|Guidelines for Cholera Control (WHO - OMS, 1993, 68 p.)|
|5. Early responses to the threat of an outbreak|
Simplified treatment is the most important advance in cholera control and means that effective treatment can be within the immediate reach of most patients. Many deaths can thus be prevented, and the excellent results obtained also serve to calm public fears.
Most cases can be treated in existing health centres if rehydration materials (oral rehydration salts and intravenous fluid) and antibiotics are available, and health workers are trained in the management of diarrhoea.
If appropriate facilities, supplies, and trained staff are unavailable or are far away, or if there are too many cases to be handled by existing facilities, it will be necessary to establish emergency treatment facilities in affected communities. Temporary facilities can be established in huts, school buildings, or tents, and can be provided with the necessary supplies and trained staff.
These facilities, set up to provide rapid and efficient treatment for a large number of patients, should not be used to quarantine them: quarantine does not help to control the epidemic. Furthermore, while it is advisable to restrict contact between patients and the surrounding community to a minimum, it is not necessary to apply strict isolation measures, such as face masks, gloves, or special clothing for health staff and visiting family members. As in any unit treating patients with a communicable disease, it is important to have convenient hand-washing facilities for people working with and visiting cholera patients. The safe disposal of excreta and vomit is essential (see section 7.2).