What is cholera?

• Cholera is a diarrhoeal illness caused by a bacterial infection in the intestine.
• Cholera causes severe watery diarrhoea and may cause vomiting.
• Cholera can cause death from dehydration (the loss of water and salts from the body) within hours if not treated.

How is cholera spread?

• Cholera bacteria are present in the faeces of infected people.
• Cholera is not likely to spread directly from one person to another. However, household contacts of cholera cases and persons living in proximity of a confirmed cholera case are at higher risk of disease.

How to protect yourself, your family and your community from cholera

1. Personal hygiene and sanitation
   • Wash your hands with soap, ashes or lime and safe water:
     • before cooking
     • before eating and before feeding your children
     • after using the latrine (or cleaning your children after they have used the latrine)
     • after taking care of and/or touching a sick person.
   • Wash all parts of your hands – front, back, between the fingers and under the nails.
   • Use the latrine to defecate. If latrines are not available, defecate away from a body of water and then bury your faeces. Children’s faeces should be disposed of in the same way.
   • Keep the latrine clean.
2. Food: cook it, peel it or leave it
   • Cook raw food thoroughly.
   • Eat cooked food immediately, while it is still warm.
   • Cover cooked food and store it carefully in a cool place.
   • Reheat cooked food thoroughly before eating.
   • Avoid contact between raw food and cooked food.
   • Wash hands before preparing, cooking or eating food.
   • Wash vegetables thoroughly with soap and safe water before eating.
   • Eat fruit and vegetables you have peeled yourself.
   • Wash your cutting board especially well with soap and safe water.
   • Wash your utensils and dishes with soap and safe water.
3. Safe drinking water
   • Collect water from a known safe source (where quality is being monitored on a frequent basis).
   • Even if it looks clear, water can contain the bacteria causing cholera.
   • Boil water for at least 1 minute or add drops or tablets of chlorine to it before drinking or using it to wash vegetables or food preparation items.
   • Keep drinking water in a clean, covered pot or bucket or other container with a small opening and a cover. It should be used within 24 hours of collection.
   • Pour the water from the container; do not dip a cup into the container.
   • If dipping into the water container cannot be avoided, use a cup or other utensil with a handle to scoop the water.
4. Water sources
   • Regularly monitor water quality as per protocol.
   • Conduct a water safety assessment with the community to eliminate potential or suspected sources of contamination.
   • Do not defecate in or near a source of drinking water (stream, river or water hole).
   • Do not wash yourself, your clothes or your pots and utensils in the source of drinking water.
   • Cover open wells and seal properly when not in use to avoid contamination.
   • Hang the buckets used to collect water when not in use; they must not be left on a dirty surface.
   • Keep areas surrounding wells and hand pumps as clean as possible.
   • Get rid of refuse and stagnant water around a water source.

What to do if you or your family is ill with diarrhoea

• The biggest danger of cholera is loss of fluid from the body.
• Do not panic, but act quickly.
• The sick person should drink a solution of oral rehydration salts (ORS) made with safe (boiled or chlorinated) water.
• Go immediately to see the community health worker or to the health centre. The sick person should continue to drink ORS while seeking care.
• Encourage continuation of breastfeeding while a child or mother has cholera.

Taking care of sick people

• Wash your hands with soap and safe water after taking care of sick people, touching them or their clothes or bedding, or handling or cleaning up their stools or vomit.
• Do not wash a sick person’s bedding or clothing in a water source.
• Avoid direct contact with stools and vomit from a person who is sick with cholera. The fluids should be dumped in the latrine and the carrying vessel carefully cleaned/disinfected.
• Disinfect the sick person’s clothing and bedding with a solution of chlorine (0.2 %). If chlorine is not available, the sick person’s bedding and clothing can be disinfected by stirring for 5 minutes in boiling water and drying in direct sunlight, or by washing with soap and drying thoroughly in direct sunlight.