CHOLERA IN GHANA
WHAT DO I NEED TO
KNOW!!
Evelyn Kwofie, MPH student
Walden University
PUBH 6165
Instructor : Dr Patrick A. Tschida
Quarter 3, 2011
* An acute disease caused by ingestion of
food or water contaminated by
a bacterium called Vibrio cholerae
* Feces contaminated water is the reservoir
of infection and vehicle of transmission
* Bacteria infects the small intestines
resulting in large amount of watery
diarrhea
* Onset is typically sudden (2-3 days)
(CDC,2011; WHO, 2011)
• Last and first pandemic in 1970/71
• Now cholera is endemic in Ghana
• Coastal sanitation poor along beaches
• Number of major breakout decreased
from 6-7 years to 3-4 years between 1971
and 2011
(Ghana government, 2011)
•
Last outbreak Sept 2010
Peaked March 2011
Regions affected the most were Greater
Accra, Eastern region and Central region.
The three regions accounted for 98% of
cumulative total of 8,494 cases and over
99.8% of the 94 deaths as of May 14, 2011
Overall case fatality rate is 1/1%
(Ghana government, 2011)
* Both adults and children living in places
overcrowded with inadequate water
treatment and poor sanitation
* People with low immunity i.e.
people living with HIV and malnourished
children are high risk (CDC, 2011).
• By ingesting feces contaminated water
and food
• Flood leading to contamination of
domestic water
* Ingesting raw shellfish or raw oysters from
contaminated waters
• It is not from person to person
(CDC,2011; WHO,2011)
*Profuse painless diarrhea also known as rice water stools
* Vomiting of clear fluid
* Dehydration (up to 1000ml/hr diarrhea may be produced)
* Low blood pressure and lethargy
* Dry skin, dry mucus membrane or mouth
* Sunken eyes and no tears
* Rapid pulse
* Muscle and abdominal cramps
* Restless, irritability, tiredness and unusual sleepiness
(CDC,2011;WHO,2011)
* Stool or rectal swab sample are collected
in early stage to the laboratory for
diagnosis (confirm cholera bacterium)
* IMMEDIATELY !!!
* Use Oral rehydration salts (ORS)
* If unable to get help right away or in absence of
ORS homemade solution can be given.
* Home made solutions consist of half a teaspoon of
salt and six level teaspoon of sugar dissolved in
one liter of safe water.
* Plain water and rice water can be given if
homemade solution is unavailable.
* Remember to use safe water. If not sure boil the
water before use and store it safely.
(WHO,2011)
• Immediate fluid and electrolytes replacement
• Oral rehydration solution
• Pre-packaged mixture of sugar and salt to be
mixed with water (drink large amounts)
• In severe cases intravenous fluid replacement
• Antibiotics
• Continue nutritious safe food and breastfeeding
for infants and young children.
(CDC,2011; WHO,2011)
• Acute renal failure
• Severe electrolyte imbalance
• Arrhythmias (Abnormal hearth rhythms)
• Coma
• Severe dehydration leading to shock
• Death
(CDC,2011; WHO,2011)
• Drink safe water
• Frequent hand washing with soap and
water
• Appropriate disposal of feces
• Boil, cook, and peel vegetables and fruits
• Keep your living area clean
• Sterilization of contaminated materials
(CDC,2011; WHO,2011)
• Continued public awareness and preventative
measures teaching
• Strengthen environmental surveillance
• Evaluate preparedness programs for readiness
for outbreaks
• Monitor and investigate bacteriology cases
• Encourage and enforce symptoms or case
reporting
• Possibly distribute ORS as part of emergency
preparedness
• Ghana government has developed :
• - A national cholera prevention and control
plan (2010-2011) and has been
disseminated to key stakeholders.
• National Task force has been formed
• Government provided extra funds
• Developed short to long term multisectoral plan
(Ghana government,2011)
• Update unaffected countries with latest
information on the disease
• Provide travelers with information
regarding risks and symptoms of cholera
• WHO enforce reporting of cases as per
protocol
• WHO supports and audit countries
• Continue WHO global Task Force on
Cholera control and prevention.
(WHO,2011)
- Cholera is fatal if left untreated
- 80% cases of cholera can be treated with
oral dehydration salts
- Prevention, preparedness and response
are essential.
- 3 – 5 million cholera cases annually
- 100 000 to 120 000 death due to cholera
(CDC,2011; WHO,2011)
• New variant strains detected in Africa and
Asia
• Cholera is an endemic in Ghana
(WHO,2011)
• Thank you ladies and gentleman for your
attention on this important matter.
• Public education 24 hotline open to public
0244727958 (Director of Public Health,
Ghana Health Service)
Centre for Disease Control and Prevention. (2011). Cholera.
Retrieved on July 19,2011 from
http://cdc.gov/cholera/disease.html
Ghana Government. (2011). Press briefing on
Cholera Outbreak In Ghana by Hon. Deputy Minister of
Health. Retrieved on July 22, 2011 from
http://www.ghana.gov.gh/index.php
WHO. (2011). Cholera. Retrieved on July 23, 2011 from
http://www.who.int/mediacentre/factsheets