization and measures to increase public awareness should be carried out in cholera-endemic areas. […] All water used for drinking, washing, or cooking should be disinfected by boiling, chlorination, ozone water treatment, ultraviolet light sterilization, or antimicrobial filtration in any areas where cholera may be present. […] Proper hand washing with soap and clean water after using a toilet and before handling food or eating is also recommended for cholera prevention as this will help kill cholera bacteria and other pathogens on the hands.
  • #21
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6838734/
    Cholera is a public health problem around the world, and it is endemic in Africa, parts of Asia, the Middle East as well as South and Central America. […] Therefore, a multifaceted approach including public policy, surveillance, water purification and hygiene, community sensitization, and the use of oral cholera vaccination (OVC) is vital to prevent, control, and reduce the cholera mortality rate. […] It is recommended that the government pass legislation to implement preventive and surveillance measures, e.g., invest in drinking water systems, sanitation systems and sewage treatment, and promote public education on basic hygiene. […] Proper disposal and treatment of all materials that may have come into contact with cholera victims feces (e.g., clothing, bedding, etc.) are fundamental.
  • #22 Cholera Treatment & Management: Approach Considerations, Treatment Guidelines, Cholera Cots
    https://emedicine.medscape.com/article/962643-treatment
    Deterrence/Prevention: The current response to cholera outbreaks tends to be reactive, in the form of an emergency response. Although this approach prevents many deaths, it fails to prevent cases of cholera. […] Sensitive surveillance and prompt reporting contribute to the rapid containment of cholera epidemics. In many endemic countries, cholera is a seasonal disease, occurring every year usually during the rainy season. […] WHO recommends improvements in water supply and sanitation as the most sustainable approach for protecting against cholera and other waterborne epidemic diarrheal diseases. However, such an approach is unrealistic for the many impoverished populations most affected by cholera. […] Education on specific hygiene practices is important in the prevention of cholera.
  • #23 Cholera: Technical guidelines and resources – PAHO/WHO | Pan American Health Organization
    https://www.paho.org/en/haiti-humanitarian-crisis-grade-3/cholera-technical-guidelines-and-resources
    Given the re-emergence of cholera in Haiti, PAHO/WHO recommends that Member States strengthen and maintain surveillance for cholera for the early detection of suspected cases and to provide adequate treatment to prevent its spread. […] PAHO/WHO encourages Member States to continue their efforts to ensure adequate basic sanitation conditions and access to drinking water, in addition to safe hygiene promotion and social mobilization, in order to reduce the impact of cholera and other waterborne diseases. […] In countries where NO cholera cases have been reported, the following is recommended: Monitor the trend of acute diarrhea diseases with an emphasis on adults. […] In an outbreak situation the following measures are recommended: Intensified surveillance with the inclusion of active case finding.
  • #24 Cholera (Human) | PreventionWeb
    https://www.preventionweb.net/understanding-disaster-risk/terminology/hips/bi0034
    Health education campaigns, adapted to local culture and beliefs, should promote the adoption of appropriate hygiene practices such as hand-washing with soap, safe preparation and storage of food and safe disposal of the faeces of children. […] Currently there are three WHO pre-qualified oral cholera vaccines: Dukoral, Shanchol, and Euvichol-Plus. All three vaccines require two doses for full protection. More than 30 million doses of oral cholera vaccines have been used in mass vaccination campaigns. […] A global strategy on cholera control with a target to reduce cholera deaths by 90% was launched in 2017.
  • #25 Section 8: Reducing the Spread of Cholera in the Community | Cholera Outbreak Response Field Manual
    https://www.choleraoutbreak.org/book-page/section-8-reducing-spread-cholera-community.html
    Spread of the disease within an area can be reduced through early detection and confirmation of cases, followed by an appropriate, well-coordinated multisectoral response. […] Access to safe drinking water for the affected population is essential to reduce the spread of the disease in the community. […] Safe food preparation is important to reduce the transmission of cholera in the community. […] It is important to isolate faeces to avoid contamination of food and water with faecal matter. […] Funerals for persons who have died of cholera can contribute to the spread of an epidemic.
