Cholera is an acute intestinal infectious disease caused by the bacterium Vibrio cholerae. In Mozambique, as in many other developing regions, cholera is a significant public health concern due to socio-economic factors, poor sanitation conditions, and extreme weather events.
Epidemiology:
Outbreak and Rainy Seasons: Mozambique is prone to cholera outbreaks, especially during the rainy seasons. Floods can contaminate water sources and facilitate the spread of the bacteria.
According to the National Directorate of Public Health, with data up to November 20 of the current year, Mozambique is approaching 40,000 cases since September 14, 2022, with 152 deaths, with particular emphasis on the province of Nampula.
Causes and Transmission:
Water and Food Contamination: Cholera typically spreads through the ingestion of water or food contaminated with the feces of an infected person.
Poor Sanitation Conditions: Lack of access to basic sanitation and clean drinking water increases the risk of contamination.
Impact on Public Health:
Severity and Dehydration: Cholera can lead to severe dehydration, and if not promptly treated, it can be fatal. Children and the elderly are particularly vulnerable.
Strain on the Healthcare System: A cholera outbreak places a significant burden on healthcare systems, especially in areas where resources are limited.
Signs and Symptoms:
The typical signs and symptoms of cholera can vary from mild to severe, and in some cases, the illness can progress rapidly to a potentially fatal condition.
Severe Watery Diarrhea: The distinctive feature of cholera is sudden and intense diarrhea. Stools become watery, resembling "rice water."
Dehydration: Due to extensive fluid loss through diarrhea, dehydration can occur rapidly. This can lead to death.
Abdominal Cramps: Cholera is often accompanied by intense abdominal pain and cramps.
Nausea and Vomiting: Some individuals with cholera may experience nausea and vomiting, although diarrhea is the most prominent symptom.
Weakness and Fatigue: Loss of fluids and electrolytes can result in a general feeling of weakness and fatigue.
Rapid Weight Loss: The rapid loss of fluids through diarrhea can lead to a significant decrease in body weight over a short period.
Low-Grade Fever: In some cases, cholera may be associated with a mild fever, but the fever is not as prominent as in some other gastrointestinal infections.
Prevention:
Infrastructure Improvement: Investing in sanitation infrastructure and providing access to clean drinking water are crucial measures for preventing cholera.
Health Education Campaigns: Educating communities about hygiene practices, such as handwashing and proper treatment of water and food, is essentia.
Outbreak Response:
Readily Available Treatment: Ensuring that health services are readily available to diagnose and treat cholera cases is crucial.
Vaccination Campaigns: In some situations, vaccination campaigns can be implemented to prevent the spread of the disease.
Treatment: It is crucial to recognise the signs and symptoms of cholera quickly in order to start appropriate treatment and avoid serious complications, such as severe dehydration. Cholera treatment usually involves the rapid administration of fluids and electrolytes to correct dehydration. In some cases, antibiotics may also be prescribed to reduce the severity and duration of the illness.
Challenges:
Logistical: In remote regions or during natural disasters, there may be logistical challenges to providing necessary medical care and supplies.
Extreme weather conditions: Extreme weather events such as cyclones and floods can aggravate the situation, increasing water contamination and contributing to outbreaks.
By Dr. Humberto F. Faria Xavier, MD
