Cholera - Prevention in Community

If you live in a community that experiences cholera outbreaks, how do you prevent an infection?

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Can cholera be prevented? Are cholera vaccines available?

Yes, cholera can be prevented by several methods. Developed countries have an almost zero incidence of cholera because they have widespread water-treatment plants, food-preparation facilities that usually practice sanitary protocols, and most people have access to toilets and hand-washing facilities. Although these countries may have occasional lapses or gaps in these methods, they have prevented many disease outbreaks, including cholera.

Individuals can prevent or reduce the chance they may get cholera by thorough hand washing, avoiding areas and people with cholera, drinking treated water or similar safe fluids and eating cleaned and well-cooked food. In addition, there are vaccines available that can help prevent cholera, although they are not available in the U.S., and their effectiveness ranges from 50%-90%, depending on the studies reported. The vaccines are oral preparations, because injected vaccines have not proved to be very effective. Two vaccines (Shanchol and mORC-VAX) are composed of killed V. cholerae bacteria and without the enterotoxin B subunit. Unfortunately, both offer protection for only about two years. Both vaccines are given in two doses, about one to six weeks apart. Unfortunately, the vaccines have limited availability; their recommended use is for people going to known areas of outbreaks with the likely possibility the person may be exposed to cholera. Some researchers suggest this limited oral vaccine availability should be changed and cite data that oral vaccine may help limit outbreaks, even after they have begun.

Research is ongoing; a research study in Haiti will try to determine if a two-dose vaccine in people will suffice to protect a difficult to treat (rural poor) population from cholera and thus save many lives. There are over 30 universities researching this disease (cholera's epidemiology, pathology, immunology, vaccine production, and other problems) currently worldwide.

 

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