• By Deborah Balzer

Cholera outbreak claiming lives

June 27, 2017

a man rinsing and washing his hands in water from a rusty pipe

The cholera outbreak in war-torn Yemen has claimed more than 1,300 lives, according to the World Health Organization and UNICEF. The two organizations have issued a joint statement saying, "We are now facing the worst cholera outbreak in the world."

Cholera is an infectious diseases usually spread through food or water contaminated with the bacterium Vibrio cholerae. It can spread rapidly in areas with inadequate treatment of sewage and drinking water.

Watch: Dr. Rajapakse discusses cholera.

Journalists: Broadcast quality sound bites with Dr. Rajapakse are in the downloads.

Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases specialist, says, "It is possible to get the infection and have only mild symptoms or no symptoms at all. However, 5 to 10 percent of people who are infected will develop severe symptoms, which can include profuse watery diarrhea, vomiting, dehydration and shock." Approximately half the people with cholera die. With treatment, the number of fatalities drops to less than 1 percent. Severely dehydrated people also may need IV fluids.

Dr. Rajapakse says, "Cholera is very rare in the U.S. and cases here are usually in travelers who acquired it elsewhere. However, outbreaks continue to occur in areas of the world that do not have reliable access to safe water, sanitation and other measures in place to prevent the spread of infections like this."

Symptoms of cholera infection may include:

  • Diarrhea
    Cholera-related diarrhea comes on suddenly and may quickly cause dangerous fluid loss — as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool).
  • Nausea and vomiting
    Occurring especially in the early stages of cholera, vomiting may persist for hours at a time.
  • Dehydration
    Dehydration can develop within hours after the onset of cholera symptoms. Depending on the of fluids lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration.

"The most important part of treatment for people with cholera is rehydration — either by mouth or through an IV line if they are very sick," says Dr. Rajapakse. "Many people will get better with this supportive care alone. Antibiotic treatment is recommended for people with severe illness or for those who are hospitalized."

Dr. Rajapakse adds, "Finding the source of the outbreak, providing safe water sources, and preventing ongoing transmission of the infection are also all necessary in large outbreaks like the one occurring in Yemen currently."

The Centers for Disease Control and Prevention has a travelers’ health website that contains information on cholera and other diseases of concern to travelers.

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