  • #26 Frontiers | Cholera outbreak trends in Nigeria: policy recommendations and innovative approaches to prevention and treatment
    https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1464361/full
    However, according to the Global Task Force on Cholera Control (GTFCC), cholera transmission can be halted and cholera deaths significantly reduced through the implementation of coordinated multi-sectoral interventions in line with a national cholera plan. […] Therefore, we recommend the development of a national cholera plan and policy in Nigeria, guided by the 2020 GTFCC cholera plan. […] The Nigerian government has effectively employed WaSH as its primary strategy for cholera control, receiving substantial backing from the Global Task Force on Cholera Control (GTFCC).
  • #27 About the GTFCC – Global Task Force on Cholera Control
    https://www.gtfcc.org/about-gtfcc/
    The GTFCC synchronizes partner efforts and investments to support a coordinated, multi-sectoral approach to cholera control and prevention. […] The GTFCC provides countries with tools, capacity support, and assistance to develop National Cholera Plans (NCPs) and implement them effectively, including: Technical support and assistance, Local-level and global-level partnership, Policy guidance, Capacity building, Research agenda development, Operational research implementation, Advocacy and communications support, Fundraising and resource mobilization. […] The GTFCC charter was created to affirm our partners collective vision of a world in which cholera no longer presents a threat to public health. The charter also commits to the Global Roadmaps target of a 90% reduction in cholera deaths by 2030.
  • #28 Cholera and other Diarrhoeal Outbreak Control | Oxfam WASH Resources
    https://www.oxfamwash.org/en/response-types/cholera
    All WASH staff should be familiar with the critical stages in the outbreak curve and key target activities for each stage as specified in the Oxfam Cholera Prevention and Control Guidelines. […] At a minimum a response to a severe diarrhoeal outbreak should entail the following: Intensive campaigns on key actions for cholera and/or diarrhoea mitigation and prevention. […] Access to oral re-hydration using Oral Rehydration Solution (ORS) or alternatives such as sugar salt solution where they are promoted by the MoH and are known by communities. […] Chlorination of all drinking water (at appropriate stages along the water chain which may include chlorination at source, along the way or at the point of use). […] Distribution of NFIs such as soap, water containers and the means to carry out disinfection of household water if necessary.
  • #29 Cholera: Technical guidelines and resources – PAHO/WHO | Pan American Health Organization
    https://www.paho.org/en/haiti-humanitarian-crisis-grade-3/cholera-technical-guidelines-and-resources
    Cholera is a disease that responds satisfactorily to medical treatment. […] The first treatment goal is to replace fluids that have been lost by diarrhea and vomiting. […] Up to 80% of cases can be treated through early administration of oral rehydration salts (WHO/UNICEF oral rehydration salts standard sachet). […] The administration of appropriate antibiotics, especially in severe cases, shortens the duration of diarrhea, reduces the volume of hydration fluids necessary, and shortens the time V. cholerae is excreted. […] With appropriate treatment the fatality rate is less than 1%. […] In order to provide timely access to treatment, cholera treatment centers should be established in affected populations. […] The implementation of prevention activities in the medium and long term is the key in the fight against cholera.
  • #30 Cholera primary prevention – wikidoc
    https://www.wikidoc.org/index.php/Cholera_primary_prevention
    Primary Prevention in a health care setting includes appropriate sanitation of potentially infected surfaces and equipment as follows: 2% chlorine, Used for disinfecting vomit, feces, and corpses, 0.5% chlorine, Used for foot baths, cleaning floors, bedding, latrines, 0.05% chlorine, Used for bathing soiled patients, handwashing, rinsing dishes, laundry. […] A number of safe and effective oral vaccines for cholera are available. Dukoral, an orally administered, inactivated whole cell vaccine, has an overall efficacy of about 52% during the first year after being given and 62% in the second year, with minimal side effects. […] The World Health Organization (WHO) recommends immunization of high risk groups, such as children and people with HIV, in countries where this disease is endemic. If people are immunized broadly, herd immunity results, with a decrease in the amount of contamination in the environment.
