With the onset of the monsoon, cases of cholera have been detected in Kerala and Gujarat, signaling an outbreak of the disease in India.
In Gujarat, areas of Rajkot were declared cholera-affected after two cases were confirmed. A 2-kilometre (1.2-mile) radius in Rajkot has been marked as cholera-affected. The notification, issued on July 5 by Collector Prabhav Joshi under the Epidemic Diseases Act, will remain in force for two months. The affected localities include Lohanagar, where the cases were detected, as well as the railway crossing and Gondal Road. Under the notification, food items made from ice have been banned until September 4.
Jayesh Vakani, Rajkot Municipal Corporation’s medical officer of health, stated that a preliminary investigation suggested the disease might have started due to contaminated water brought from outside. Some residents of Lohanagar, who are involved in selling fish, reportedly stored the fish in a small pit in their homes, potentially leading to contamination. Vakani emphasized that an area is declared cholera-affected if even one case is reported.
The situation is under control with 25 teams deployed to survey and identify suspected cases. Around 1,500 residents in the affected areas are being monitored, with regular checks on water and food supplies. All government and private hospitals in Kalol have been instructed to watch for suspected cases and report them immediately.
In Kerala, an outbreak of cholera was reported at a private care home in Thiruvananthapuram’s Neyyattinkara area. According to Health Minister Veena George, the initial suspicion of food poisoning led to the discovery of cholera cases. The State Health Department is on alert and has ramped up preventive measures following the outbreak.
The outbreak intensified after a 10-year-old child in a Thiruvananthapuram hostel was diagnosed with cholera. According to Onmanorama, 22 people are showing symptoms, with 14 at Thiruvananthapuram Medical College Hospital, two at SAT Hospital, and six at Iranimuttom Community Health Centre.
Cholera, caused by the bacterium _Vibrio cholerae_, is an acute diarrhoeal infection resulting from ingesting contaminated food or water. Symptoms include severe diarrhoea, nausea, vomiting, and dehydration, which can be fatal if untreated. According to the World Health Organization (WHO), most infected people do not develop symptoms but can still spread the bacteria for 1-10 days through their feces.
Currently there are 3 WHO pre-qualified oral cholera vaccines (OCV): Dukoral®, Shanchol™, and Euvichol-Plus®. All 3 vaccines require 2 doses for full protection.
Immediate treatment for cholera includes rehydration, intravenous fluids, antibiotics, and zinc supplements. The Mayo Clinic notes that dehydration symptoms can include irritability, fatigue, sunken eyes, dry mouth, extreme thirst, dry and shriveled skin, reduced urination, low blood pressure, and irregular heartbeat.
The Indian Council of Medical Research (ICMR) is exploring vaccine development for cholera, leveraging platforms used for COVID-19 vaccines. The WHO, in collaboration with the ICMR, has cautioned nine Indian states, including Kerala, about the potential for cholera outbreaks.
During the 19th century, cholera spread globally from its original reservoir in the Ganges delta in India. Six subsequent pandemics killed millions of people across all continents. The current seventh pandemic began in South Asia in 1961, reached Africa in 1971, and the Americas in 1991. Cholera is now endemic in many countries.
The Global Task Force on Cholera Control (GTFCC), with its Secretariat based at the World Health Organization (WHO), was revitalized in 2014. The GTFCC is a network of more than 50 partners active in cholera control globally, including academic institutions, non-governmental organizations, and United Nations agencies.
In October 2017, GTFCC partners launched a strategy for cholera control, “Ending Cholera: A Global Roadmap to 2030.” This country-led strategy aims to reduce cholera deaths by 90% and to eliminate cholera in as many as 20 countries by 2030.
