How to Control Cholera

Cholera, which is a disease caused by vibrio cholerae bacteria, can be treated if its detected early enough. For the most part, cholera can be controlled by treating its main symptoms–dehydration, diarrhea and vomiting, and muscle cramps. Scroll down to Step 1 to learn about ways to control cholera, as well as ways to prevent it in the first place.

Steps
Controlling Dehydration
Check for signs of mild to moderate dehydration. If you have cholera, you are most likely dehydrated, as dehydration is the number one symptom of this condition. Dehydration can range from mild and moderate, to severe. Mild to moderate dehydration signs include[1]:
Having a dry, sticky mouth.

Feeling thirsty and tired.

A decreased output of urine (which means not going to the bathroom very much). In infants this means no wet diaper for over three hours.

Having dry skin.

Headache.

Constipation.

Recognize signs of severe dehydration. While being dehydrated is definitely cause for concern, being severely dehydrated means you should be hospitalized immediately. It also means that you are in a life threatening situation, so act quickly. Signs of severe dehydration include[2]:
Your eyes look like they are sinking into your head, and the skin around your eyes is raised.

Your lips are chapped and dry and you are extremely thirsty.

Your skin does not snap back into its normal position when pinched but instead sinks back down slowly (this is known as the Pinch Test).

You have a fever above your normal temperature (which is 98.6ºF or 37ºC).

Very little urine production, and the urine that is produced is extremely dark in color.

You experience rapid heartbeat and rapid breathing.

Rehydrate yourself if you are moderately dehydrated. For adults who become dehydrated because of cholera, it is important to get fluids in your system right away. The World Health Organization recommends that you rehydrate orally as soon as possible.[3] This means drinking:
Treated (cholera-free) water.

Coconut water.

Electrolyte-rich drinks like Gatorade.

Soup or bouillon.

Oresol (which is an oral rehydration solution).

Make your own Oresol. If do not have any packets of Oresol readily available to you, you can make your own rehydrating drink with the help of some common kitchen items. Keep in mind that you should drink at least one cup of this mixture after every time you have diarrhea. To make your own Oresol[4]: Wash your hands and the glass or bottle you are making the mixture in. Make sure that you only use water that has been treated to wash your hands and utensils.

Mix one liter of clean, treated drinking water with 8 teaspoons of sugar and one teaspoon of salt.

Shake or stir the water to make sure the ingredients are thoroughly mixed, and then drink it.

Rehydrate your child if he or she is moderately dehydrated. Dealing with a dehydrated child can be a little trickier than forcing yourself to drink liquids when you feel ill. However, it is very important that the child be rehydrated as soon as possible (which means right after her last bout of diarrhea). To rehydrate a child follow these guidelines[5]:
For a child with cholera but no current signs of dehydration: Children who are less than two years old should drink 50-100 mL of liquid after having diarrhea. Children 2 to 9 should drink 100-200 mL, and children 10 or older should drink at least 2,000 mL a day.

For mildly dehydrated children: Children less than 4 months old should drink 200-400 mL; children 4 to 11 months old should drink 400-600 mL; children 1 to 4 years old should drink 600-1200 mL; kids 5 to 14 to should drink 800-2,200 mL; and kids 15 and older should drink 2,200-2,400 mL.

Children of all ages with severe dehydration should immediately be taken to the hospital.

Get to the hospital if you are severely dehydrated. If you or someone you are with, including an adult or child, is severely dehydrated, you should go to the hospital immediately so that you can get rehydrated with the help of an IV (an intravenous line).[6]

Controlling Other Symptoms
Take antibiotics. Doctors can prescribe antibiotics that will help you control the diarrhea brought on by cholera. These antibiotics won’t necessarily kill the microbe responsible for the cholera, the will make the duration of your symptoms shorter. You will have to talk to a doctor before you can get these prescriptions. Doctors normally prescribe[7]: Tetracycline: Adults take 500 mg every 6 hours while children should take 125 mg per every kilogram (mg/kg) of their body weight every 6 hours for a period of 72 hours.

Furazolidone: 100 mg for adults and 125 mg/kg for children every 6 hours in a period of 72 hours.

Chloramphenicol: Adults should take 500 mg while children should be given 18 mg/kg weight every 6 hours for 72 hours.

Adults can also take a doxycycline 300 mg tablet (Monodox, Oracea, Vibramycin) or azithromycin 500 mg tablet (Zithromax, Zmax) in a single dose.