  • #31 Cholera disease – Symptoms, Causes, Types and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number f
    https://www.pacehospital.com/cholera-disease-symptoms-types-causes-prevention-and-treatment
    Cholera prevention and control […] Using different methods and strategies is the key to prevent, control, and decrease the number of deaths from cholera. Here are the following measures: Improved water, sanitation, and hygienic services: Economic development (using safe water and good hygienic practices) is one long-term solution for preventing cholera. Use of oral cholera vaccines (OCVs): Protection against cholera appears to continue for up to two years following a single dose of vaccine and for three to four years with an annual (yearly) booster. Surveillance: Rapid diagnostic tests (RDTs) can be valuable tools to detect outbreaks of cholera disease; nevertheless, to confirm the diagnosis, stool samples are sent to a laboratory for confirmation of Vibrio cholerae O1 or O139 by culture or by polymerase chain reaction (PCR). Sewage and fecal sludge management: In areas affected by cholera, fecal sludge (a mixture of human excreta, water, and solid waste) and sewage must be treated and managed effectively. Disinfection: Materials that may come in contact with the cholera patients need to be washed in hot water; if possible, chlorine bleach can be applied. Raising public awareness: Measures can be taken to increase awareness of cholera among people. Other measures: Using boiled or chlorinated water and avoiding uncooked vegetables and undercooked shellfish can prevent cholera.
  • #32 Cholera – including symptoms, treatment and prevention | SA Health
    https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/cholera/cholera+-+including+symptoms+treatment+and+prevention
    Antibiotics shorten the duration of the illness and lessen the severity, but they are not as important as rehydration. […] Exclude people with cholera from childcare, preschool, school and work until there has been no diarrhoea for at least 24 hours. […] Follow good hand washing procedures. […] Severely ill patients should be isolated in hospital. […] People who are less severely ill can be nursed at home. […] All linen and articles used by the patient should be washed in hot soapy water and the room thoroughly cleaned when the person has recovered. […] Vaccines are available but are recommended only for travellers to high-risk countries. […] When travelling to high-risk countries, seek advice from a travel medical clinic or an experienced general practitioner on how to protect yourself from cholera and other diarrhoeal illnesses. […] Good food handling procedures should always be followed, including when travelling. […] Contacts (for example, family members) of a case should be observed for 5 days from the date of the last exposure to the infected person.
  • #33 Chemoprophylaxis in Contacts of Patients with Cholera: Systematic Review and Meta-Analysis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3216950/
    There is a pressing need for effective measures to prevent the spread of cholera. Our systematic review assesses the effects of chemoprophylaxis in preventing cholera among exposed contacts. […] Chemoprophylaxis refers to the administration of medication to prevent disease or infection. In the case of cholera, healthy individuals are given antibiotics with the aim of protecting them against the disease, limiting the spread of the disease and curtailing an epidemic. […] WHO does not recommend chemopophylaxis arguing that routine treatment of a community with antibiotics, or mass chemoprophylaxis, has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security. […] Nevertheless, large-scale selective antibiotic prophylaxis has been provided to the contacts of people with cholera during outbreaks, as part of comprehensive community interventions.
  • #34 3.7 Antibiotic prophylaxis | MSF Medical Guidelines
    https://medicalguidelines.msf.org/en/viewport/CHOL/english/3-7-antibiotic-prophylaxis-23448873.html
    Treatment of an entire population with antibiotics is currently not recommended by the WHO. […] Targeted antibiotic prophylaxis is recommended for closed institutional settings, such as prisons or orphanages, where, given the nature of the facilities, significant exposure is likely to occur over a short period of time. Chemoprophylaxis should be given simultaneously to all individuals as soon as possible after the first case is recognized. The prophylactic dose of antibiotic is the same as the therapeutic dose. […] Selective chemoprophylaxis can be considered as an additional mean to control cholera for these settings, but does not replace the other control measures described in this chapter.
  • #35 Chemoprophylaxis in Contacts of Patients with Cholera: Systematic Review and Meta-Analysis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3216950/
    We conducted this systematic review of the findings of randomized clinical trials (RCT) and controlled clinical trials (CCT) to assess the effects of chemoprophylaxis and its effectiveness in preventing cholera in patient contacts. […] Our findings suggest that chemoprophylaxis has a protective effect among household contacts of people with cholera but the results are based on studies with a high risk of bias. Hence, there is a need for adequate reliable research that allows balancing benefits and harms by evaluating the effects of chemoprophylaxis.
  • #36 Chemoprophylaxis in Contacts of Patients with Cholera: Systematic Review and Meta-Analysis | PLOS One
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0027060
    Nevertheless, large-scale selective antibiotic prophylaxis has been provided to the contacts of people with cholera during outbreaks, as part of comprehensive community interventions. […] We conducted this systematic review of the findings of randomized clinical trials (RCT) and controlled clinical trials (CCT) to assess the effects of chemoprophylaxis and its effectiveness in preventing cholera in patient contacts. […] Our findings suggest that chemoprophylaxis has a protective effect among household contacts of people with cholera but the results are based on studies with a high risk of bias. Hence, there is a need for adequate reliable research that allows balancing benefits and harms by evaluating the effects of chemoprophylaxis.
