Cholera Treatment Prevention in Sierra Leone Zainab Blell

Cholera Treatment & Prevention in Sierra Leone Zainab Blell MPH Student

Introduction • 2012 Cholera Outbreak in Sierra Leone • Purpose for This Briefing • Learning Objectives for Today

2012 Cholera Outbreak • Global health issue affected thousands in Sierra Leone • Worst outbreak in Sierra Leone in 15 years • Highest impacts overcrowded communities and slum areas • Alarming because Cholera is a preventable and easily treatable disease. Reference Schlein, L. (2012). Sierra Leone's Cholera Epidemic Easing But Not Over. Voice of America. com. Retrieved from, http: //www. voanews. com/content/cholera-epidemic-in-sierra-leone-easing-but-not-over/1511745. html

PURPOSE • To increase knowledge and reduce the impact or incidence of the disease on Sierra Leoneans • Continue sounding the alarm on the danger of cholera so government officials and their development partners will allot resources to educate communities that are highly susceptible

Learning Objectives • • What Cholera is About Cholera Global Epidemiology Cholera Epidemic in Sierra Leone How It’s Transmitted Symptoms and Diagnosis Treatment & Prevention Additional Resources for More Information

About Cholera General Information, Epidemiology, Cholera in Sierra Leone

What Cholera is • An infection of the intestines with a bacteria called VIBRIO CHOLERAE • Bacteria occurs naturally in coastal waters and can attach to shellfish causing infection • Many can be infected by environmentally contaminated food • Diarrhea from infected individuals contain large amounts of the bacteria • In humans the incubation period for symptoms is 1 -5 days • Infected patients can recover quickly if treated promptly Reference CDC, (2010). Cholera. Retrieved from http: //www. cdc. gov/cholera/disease. html CDC, (2011). Cholera: Epidemiology and Risk Factors. Retrieved from, http: //www. cdc. gov/cholera/epi. html

EPIDEMIOLOGY • 45 countries reported 221, 226 cholera cases and 4, 946 cholera death • Areas with poor resources continue to report the majority of the cases • Cholera remains endemic in Sub-Saharan Africa • The first number of cases reported in Sierra Leone were in 1970 and 1971 • Most recent large outbreak was in 2007 and 2008 Reference Schlein, L. (2012). Sierra Leone's Cholera Epidemic Easing But Not Over. Voice of America. com. Retrieved from, http: //www. voanews. com/content/cholera-epidemic-in-sierra-leone-easing-but-not -over/1511745. html World Health Organization, (2009). Cholera Country Profile: Sierra Leone. Retrieved from, http: //www. who. int/cholera/countries/Sierra. Leone. Country. Profile 2009. pdf

Timeline for 2012 Cholera Outbreak in Sierra Leone • February 27: Mo. HS reported outbreak in Kambia, Port. Loko and Pujehun district • Growth of the outbreak spread rapidly once declared in Freetown • On August 16 th, President Ernest Bai Koroma declared a national State of Emergency • As of September 20, 18, 919 total cases were reported with 273 deaths Reference Schlein, L. (2012). Sierra Leone's Cholera Epidemic Easing But Not Over. Voice of America. com. Retrieved from, http: //www. voanews. com/content/cholera-epidemic-in-sierra-leone-easing-but-not -over/1511745. html World Health Organization, (2012). Cholera in Sierra Leone. Retrieved from http: //www. who. int/csr/don/2012_08_22/en/index. html

Cholera Transmission/Risk Factors Where cholera is found, how it is transmitted, who is at risk for contracting cholera Work as a community to combat cholera –see CDC’s link http: //www. cdc. gov/cholera/pdf/posters/11_229310 -E_stigma_print. pd Reference CDC. (2012). Prevention & Control. Retrieved from http: //www. cdc. gov/cholera/prevention. html

Cholera in the Environment • Cholera naturally lives in water for long period • Poor sanitation that’s aggravated by war, and natural disasters • Poor sewage systems • Overcrowded slums and waterfront

Cholera in Food • SHELL FISH shrimps crabs • RAW FRIUTS AND VEGETABLES lettuce tomatoes guavas • COOKED GRAINS

Symptoms of Cholera • • • Copious watery stools Vomiting Rapid Heart rate Loss of skin elasticity Dry mucous membranes Low blood pressure Thirst Muscle cramps Restlessness and irritability Reference CDC, (2010). Cholera. Retrieved from http: //www. cdc. gov/cholera/disease. html CDC, (2011). Cholera: Epidemiology and Risk Factors. Retrieved from, http: //www. cdc. gov/cholera/epi. html

