Thousands of dead by cholera in West Africa

Severe cholera epidemic in West and Central Africa

17.09.2012

Thousands of lives are currently threatened by the spread of cholera in Central and West Africa. Outbreaks of cholera have been reported in several West and Central African countries. Tens of thousands of Africans are already ill. The experts at the World Health Organization (WHO) cite the inadequate hygiene standards and the lack of segregation of sewage and drinking water systems locally as the determining cause. Thus the bacterium Vibrio cholerae is spread over drinking water and food.

In Europe, cholera is one of the long-forgotten diseases. The infectious disease develops its horror here, especially in the 19th century. However, with the development of sewage systems, improved hygiene standards and medical advances, cholera has been completely eliminated in Europe. In Africa, however, the bacterial disease continues to threaten thousands of lives. Faced with the current massive spread in several African countries, WHO experts have called for a state of emergency.

Cholera: A deadly infectious disease
Especially in poor countries, with poor drinking water supply, inadequate sewage systems and low hygiene standards, cholera is still a serious threat today. The infection with the bacterium Vibrio cholerae causes after a few days incubation initially severe diarrhea, nausea and vomiting. Those affected lose an extremely high amount of fluid, leading to an acute lack of fluids (exsiccosis). If the fluid loss is not balanced, this can have fatal consequences after only a short time (24 to 48 hours). In addition, severe complications such as pneumonia, sepsis and dizziness, including coma, can be severe. In West and Central Africa, unusually heavy rains have led to an increase in the detection of cholera pathogens in drinking water and the corresponding infestation of many people. Especially in the densely populated areas with poor hygienic conditions numerous cholera infections are recorded. From here, however, the pathogens reach the rural areas after the first outbreaks.

More than 50,000 Africans suffer from cholera
At the beginning of September, the WHO reported „a total of 16,360 cholera cases, including 255 deaths“ in Sierra Leone. The majority of illnesses are concentrated in the western part of the country, where the capital Freetown is located. The lethality was 1.6 percent, according to the WHO statement. In total, outbreaks of cholera have been reported in 15 West African countries, including Guinea, Liberia, the Congo, Niger and Nigeria. More than 55,000 people have already contracted this year, an increase of 34 percent over the same period last year. Around 1,100 people have died of cholera in West and Central Africa since the beginning of the year. However, the peak of the disease is likely to be in the affected regions. The President of Sierra Leone has the cholera epidemic as „humanitarian crisis“ which requires close cooperation between governments and aid organizations.

Good treatment options for cholera infection
With proper medical care, cholera can be treated well today so that most infected people survive the disease. By balancing the fluid loss with electrolyte solutions - at worst by infusion - acute threats due to dehydration of the organism can be avoided. In addition, the use of an antibiotic is considered for severe disease progression. In the African countries currently affected, however, most of the available medical resources are not available, so the disease poses a high risk to the population.

Further increase in cholera infections is expected?
Due to the bacterial contamination of the drinking water, the number of cholera infections threatens to skyrocket. Here, above all, the supply of unencumbered drinking water is required to prevent the spread of cholera, the experts said. Quick action by governments and aid organizations remains the only option. Immediately the should „Governments declare a state of emergency“, said World Health Organization Africa Director Luis Sambo, adding that cooperation between health authorities in various countries is also needed to end the cholera epidemic. Manuel Fontaine of the United Nations Children's Fund UNICEF also stressed the importance of providing clean drinking water, because it could „not that a mother has to ask each time she gives her child something to drink about whether the drink is fatal.“

Cooperation of governments and aid organizations in the fight against cholera
In Sierra Leone, the government is already working with international partners and aid agencies such as UNICEF, Oxfam, British Red Cross, Save the Children, Care and WHO. The World Health Organization has one in the capital, Freetown „Cholera Control and Command Center“ set up. To enable rapid laboratory diagnostics, the laboratories were supplied with appropriate materials and reagents at national level to transport and analyze the laboratory samples. This is of particular importance to determine the spread of cholera in a timely manner. However, the epidemic can not be controlled by laboratory analysis alone. In the first place, this requires the supply of clean drinking water and the immediate medical care of those affected. (Fp)

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Image: Dieter Schütz