Filenews 1 February 2023
Recommendations to travellers for protection against cholera were published by the Ministry of Health, in view of the recording of cholera cases in countries neighbouring Cyprus.
As the Ministry states, "cholera is an acute diarrhoeal disease due to the infestation of the intestine by enterotoxin produced by the strains of the bacterium Vibrio Cholera. Some of the serotypes of enterotoxin cause severe disease characterized as "cholera" and epidemics. Residents of areas endemic to the disease acquire antibodies to cholera in childhood.
Cholera epidemics have been described in the past with tens of thousands of cases and hundreds of deaths. Cases of cholera are constantly recorded in many parts of the world and especially in countries with low socio-economic level mainly in Africa and Asia. Recently, cases of cholera have been recorded in countries neighbouring Cyprus, namely Syria (807 confirmed cases and 68 deaths with several more suspected cases from the end of August to October 2022) and Lebanon (5912 cases with 23 deaths from the beginning of October 2022 to January 5, 2023).
Modes of transmission
The transmission of the disease occurs through the consumption of contaminated water or food. Water is usually contaminated by patients' faeces which in turn can directly or indirectly contaminate food. Food can also become infected by soiled hands during meal preparation or when consumed.
The incubation period of the disease ranges from a few hours to five days, and the patient transmits the disease up to 10 days after the onset of the disease. The disease affects all ages and occurs mainly with severe acute diarrheal syndrome and vomiting leading to dehydration and in severe cases death if not treated in time.
Therapy
Hydration is the cornerstone of treatment. Oral administration of fluids and salts, as well as intravenous administration of fluids and electrolytes in severe conditions reduces mortality. Antibiotics are administered only in severe cases.
Information for Travellers Arriving from Cholera Countries
Travellers returning from countries with a case should be on increased alert for symptoms of the disease, as listed below. In case of symptoms of the disease should apply contact precautions and strict hand hygiene measures and apply to the hospital.
General Precautionary Measures for Travellers travelling to high-risk countries
As a precaution, people traveling to areas with poor sanitary conditions are advised to consume bottled water and drinks, pasteurized dairy products and milk. It is also recommended to avoid ice cubes, raw salads, reheated food as well as raw seafood and prefer fruits that are peeled. In addition, they should strictly follow the rules of good hygiene.
It is understood that in case of any medical problem someone should immediately contact the official medical services of the country.
Consumption of drinks and foods
In particular, travellers should:
- Choose carefully the foods and drinks they consume. Any type of food, and in particular raw food, should be considered potentially contaminated (avoiding cold, raw or undercooked, unpasteurised foods).
- Eat food well cooked and even hot when served. Dishes containing meat or fish should be consumed if the traveller knows that they are freshly cooked and not reheated.
- Prefer fruits, nuts and vegetables that have a thick shell, peel or shell which they should wash or peel themselves before consuming them.
- Use sealed and bottled water or carbonated water.
- Consume drinks straight out of the box or bottle.
- Ask for ice-free drinks.
Travellers must NOT:
- Consume fresh salads, raw or undercooked eggs, poultry, meats and seafood.
- Consume cooked foods that are for several hours at ambient temperature (e.g. buffet).
- Consume granites or iced drinks that may have been prepared with contaminated water.
- Consume fruit juices unless they come directly from a sealed box.
- To consume tap water."
Sources