  • #37 Roadmap 2030 – Global Task Force on Cholera Control
    https://www.gtfcc.org/about-cholera/roadmap-2030/
    The global strategy for cholera control aims to reduce cholera deaths by 90% and the eliminate the disease in 20 countries by 2030. […] A targeted prevention strategy focused interventions in cholera PAMIs. […] By identifying PAMIs, the strategy allows partners implement solutions that prevent cholera transmission. […] The strategy is designed to make a strong impact in the short term while implementing disease surveillance, case management and other control measures in the long term. […] To prevent cholera and protect communities. […] To improve access and quality of care to reduce cholera related deaths.
  • #38 About the GTFCC – Global Task Force on Cholera Control
    https://www.gtfcc.org/about-gtfcc/
    The WHO cholera program establishes and upholds norms and standards for cholera control efforts through the GTFCC Technical Working Groups: Case Management, Epidemiology, Laboratory, Oral Cholera Vaccine (OCV), Water, Sanitation, and Hygiene (WASH). […] The Country Support Platform (CSP) is the GTFCCs operational arm that provides country-level support through technical assistance, policy and advocacy, resource mobilization and fundraising, capacity building, and implementation of research projects.
  • #39 Public Health | Stop Cholera
    https://publichealth.jhu.edu/stop-cholera/gtfcc-resources/public-health
    This collection of resources are intended to support countries which are developing and executing effective cholera control and elimination strategies. […] The NCP Template equips countries with a structured and flexible framework to develop their National Cholera Plans (NCPs). […] The Guidance for Integrating Community Engagement into National Cholera Plans provides a structured approach for countries to incorporate community engagement in cholera control strategies and outlines community-centered activities across four phases: Inception, Development, Implementation, and Monitoring. […] A resource designed to guide public health professionals and program managers in effectively detecting, monitoring, and responding to cholera outbreaks, this manual emphasizes a multisectoral approach, integrating epidemiology, case management, water, sanitation, hygiene (WaSH), logistics, community engagement, and risk communication.
  • #40 An assessment of the progress made in the implementation of the regional framework for cholera prevention and control in the WHO African region | BMJ Global Health
    https://gh.bmj.com/content/10/1/e016168
    The urgency to empower the overall environment for the effective implementation of the framework has been revealed through this study. […] Effective implementation of the framework requires strong political commitment, strengthened health systems and increased investment in the long-term cholera control measures, among others. […] To eliminate cholera in line with global and regional strategies, there is a need to have a dedicated programme and funding like other programmes such as polio, HIV/AIDS and others, targeted for eradication and control/elimination. […] The international community should prioritise cholera and make major decisions such as UN cholera funds or STOP cholera initiatives to provide adequate domestic and external funding for cholera elimination by 2030.
  • #41 Searching for new avenues to control cholera – Defeat DD
    https://www.defeatdd.org/blog/searching-new-avenues-control-cholera/
    Cholera, a bacterial disease that leads to rapid dehydration, has afflicted humanity for centuries. Left untreated, it can be fatal. Oral cholera vaccines (OCV) have been a game-changing intervention since they became available in 2013, complementing other diarrhea control efforts like improved sanitation and oral rehydration salts (ORS) and zinc to treat dehydration. […] Researchers are developing a new type of food supplement derived from immunoglobulins that bind to the cholera toxin and prevent gut infection. These binding proteins, a powder mixed into food products, block the interaction between cholera toxins and intestinal receptors and reduce cholera-related diarrhea. […] Recently, researchers have focused on the use of antidiarrheal drugs to treat cholera and other major acute watery diarrheal diseases by stopping diarrhea itself. A challenge is that, during a diarrhea infection, these medicines can pass through the digestive system too quickly to be absorbed. […] Alongside acceleration of focused, prompt prevention of cholera outbreaks, enhanced case management would be a welcome development as we work toward the goal to reduce cholera morbidity and mortality by 90% in 2030. It is essential to continue investing in these efforts.
