Cholera causes profuse diarrhoea and vomiting, and infected people can die of profound dehydration, sometimes within a matter of hours. It often breaks out when there is overcrowding and inadequate access to clean water, rubbish collection, and proper latrines. This situation can be especially problematic in rainy seasons when houses and latrines flood and contaminated water collects in stagnant pools.
Cholera is caused by infection with bacteria, which is excreted in faeces and vomit. The infection spreads when someone ingests the bacteria through contaminated food or water, or comes into contact with excretions from an infected person and does not wash their hands before eating or preparing food. Contamination of food or water supplies causes massive outbreaks in a short period of time.
The bacteria causes the cells lining the intestine to secrete huge amounts of fluid and this leads to profuse diarrhoea and vomiting. A patient undergoing treatment can lose over 50 litres of fluid during a bout of cholera. Untreated, an infected person will die of dehydration well before this and this can take only a couple of hours.
The most effective way to prevent the spread of infection is to interrupt the contamination cycle through the provision of safe water and soap and educating people on washing hands, disposing of faeces, pit latrines and protecting water stocks. Because of this, MSF water and sanitation engineers and logisticians have a vital role to play.
MSF has developed cholera treatment kits to provide rapid assistance and sets up cholera treatment centres in areas where there are outbreaks. Cholera is treatable and in many situations, MSF teams are able to limit the case fatality rate to less than 1%.