In an effort to rapidly contain the resurgence of cholera in South Sudan, WHO has secured oral cholera vaccine to vaccinate the communities in Leer Town and other areas. The 20 February integrated food security phase classification (IPC) identified Leer and Mayendit. With Global Acute Malnutrition (GAM) rates that exceed 30% in the two locations. Co-morbidity with cholera will result in rapid spread and high fatality rates.
Since October 2016, Leer town and Mayendit North have been affected by cholera outbreaks with limited humanitarian access.
“Insecurity coupled with sub-optimal access to safe water and sanitation infrastructure allowed the bacteria to spread to 12 counties in 9 states across the country” says Dr Wamala Joseph Francis, WHO Epidemiologist. The complementary oral cholera vaccine vaccination campaigns should interrupt all the residual transmission in high-risk populations and hotspot areas in the immediate term thus allowing time for government and partners to improve access to safe water and sanitation.
Health and WASH cluster partners prioritized nine high-risk populations for emergency complementary oral cholera vaccination. A multi-year plan for complementary oral cholera vaccination alongside improving access to safe water, sanitation, social mobilization, case management, and surveillance will be validated and launched on 9 March 2017.
Cholera is a potentially fatal water-borne disease transmitted through contaminated water and/or food. It causes watery diarrhea and vomiting that can rapidly lead to death through severe dehydration.
To slow the current surge in cholera cases, WHO and partners have secured the initial batch of 68 967 doses of oral cholera vaccine for Leer, Padeah, and Thonyor in Leer county. MedAir, an emergency operational health cluster partner will coordinate the deployment of the vaccine alongside WFP’s food distribution headcount on 27 February 2017.
“Delivering this safe, affordable and effective oral cholera vaccine in South Sudan is vital to help tackle the rise in cholera cases, said Dr Abdulmumini Usman, WHO Representative to South Sudan. While access to clean water and sanitation systems is the ultimate solution to stopping the spread of cholera, we must utilize all tools available to help prevent continued needless deaths,” said Dr Usman.
Since 2014, South Sudan has conducted oral cholera vaccine campaigns on an annual basis, vaccinating over 600 000 people with vaccines sourced from the International Coordinating Group (ICG) emergency stockpile.
Drink home-made Gatorade (salt/sugar/water) to save the life of a cholera patient. One aspect overlooked by the media is the fact that fluids containing salt water is the major treatment for Cholera (bacteria) as well as Ebola Virus, and Dengue Fever (virus) as they cause massive fluid loss through diarrhea and/or vomiting. Yet the media loves to focus on the high-tech futuristic vaccines that of course never materialize. But the fact is most Ebola, Dengue, and Cholera patients recover if they are given fluids and electrolytes. Sodium—from salt—is THE major electrolyte of the body.
Cholera is caused by ‘fecal-to-oral’ contamination. Fecal-to-oral involve the many ways feces gets in the mouth, whether from not washing hands, drinking fecal-contaminated water, eating food after handling dirty money, etc. Vaccines should be far down on the list of ways to tackle this problem, especially since ‘fecal-to-oral’ doesn’t just involve cholera. Teaching better sanitation should be at the top of the list. Fecal-to-oral is also involved in other serious diseases, including polio, hepatitis A & E, toxoplasmosis, parasites, giardia. So even if a truly effective vaccine for one of those things were developed, countries that don’t deal with sanitation will still be very sick countries.
But knowing how to treat someone with cholera is helpful, since millions get this every year and millions will die within a few days because of the fluid loss through the watery diarrhea. So you must replace the fluids. Here’s how to do it: Oral Rehydration Solution (ORS)…How to replace fluids/electrolytes without needing an IV or sterile water.
The ORS recipe is:
1 liter (quart) water
2 TABLEspoons (TBS) sugar
½ TEAspoon (tsp) salt If you do not have salt and sugar available, you can drink plain water and eat salty chips—chips are carbohydrates that will ‘turn into’ sugar when you eat them). Or you can make rice gruel and add salt. Go to http://www.rehydrate.org to learn more.
You must drink at least as much of the above recipe as you are losing through diarrhea or vomiting. For babies with life-threatening diarrhea, it is a good idea to catch their diarrhea and measure it and make absolutely certain you are replacing at least the same amount as they are losing. Take notes as you go, with times and amounts caught and/or replaced, so you can keep a record of your treatment.
ORS is considered the greatest medical discovery of the 20th Century in terms of number of lives saved. The Chinese discovered it over a thousand years ago but it was in the 20th Century that the underlying mechanism was elucidated (“sodium glucose co-transport system”). Several million babies (and adults) are saved per year in India alone with this salt, sugar and water combination. I encourage most healthy people to drink a liter of this amazing solution every day between meals (water with meals), as most people are not optimally hydrated. You can literally feel the ORS moving into your body rather than sloshing around your stomach as plain water does. All athletes drink ‘electrolytes’ (salt) plus water with a little sugar added. Gatorade has the same sugar as above recipe but Gatorade tastes many times sweeter than above recipe because of artificial sweeteners added. The above recipe has 100 calories and you can barely taste the sugar, and not taste the salt at all.