  • #42 Frontiers | Cholera outbreak trends in Nigeria: policy recommendations and innovative approaches to prevention and treatment
    https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1464361/full
    This increasing trend necessitates a proactive measure to tackle the country’s rising cholera infection cases. Hence, this paper aims to evaluate the trends of cholera incidences in the country while proposing effective, innovative approaches to preventing and treating infection. […] To stop the spread of cholera, case-area targeted interventions (CATI) are being used more frequently. […] It is also important to emphasize the significance of safe drinking water and improving sanitary conditions (WASH) and also leverage the following policy recommendation to support already existing cholera control and prevention across the nation: […] WASH has been an effective strategy used to control cholera globally. […] There is a need to establish WASH policies nationwide to provide clean drinking water, which would directly and indirectly serve as a basic step for the control of cholera and other related diseases in Nigeria.
  • #43 Cholera: Technical guidelines and resources – PAHO/WHO | Pan American Health Organization
    https://www.paho.org/en/haiti-humanitarian-crisis-grade-3/cholera-technical-guidelines-and-resources
    Experience has shown that measures such as quarantine to limit movement of people and the seizure of goods are unnecessary and ineffective in controlling the spread of cholera. […] The risk of infection for international travelers is very low for most travelers, even in countries where cholera outbreaks are active, as long as proper preventive measures are followed.
  • #44 Cholera
    https://www.nhs.uk/conditions/cholera/
    There are things you can do to help avoid getting ill while travelling in areas where cholera is found. […] wash your hands with soap and water regularly, especially after using the toilet and before preparing food or eating […] only drink bottled water or tap water that’s been boiled […] brush your teeth using bottled or boiled water […] do not eat uncooked fruit and vegetables (including salads) that you have not washed with bottled or boiled water and prepared yourself […] do not eat shellfish and seafood […] do not have ice in your drinks […] There’s a vaccine for cholera, but most people do not need it. […] It’s usually only recommended if either: you’re travelling to an area where cholera is common and you’ll be visiting remote places without access to medical care […] you’re an aid or disaster relief worker going to an area where a cholera outbreak is likely […] The vaccine is given as a drink. For adults, 2 doses (given 1 to 6 weeks apart) can provide protection for up to 2 years. […] You need to have had both doses at least a week before travelling.
  • #45 Cholera: How It Spreads and Tips for Prevention
    https://www.verywellhealth.com/cholera-overview-1958786
    Cholera is a bacterial infection that’s caused by a microbe that thrives in water. […] Cholera is extremely rare in the United States and other developed countries where public sanitation is well-established and good personal hygiene is widely practiced. […] If you plan to visit an area that is known to have cholera outbreaks, you should take proper measures to protect yourself. […] The World Health Organization (WHO) suggests that a combination of strategies needs to be in place to combat cholera worldwide. These strategies include: Timely reporting of disease-related information from local governments to global policymakers and surveillance of testing methods and data, Universal access to safe drinking water, basic sanitation, and good hygiene practices, Improved access to treatment methods, particularly oral rehydration solutions (ORS), Collaboration between communities that addresses local culture, practices, and beliefs to engage people in prevention programs, Improved access to cholera vaccines.
  • #46 Cholera – Epidemiology, Prevention and Control | IntechOpen
    https://www.intechopen.com/chapters/50256
    Cholera is an important public health problem, causing substantial morbidity and mortality especially in the developing countries. […] An integrated, multisectoral program, designed on evidence-based interventions, is required to prevent and control cholera. […] For the prevention and control of cholera, it is important to understand the factors that are responsible for initiating and sustaining cholera infection in a community. Measures for the prevention of cholera include provision of clean water and proper sanitation to the cholera-endemic communities. […] Health education regarding personal hygiene and food hygiene should be provided to these communities. […] CDC has listed five basic cholera prevention messages. These include drinking and using safe water; washing hands with soap and water; using latrines or proper sanitation methods; proper cooking of food, covering it, and eating it hot; proper cleaning up of places used for bathing and washing clothes.
  • #47 Cholera – Epidemiology, Prevention and Control | IntechOpen
    https://www.intechopen.com/chapters/50256
    Currently, there are two oral cholera vaccines available: Dukoral and Shanchol. […] In cholera-endemic regions and those at high risk for outbreaks, cholera vaccines should be used along with other prevention and control strategies. […] Cholera-endemic areas should prioritize cholera control measures. […] The main strategies for cholera control include appropriate and prompt management of cholera cases; strengthening laboratories; training and capacity building of health-care workers; and availability of adequate medical supplies for management. […] A well-organized, multisectoral approach is required to control cholera outbreaks.