|Water and Sanitation in Emergencies - Good Practice Review 1 (ODI, 1994, 120 p.)|
There are many practical steps that can be taken to contain cholera and limit its spread.
Cholera is transmitted by the faecal-oral route. People can be infected but not show any signs of sickness. Their faeces will contain the cholera vibrio. Therefore, take firm action to implement the normal measures to control the transmission of faecal-oral diseases:
· Monitor the supply and preparation of food.
· Wash your hands before preparing food and especially after using the toilet.
· Cook food thoroughly.
· Eat cooked food immediately. If cooked food has to be stored, boil or reheat it thoroughly before eating it.
· Fruits and vegetables should be cooked and peeled. Raw, unpeeled fruit should not be eaten.
Safe drinking water
Wherever possible obtain drinking water from a safe, uncontaminated source such as a sealed well, a borehole, rainwater, or a well-maintained piped water supply. If you are not sure that the water is safe:
· Disinfect it with alum, potash or chlorine.
· Bring the water to the boil, then boil it vigorously for one minute before using.
· Store water in a clean, covered container. Use a ladle with a long handle to take water out, so that your hands do not come into contact with the water.
Hygiene and waste disposal
· If possible, wash kitchen dishes with soap, rinse with clean water, and use a clean cloth to wipe dishes dry (or leave dishes to dry in sunlight in a clean place).
· Dispose of all stools and faecally contaminated materials in a latrine, or bury them if latrines are not available.
· Provide safe excreta-disposal facilities, ensure they are used and prevent indiscriminate defecation.
Public health measures
If an epidemic occurs, local authorities should take the following actions:
· Provide and maintain safe and adequate community facilities for excreta disposal.
· Ensure an adequate supply of safe drinking water.
· Prevent the use of contaminated drinking sources.
· Provide information about how people can purify water at home.
· Ensure the immediate and hygienic disposal of dead bodies.
· Discourage large gatherings, such as feasts or funerals.
· Establish emergency treatment centres with sufficient amounts of essential supplies, such as oral rehydration salts and intravenous rehydration solution.
· Train medical personnel, if necessary, so that they can identify patients early and treat them correctly.
· Treat cholera patients in a separate area and disinfect contaminated materials, such as bedding and drinking vessels.
Common sources of infection
· Water contaminated at its source (for example, by faeces leaking into an incompletely sealed well) or during storage (perhaps by contact with faecally contaminated hands).
· Contaminated foods that are eaten raw or undercooked, or stored at a temperature at which bacteria can rapidly multiply.
· Raw vegetables that have been washed with contaminated water.
This extract is a modified version of the reprint which appeared in the spring 1993 issue of Dialogue on Diarrhoea.