Treatment

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Treatment

Adjuncts To Therapy

Antibiotics should be given as soon as vomiting has stopped, which is usually after three to four hours of oral rehydration. Injectable antibiotics have no special advantages. No other medication should be given to treat cholera, like anti-diarrheas, anti-emetics, anti-spasmodic, cardio tonics and corticosteroids. Antibiotics used are tetrocycline, doxycycline Furazolidinen and Bactrim.

Related Issues

Oral Rehydration Therapy

Intravenous Rehydration Therapy

Maintenance Therapy

Sanitation Measures

Water control: As water is the most important vehicle of transmission of cholera, all steps must be taken to provide properly treated, or otherwise safe water to the community for all purposes (drinking, washing and cooking.) In urban areas, properly treated drinking water containing residual chlorine should be made available to all families. This water should be stored in the household in narrow mouthed, covered containers. In rural areas, water can be made safe by boiling or by chlorination.

Chemoprophylaxis

Mass chemoprophylaxis is not advised for the total community in order to prevent one serious case of cholera.

Vaccination

The cholera vaccine is the only specific prophylactic available against cholera.

Dosage

Primary Immunization consists of two equal doses, injected subcutaneously, at an interval of about four to six weeks. The vaccine is not given to children under one year of age.

Reactions

Cholera inoculation is generally accompanied by local tenderness, mild swelling, even some redness, and occasionally, mild to moderate temperature elevation.

Protective Value

The protective value of currently available vaccines is estimated at about 50 per cent for a period of about three to six months. To sum up, cholera vaccines available at present are not helpful in the control and prevention of the disease. They can be used as an adjunct to other preventive measures such as drug prophylaxis, sanitation and health education. The World Health Assembly in May 1973 abolished the requirement of a cholera vaccination certificate for international travel, although a few countries (e.g. Sudan, Libya) continue to demand such a certificate.

Health Education

The most effective prophylactic measure is perhaps, health education. It should be directed mainly to:

The effectiveness and simplicity of oral rehydration therapy.
The benefits of early reporting for prompt treatment.
Food hygiene practices.
Hand washing after defecation and before eating.
The benefit of cooked, hot foods and safe water. Since cholera is mainly a disease of the poor and ignorant, these groups should be tackled first.

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