Cholera as soon as you change the water in the jar!

 Cholera as soon as you change the water in the jar!

A few days ago I was talking to a cholera patient. He told that the person who used to transport the jar water that he was always using used a different jar when he went to his village for a few days and had to be admitted to the hospital due to diarrhoea.

Past experience and tests show that cholera in Nepal is mainly spread through water. However, there is a risk of cholera even if the infected food or raw vegetables or fruits are washed with cholera infected water. Cholera is increasing day by day in Nepal.

While preparing this article, the official data of 27 confirmed cases of cholera across Nepal has been released. It seems that not only the number but also the area/geography is expanding. It is said that Cholera which was first seen in Kathmandu passed through Dhangadhi and recently also appeared in Pyuthan. With more heavy rains, it seems that the spread of cholera is continuing and possibly intensifying.

Cholera is not a new disease in Nepal. Its presence has been going on for centuries. But it can be considered ironic that its risk/presence remains even till today. In many countries of the world, cholera has been limited to history.

Currently I am working at Shukraraj Tropical and Communicable Disease Hospital, initially under the name of 'Cholera Hospital'. No. It was established in 1990. Even a decade ago, cholera outbreaks in hospitals were widespread. The last time cholera patients were extensively treated in this hospital in 2010. But unfortunately, when cholera spread in Haiti at the same time, Nepal had to bear the brunt of the source of the epidemic. I also refuted this allegation through scientific articles. However, it has not been possible to put a complete brake on the rate of occurrence of cholera and death due to it in Nepal.

Recently, in 2021, when cholera spread in some villages of Kapilvastu, some died due to delay in treatment. At present, it seems that the efforts of the Nepal government to keep cholera at 'zero death rate'.

Cholera is a highly contagious and deadly bacteria. If severe cholera is not treated within a few hours, the patient may die. Symptoms appear within a few hours to five days after infection. The initial symptoms of cholera are milky thin stools like watery stools, vomiting, muscle spasms (especially of the stomach), restlessness. In the hospital where I work, a recently confirmed cholera patient was also admitted with milky, watery stools. Problems such as low blood pressure, increased heart rate, and dry mouth will continue to appear. If the treatment is not done on time, the patient may even die.

Severe cholera is seen in only one or two out of 10 infected people. But there is a risk of spreading because moderate or asymptomatic infected people will excrete cholera bacteria through their stools for 10 days.

To prevent the spread of cholera, safe water, personal hygiene and water available in the market should be monitored regularly. It is very important to make sure whether tap water or bottled water is potable before we drink it. The above-mentioned patient had to become infected and sick because he did not pay attention to the water he drank from the changed jar. Almost a decade ago, many people did not believe when I published the first case of cholera in Nepal after drinking bottled water (not known by the manufacturing company). It had to wait for a few years to be confirmed.

A few years ago, when cholera was observed in Lalitpur, the bacteria was found in the water of the jar. The person who sold the water from that jar was also punished. In many infected people, symptoms are either moderate or mild or asymptomatic. But such infected people are spreading the cholera bacteria through their feces. Cholera spreads if the infected person does not wash his hands properly with soap and water after defecating. Another main reason is lack of permeability or dilution of commercial water. At least in case of monsoon season or cholera/bush diarrhoea, rapid monitoring is necessary to be regular and strict.

There is a cure for cholera. If you reach the hospital on time and receive treatment, the patient will recover completely. But if the treatment is delayed, especially in severe cholera, the risk of death increases greatly. For example, in 2021, when cholera spread in some villages of Nawalparasi, more than half a dozen people had to die due to lack of timely treatment.

Therefore, currently, cholera is not only concentrated in the city but also in the rural areas (recently also seen in Pyuthan), which is a matter of concern. In such places, it seems that the possibility of death is high due to the geographical difficulty of not being able to reach the hospital in time. Past experience also shows that possibility. Vaccination against cholera is also available. It seems that such vaccines would be more successful if they can be used especially in villages that are geographically difficult and far from health centers.

Cholera is spread especially through water medium. So how safe is the water you drink? Have you thought?