Cholera Epidemiology

Cholera Epidemiology: By Dr. Japhet Olugbogi, Medical Officer of Health 

Fatalities from cholera in 2021 dwarfed COVID-19 related deaths within the same period. Cholera, he insisted, is a very deadly disease, a bacterial disease, and an infectious disease in that it’s communicable from one person to another.
“So, unlike COVID-19 and other diseases, cholera has to deal with what you put into your mouth when people consume bad water, water that is impure, use cutlery that is not washed or adequately washed, plates, utensils. “Even the tips of bottled water, tips of canned malts or plastic drinks, pure water that was soaked in bad water, all these are some things that can cause cholera because it is transmitted through the oral route, unlike COVID-19.

“What I mean by faecal route is that when faecal matter stains all those items that I mentioned earlier, even the tips of our fingers, you put them in your mouth, and the person can have cholera. Now, people who have cholera, you can know them when they start defecating and vomiting and the faecal matter looks like rice water, and the individual defecates on so many occasions within a short interval.

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“When they do that they are losing water from the body, losing electrolytes from the body, and before you know it the individual gets tired, weak and fatigued. If that defecation continues and the vomiting continues, the individual continues to lose all their strength and before you know it, the individual can pass away.

That is why it kills even much faster than COVID-19 or malaria. Cholera can kill somebody in one day and in hours. “And if you are catering for somebody who has cholera, the person needs to be very careful, when you leave in a house where somebody who has cholera stays or you are in a hospital or ward where somebody who has cholera, everybody around needs to be very careful because the vomitus and the faecal matter are very contagious.

“When somebody is passing stools that are watery you don’t know when such faeces stains the surfaces and when individuals who cater for them use their hands to touch the bed linings or the clothing around. “So, cholera can be transmitted when people who cater for those who have it, people who share an apartment or room or house with somebody who has cholera are.

People who had cared for them in the hospital can also develop cholera if care is not taken because it is very highly contagious. When one has cholera, doctors will need to give an IV fluid, which is called drip.” Olugbogi added: “There are special drips for it to replenish the water that the individual is losing because as the individual is losing water from the body, they are losing electrolytes and are losing a lot of minerals from the body that naturally gives energy to the body. That is why you see them look as if they have been sick for several years after a few hours when they have cholera.

“So, cholera is very dangerous and it’s usually commoner in slums, the outbreaks usually occur in slums where they don’t have WASH services like water and sanitation and hygiene services, places where they don’t have toilets, places where they do what we call short put or open defecation, or people who have the habit of passing stool inside nylon or some containers and discard them in drainages or even throwing them into bushes. “These are the areas where cholera usually breaks out because when it rains, what happens is that the rainwater, the flood wash this faecal matter into the homes, into the water sources and before you know it they start having cholera. There are some areas in Lagos where cholera broke out last year and we found that there are shallow drains there.

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“Apart from that the pipes that carry water from some boreholes or from some tanks that are makeshift boreholes pass through drainages and you would see that some of them are already leaking and black rubbers were used to tire them.
“This is a recipe for disaster, such a habit is a recipe for cholera outbreak and it happens in so many places in Lagos. So, what we do is to advise those who have shallow wells in their areas where they use to cook or drink to insure that they boil these water, even tap waters, they should boil them and allow them to cool down and sift them before they consume them or before they use them to do anything or taking to the mouth.

“Apart from that, landlords in many places need to plan to have proper drainages and sink proper boreholes and to have toilets when they build their houses. A lot of people build houses; they don’t make plans for these services.

 “Cholera is real and we all need to create a better society for these vulnerable children and for all those other people that are vulnerable to ensure that they do not get killed by a disease that should not ordinarily kill them.”

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