Take zinc supplements to combat diarrhea. Studies show that zinc supplements can help control the diarrhea problem you are experiencing. This is because zinc makes the lining in your stomach and intestines less vulnerable to irritation, even when you have cholera. It is recommended that you take: Adults should take 50 to 300 mg per day.[8]
Children 6 months or older should take 20 mg a day for 10-14 days.[9] Children younger than 6 months should take 10 mg a day for 10-14 days.[10]

Control your hygiene while you have cholera symptoms. Even though you will probably be feeling weak and awful, it is really important that you continue to keep up your hygiene practices so that you don’t get more sick or get anyone else sick. Wash your hands whenever you go to the bathroom or deal with dirty diapers. Dispose of human waste properly if you do not have a proper toilet (this is explained more in Step 5 of Method Two).

Preventing Cholera
Make sure that the water you drink is safe. If you are traveling through or living in an area where cholera is present, it is really important that you drink only water that is either bottled or has been treated (treated water will be covered in Step 2). Bottled water is always a good bet, so long as the bottle cap is sealed when you purchase the water.
Make sure to wipe the lip and cap of the bottle off to get rid of any lingering cholera bacteria that might have gotten on the outside of the bottle.

Purify any water that you think could have cholera bacteria in it. Treating (or purifying) water is another option when it comes to drinking water in an area that is known to have cholera. There are quite a few ways to purify water but some of the best and most efficient include[11]:
Boiling the water. Put the water in a clean pot or heat-resistant container and bring it to a boil on the stove or over a fire. Do not turn the heat off when you see bubbles (which means that the water is boiling)–continue to let the water boil and bubble for at least one minute. Let the water cool down a bit before you drink.

Use bleach. Add about 8 drops of bleach to a gallon of water or 2 drops of bleach for every of water. Shake and let the water stand for at least 30 minutes before you drink it.

Use iodine purification tablets or liquid. Iodine works as a water purifier. You can get prepackaged water purifying tablets at most outdoor adventure stores and pharmacies. Follow the instructions on tablets’ packaging. If you have a liquid 2% tincture of iodine, you can add 5 drops to every quart of clear water.[12]

Make sure to wash your containers with treated water before storing water in them. Storing the water properly is also very important so make sure that you keep your water in clean containers. You can use treated water to clean your containers and make sure to keep them covered if you are storing them outside.

Wash your hands thoroughly and often. You should follow the three second rule when washing your hands: turn the faucet on and then lather your hands with soap. Rub your palms together and then rub the backs of each of your hands. Clean the areas between your fingers and then work your way up to your wrists. Rinse your hands thoroughly with clean water and then pat them dry. This should all take about three minutes (which is how long it takes to sing the birthday song–you can sing it in your head while you wash if that helps).[13]
Wash your hands before preparing a meal and eating. You should also wash them after eating.

Wash them after going to the bathroom, changing soiled diapers, and caring for someone with diarrhea.

Clean your hands with hand sanitizer if there is no soap present.

Know the proper way to dispose of waste. You should always defecate (the medical term for going #2) in a bathroom. However, sometimes this isn’t possible–like when you are hiking in a remote part of a third world country. If you do have to go outside, make sure that you get as far away from a water source as possible (as it can contaminate the water). After doing your business, bury your feces and wash your hands with clean water and soap.[14] You can also defecate into a plastic bag, tie it up, and bury far away from a water source.

If you are concerned a bathroom might have cholera in it, clean it with a bleach mixture. Mix one part bleach with 9 parts water and clean everything.

Avoid eating raw food. The cholera virus thrives in contaminated water which means it’s unwise to eat food that is raw (which means it has not been cooked). This is a good rule to follow whenever you are in a foreign country but is particularly important when you are in an area affected by cholera.[15]

Eat food that you know is safe. Always check to make sure that your food is thoroughly cooked. One of the best ways to do this is by cooking the food yourself. If you do happen to go out to eat, don’t be afraid to ask the waiter how a certain dish is prepared.[16]
Always wash fruit with treated water and stick to fruit that has a protective layer that you don’t eat (such as a papaya, passion fruit, or orange).

Only eat cooked seafood. Make sure that it is cooked all the way through and try to eat it while it is still hot.

Maintain your hygiene. Making sure that you and your surrounding are clean will help to keep you from getting cholera. Try to bathe twice a day with water that has been treated. If you can’t bathe with treated water, try to keep water from getting into your eyes, mouth, nose, and ears.[17] Make sure that your bathroom or latrine is located at least from the water source so that your water source does not become contaminated.

Tips
Avoid drinking water that you don’t know the source of.

Always ask for drinks without ice, as ice can also contain cholera.

Know that the only real symptoms of cholera are dehydration, diarrhea and vomiting, and muscle cramps. Some people might not have any of these symptoms.

Warnings
If you think you have cholera, talk to a doctor right away for more information and treatment.

Sources and Citations
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