Cholera in West Africa
Released: September 23, 2005
The Public Health Agency of Canada (PHAC) is currently monitoring an
increase in cholera activity in West Africa.
West Africa has experienced an unusually high number of cases of cholera
this year with 43 279 cases, including 724 deaths reported as of September
23, 2005. Seasonal factors, including a heavy rainy season, along
with increased population movement in the area have contributed to this
increase in cholera activity.
Breakdown by country:
Benin: 210 cases including 4 deaths
have been reported between June 6 and September 4. The outbreak, which
started in Cotonou in early June, has now spread to Oueme region.
Burkina Faso: 615 cases including
9 deaths have been reported in Ouagadougou town between Augsut 8 and
September 4, affecting sectors of the town with precarious water and
sanitation conditions. The outbreak currently seems to be under control.
Guinea: 1956 cases including
72 deaths have been reported between mid-July and September 4. The
two most affected towns are Conakry and Kindia. Control efforts
are ongoing.
Guinea-Bissau: 14 303 cases
including 252 deaths have occurred between June 6 and September 11 in
the country. The regions of Bissau and Bimbo account for 83% of
cases. Cholera has now spread to remote areas with all 11 regions
affected.
Mali: 158 cases including 20 deaths have occurred
between June 20 and July 24. The situation appears to be under
control, although cholera is an ongoing problem in Mali.
Mauritania: 2640 cases including
55 deaths have been reported from 6 regions between July 20 and September
21. Nouakchottaccounts for 89% of all the cases.
Niger: 431 cases including 44
deaths have been reported between July 13 and September 19, with Bouza
district being the most affected. Control measures are being put
in place, although the risk of waterborne diseases has been exacerbated
by the current humanitarian situation.
Senegal: 23 325 cases including 303
deaths have been reported during the outbreak which began in January
and peaked at the end of March. Dakar has been most affected, due
to unusually heavy rains.
Source: WHO
Cholera is an acute intestinal infection caused by the bacterium Vibrio
cholerae. The bacterium produces a toxin, which causes an
infected person to dehydrate through vomiting and profuse watery diarrhea.
Cholera is acquired directly through drinking or eating contaminated
water or food, or indirectly from exposure to the feces or vomit of an
infected person. Person-to-person exposure is unlikely when good
hygiene practices (e.g., hand washing) are in place. Undercooked
or raw shellfish, such as crabs, fish, shrimp, mussels and oysters, and
unpeeled fruits and vegetables have been associated with infection. Cholera
outbreaks are usually caused by contaminated water, where sewage and
drinking water supplies not been adequately treated.
Cholera is found year-round in many tropical countries throughout the
regions of Africa, Asia, and South America, with outbreaks typically
occurring during rainy seasons.
For comprehensive information, please visit the Travel Medicine
Program's Disease
Information Backgrounder on cholera.
Recommendations
As cholera is spread through contaminated food and water, the
Public Health Agency of Canada strongly
recommends that travellers to areas experiencing an outbreak
of cholera exercise general food and water precautions to
minimize their risk of exposure. The key principles to
remember are: boil it, cook it, peel it or leave it!
- Eat only food that has been well-cooked and is still hot
when served.
- Drink only purified water that has been boiled or disinfected
with chlorine or iodine, or commercially bottled water in sealed
containers.
- Drinking carbonated drinks without ice, including beer, is
usually safe.
- Avoid ice, unless it has been made with purified water.
- Boil unpasteurized milk.
- Avoid unpasteurized dairy products and ice cream.
- Avoid uncooked foods - especially shellfish - and salads. Fruit
and vegetables that can be peeled are usually safe.
- Avoid food from street vendors.
- Wash hands before eating or drinking.
A vaccine against cholera is licensed in Canada; however, the
Public Health Agency of Canada does
not recommend vaccination for the prevention of cholera in
the majority of travellers to cholera-endemic areas.
However, travellers who may be at increased risk for acquiring
cholera -- for example, health professionals working in endemic
areas, aid workers in refugee camps, travellers to remote cholera
areas without access to safe water supplies -- may wish to consider
receiving the vaccine. Travellers should seek a detailed,
individual risk assessment to determine their need for vaccination. |
As a reminder...
The Public Health Agency of Canada routinely recommends that Canadian
international travellers consult their personal physician or a travel
clinic prior to international travel, regardless of destination, for
an individual risk assessment to determine their individual health risks
and their need for vaccination, preventative medication, and personal
protective measures.
The Public Health Agency of Canada recommends, as well, that travellers
who become sick or feel unwell on their return to Canada should seek
a medical assessment with their personal physician. Travellers
should inform their physician, without being asked, that they have been
travelling or living outside of Canada, and where they have been.
Additional information from the Public Health Agency of Canada:
The Committee to Advise on Tropical Medicine and Travel's Statement
on New Oral Cholera and Travellers' Diarrhea Vaccination, provides
comprehensive information on cholera vaccination.
External sources of information:
For additional information on cholera, including worldwide distribution
of cases in past years, visit the World
Health Organization's cholera
site  .
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