The current cholera epidemic in Zimbabwe has hit
more than 91,000 and left almost 5,000 dead. Zimbabwes health
system was once the envy of Africa, but nearly a decade of economic
collapse has left hospitals and clinics in a shambles.
it, cook it, peel it, or forget it
If you are going to travel through Zimbabwe, you
risk contracting this disease. It can be deadly if not treated.
Cholera is one of the most common organisms in surface waters of
the world. It occurs in both freshwater and marine habitats and
lives in associations with aquatic animals. Some species live in
mutualism with fish and other marine life. Other species are
pathogenic for fish, eels, frogs and many other vertebrates and
invertebrates including humans.
V. cholerae is a pathogen (from Greek πάθος
pathos "suffering, passion" ) of humans. It is characterised as a
sudden onset of profuse painless watery stools or diarrhea with
Up to 80% infected persons may experience mild or no
symptoms. In severe cases there is acute onset of profuse watery
diarrhea (so called "Rice water" stools, due to the similarity to
actual cooked rice water).
Occasional vomiting, rapid dehydration and
circulatory collapse can occur as a consequence. Infected
individuals may loose up to 30 litres of fluid per day in stools.
Severe cases can develop symptoms of shock within 2 hours. Without
proper treatment, death can occur within hours. For every 1
symptomatic infected individual there are approximately 40
asymptomatic cases or carriers in the community.
Transmission occurs when there is ingestion of water
contaminated with faeces or vomit from infected individuals.
Occasionally food contaminated by faeces is transferred by flies or
consists of rapid rehydration. Eighty to ninety percent of infected
people can be successfully treated with oral rehydration (8
teaspoons of sugar and a ฝ teaspoon of salt in litre of safe water).
If dehydration is more severe, intravenous fluids should be
administered. Antibiotics are not routinely used in the treatment of
cholera. A recently developed oral vaccine for cholera is licensed
and available. (Dukoral from SBL Vaccines).
The vaccine appears to provide somewhat better
immunity and have fewer adverse effects than the previously
available vaccine. However, CDC does not recommend cholera vaccines
for most travelers.
Further information about Dukoral can be obtained
from the manufacturers: Dukoral ฎ SBL Vaccin AB, SE-105 21
Stockholm, Sweden. Telephone +46-8-7351000, e-mail: