Cholera


Cholera is an infectious intestinal disease common in Southern Asia.
Cholera is caused by a comma-shaped bacterium called Vibrio Choleras. The
microorganism is transmitted by water or food that has been contaminated
with the feces of people who have the disease. Cholera occurs when Vibrio
Cholera enters the intestines and releases Cholera toxin. The toxin causes
the intestine to secrete large amounts of water and salt. Because the
intestine cannot absorb the water and salt at the rate they are secreted,
the patient suffers severe diarrhea. This loss of fluid causes severe
dehydration and changes in the body chemistry. If untreated, the illness
can lead to shock and eventually death. With proper treatment, Cholera
lasts only a few days. Prevention of Cholera requires adequate sanitation
facilities. A vaccine against the illness has been developed, but it is
not very effective. People who travel in areas where Cholera is widespread
should not drink the local water. They should cook all foods that may have
been exposed to water. Peru, already afflicted by economic ills and
feastering guerilla insurgency, is now plagued by an epidemic of Cholera.
As of February 25, 1991, the disease had claimed 90 lives and infected at
least 14,000 people. It is the first major outbreak of Cholera in the
western hemisphere since early in this century. In Peru, local authorities
have moved quickly to stem the epidemic, which is spread by poor hygiene
and contaminated water, raw food, and fish. To avoid spreading, health
officials in Ecuador, Bolivia, and Chile, have prohibited the importation
of uncooked Peruvian food products. Coastal waters have shown a high
degree of contamination by testings. In early May 1991, as Cholera began to
spread eastward into PeruŐs jungle, volunteer doctors from Lima began to
navigate the rivers with boats of Peruvian Amazons, stopping at each
silt-house hamlet searching for the sick. The doctors brought their I.U.S.
rehydration packets to the people who drink the contaminated river water.
After five months, Cholera is spreading to other countries in Latin America
-- and a few cases have been seen in the United States. Although Cholera
is disappearing from Peru for now, it will eventually become native,
reappearing in weakened people for each year. This is CholeraŐs normal
course. Truly astonishing, however, is the Peruvian governmentŐs success
in treating it. Two thousand people have died; less than 1 percent of the
roughly 250,000 who got the disease. In the worldŐs last huge epidemic in
West Africa in the early 1970Ős, the death rate was between 20 and 30
percent. Cholera has killed 2,000 people while 40,000 children under 5 die
ea year from diarrhea in Peru. On January 23, 1991, the inevitable
happened. The first cases of Cholera appeared. The bacteria was probably
brought by a fishing boat from Asia. It would be hard to think of a
country worse prepared, because diarrhea and vomiting can kill cholera
victims within a few hours unless they receive rehydration. This is a
country living in poverty. Help is not around the corner and the closest
health clinic is a dayŐs journey on foot, horse, or bicycle. The clinic is
only likely to stock only the most basic and simple medicines. The Cholera
bacterium lives in contaminated waters and foods; it infects humans unless
it is killed by thorough cooking. Cholera is a disease of poverty,
practically absent from wealthy neighborhoods, but prevalent among those
who donŐt wash, drink clean water, properly dispose of waste, or eat
properly cooked food. Every control measure requires water but a smaller
percentage of people have water and sewers in Peru than practically
anywhere else in the hemisphere.