CHOLERA, DIARRHEA & DYSENTERY UPDATE (14): EUROPE (ITALY) AFRICA
(SOUTH AFRICA)
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
Europe
[1] Cholera – Italy (Sardinia)
Africa
[2], [3] Cholera – South Africa (Gauteng)
Europe
[1] Cholera – Italy (Sardinia)
Date: Mon 19 Jul 2023
Source: Breaking Latest News [edited]
https://www.breakinglatest.news/health/first-case-of-cholera-in-cagliari-since-1973-epidemic-symptoms-transmission-and-prevention/
In a shocking turn of events, a case of cholera has been identified in
Cagliari, the capital city of Sardinia. The patient, a 71-year-old
pensioner from Arbus, is the 1st to contract cholera since the
epidemic that struck Sardinia, Campania, and Puglia in 1973.
The man is currently being treated at the infectious disease
department of the Santissima Trinità hospital in Cagliari, where the
presence of the Vibrio cholerae bacterium, which causes cholera, was
confirmed. Fortunately, his condition is stable and showing signs of
improvement.
Cholera is an acute diarrheal infection caused by the V. cholerae
bacterium, with 2 serogroups (V. cholerae 01 and V. cholerae 0139)
known to cause epidemics. It is primarily transmitted through the
ingestion of contaminated water or food, particularly raw or
undercooked seafood. Other foods can also serve as a vehicle for
transmission.
Under normal sanitary conditions, direct person-to-person contagion is
very rare. The necessary bacterial inoculum for transmission is over a
million, making it difficult to infect others through simple contact.
The incubation period for cholera usually ranges from 24 to 72 hours,
but in exceptional cases, it can vary between 2 hours and 5 days,
depending on the number of bacteria ingested.
Most infected individuals, approximately 75%, do not show any
symptoms. However, in those who do exhibit symptoms, only a small
proportion develop a severe form of the disease. The predominant
symptom is watery and brown diarrhea, often referred to as “rice
water” due to its appearance. Continuous fluid loss can lead to
dehydration, shock, and in severe cases, fatality. Other symptoms may
include vomiting and leg cramps, while fever is not prevalent.
The treatment for cholera primarily involves fluid replenishment and
rehydration therapy. Oral rehydration is successful in 90% of cases,
particularly through the intake of solutions rich in sugars,
electrolytes, and water. In severe cases, intravenous fluid recovery
may be necessary, requiring large volumes of liquids. The use of
antibacterials, such as tetracyclines or ciprofloxacin, can shorten
the course of the disease and reduce symptoms, especially in severe
cases.
Prevention measures for cholera epidemics include water purification
and sewage system operation. Ensuring the safety of food and water,
improving hygiene practices, and educating individuals on hygienic
precautions during food preparation and intake are essential in
reducing the spread of the disease. The V. cholerae bacterium is
highly sensitive to the action of common detergents and
disinfectants.
Although the possibility of infection for tourists is low,
humanitarian groups operating in disaster-affected areas and refugee
camps are at higher risk. An oral vaccine containing inactivated
bacteria and a partial toxin is available as a preventive measure. The
vaccine is administered in 2 doses for adults and children over 6
years old, and 3 doses for children aged 2 to 6 years. A booster dose
is recommended every 2 years, with the vaccination course completed at
least one week before potential exposure to infection.
The identification of this cholera case in Cagliari serves as a
reminder of the importance of sanitation, food safety, and hygiene
practices in preventing disease outbreaks. Local authorities and
healthcare professionals are taking necessary measures to ensure the
containment of the disease and to protect public health.