Cholera Treatment • • • Oral Rehydration Salts (ORS) Sugar Salt Solutions Intravenous Fluids Antibiotic therapy Zinc treatment what to do if you contract cholera-see link http: //www. cdc. gov/cholera/pdf/posters/11_229310 -B_if_you_get_cholera_adult_print. pdf Reference CDC. (2012). Cholera, Prevention & Control. Retrieved from http: //www. cdc. gov/cholera/prevention. htm CDC. (2011). Cholera- Treatment. Retrieved from, http: //www. cdc. gov/cholera/treatment/index. html

Prevention and Control Through Proper Sanitation & Food Preparation

General Sanitation • Wash hands at all times with soap and clean water • If there is no soap, scrub hands with ash or sand rinse with clean water • Keep kitchen and places where the family bathes and washes clothes clean and separate Reference CDC. (2012). Prevention & Control. Retrieved from http: //www. cdc. gov/cholera/prevention. html

Use Safe Water • Boil it to a complete boil for one full minute • Treat it with chlorine or household bleach http: //www. cdc. gov/safewater/locations. html • Use Safe Water For: ▫ ▫ Drinking Washing and preparing food, like fruits and vegetables Brushing teeth Cleaning kitchen utensil Reference CDC. (2012). Prevention & Control. Retrieved from http: //www. cdc. gov/cholera/prevention. html

Proper Waste Management • Use toilets, latrines, plastics or bury your feces • Keep latrines and toilets clean at all times to prevent flies • If you do not have a toilet or latrine ▫ Defecate 30 meters away from any type of water and bury the feces ▫ Defecate in a plastic bag and dispose it in a latrine or bury it away from any water • Wash hands after defecating with safe water Reference CDC. (2012). Prevention & Control. Retrieved from http: //www. cdc. gov/cholera/prevention. html

Food Preparation • Food must be cooked well especially seafood! • If you cannot Boil it, Cook it, or Peel it then Leave it! • Do not eat foods that are not washed and peeled or cooked thoroughly. Reference CDC. (2012). Prevention & Control. Retrieved from http: //www. cdc. gov/cholera/prevention. html

Review of Content Covered: • • What is Cholera? About Cholera Global Epidemiology Cholera Epidemic in Sierra Leone How It’s Transmitted/Risk Factors Symptoms and Diagnosis Treatment & Prevention Additional Resources for More Information

Additional Prevention Steps • • • Allocate resources to provide proper sanitation Provide safe public wells and toilets Promote rural migration Improve case management skills Strengthen surveillance system and epidemiology investigation • Promote community education on proper hygiene and sanitation all year round

A Note on Vaccination • Offers incomplete, short-term protection • Mass vaccination or routine antibiotics will not prevent the spread of cholera • There are two oral cholera vaccines available: ▫ Dukoral. ▫ Shan. Chol, Reference CDC. (2012). Cholera: Prevention and Control. Retrieved from, http: //www. cdc. gov/cholera/prevention. html

Additional Resources • CDC. (2011). Cholera: General Information including Symptoms. http: //www. cdc. gov/cholera/general/ • CDC. (2012). Cholera: Prevention and Control. http: //www. cdc. gov/cholera/prevention. html • CDC Safe Water Website: http: //www. cdc. gov/safewater/locations. html • CDC. (2011). Cholera- Treatment. http: //www. cdc. gov/cholera/treatment/index. html

References • CDC. (2010). Cholera. Retrieved from http: //www. cdc. gov/cholera/disease. html • • CDC. (2011). Cholera: Epidemiology and Risk Factors. Retrieved from, http: //www. cdc. gov/cholera/epi. html • CDC. (2012). Cholera: Prevention and Control. Retrieved from, http: //www. cdc. gov/cholera/prevention. html • CDC. (2011). Cholera- Treatment. Retrieved from, http: //www. cdc. gov/cholera/treatment/index. html • Mathiu, S. (2012). Retrieved from http: //unipsil. unmissions. org/ • Schlein, L. (2012). Sierra Leone's Cholera Epidemic Easing But Not Over. Voice of America. com. Retrieved from, http: //www. voanews. com/content/cholera-epidemic-in-sierra-leone-easing-butnot-over/1511745. html • World Health Organization, (2009). Cholera Country Profile: Sierra Leone. Retrieved from http: //www. who. int/cholera/countries/Sierra. Leone. Country. Profile 2009. pdf • WHO, (2012). Cholera in Sierra Leone. Retrieved from http: //www. who. int/csr/don/2012_08_22/en/index. html • •

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