Cholera patients who seek treatment in private clinics and hospitals or those who don’t show any symptoms to start with have not been counted. The main reason for the spread of cholera is unsafe drinking water. The Kathmandu Upatyaka Khanepani Limited (KUKL) has already warned its customers not to rely on the safety of piped water and to consume such water only after properly boiling it. More than that, epidemiologists advice people to avoid eating out in places where they are not assured of proper sanitation, to resist raw or half-cooked meat products and vegetables and to drink only bottled water.  The panic over cholera is justified. Although less than a percent of those who get timely treatment die from it, the mortality rate for untreated cholera cases shoots up to 50-60 percent of all infections. Moreover, many people don’t get timely treatment as they cannot differentiate common diarrhea from cholera-induced loose motion.

Even though all the cholera cases this year have been reported inside Kathmandu Valley, at even greater risk are the places that have been inundated by recent floods and landslides. The 14 districts that were most affected by last year’s earthquakes are also vulnerable, with hundreds of thousands of people still putting up in makeshift tents. During the 2008 Koshi floods 20 people had died of cholera as they were compelled to consume unsafe water. Right now hundreds of villages in Tarai-Madhesh are under water. Thousands have been rendered homeless. They as such have no place where they can filter or boil water for safe consumption. The big risk with such unhygienic conditions right around the country this monsoon is that a potentially deadly disease like cholera might take hold in a particular locality. And if the initial infections are not contained, there is a bigger risk of appearance of stronger, more drug-resistant strains of Vibrio cholerae, the bacteria that causes cholera.

This is why early detection and treatment is important. If there is persistent watery diarrhea, you would be advised to immediately test for cholera than wait for the watery discharge to stop. Waiting is dangerous in case of bacterial infection with short incubation period like cholera. But since nearly all new cases of cholera in Nepal can be traced to unsafe drinking water, surely, properly filtering and boiling the water you consume is the best course of action against not just cholera but also against a host of other water-borne diseases like typhoid, giardiasis and dysentery. With the temperatures soaring, you would also be well advised to carry your own water when heading out. And try to avoid the eateries you don’t know.

These measures should suffice to keep cholera at bay. As for the thousands of flood victims, the first order of business should be to ensure that they have access to chlorine tablets that can kill up to 99.99 percent of all harmful bacteria and virus. The precautions against cholera aren’t difficult to take. The failure to do so, meanwhile, could prove deadly.

Source: Republica/ 30 July 2016