The security situation in the eastern Democratic Republic of Congo (DRC) province of North Kivu has been deteriorating for months because of armed conflict between various renegade soldier groups. The fighting has resulted in the displacement of approximately 250,000 people from the area fleeing the violence in search of safety. Health concerns have also risen in violence-ridden areas of the eastern DRC. According to a World Health Organization (WHO) Global Alert and Response (GAR) issued Monday, the DRC has reported a sharp increase in the number of cholera cases in the armed conflict area of North Kivu. For the three weeks spanning June 11 to July 1, 368 new cases of cholera were reported. Because of the lack of security in the area, there is a concern those stricken with cholera will have difficulty in accessing the health-care facilities and could increase the number of severe and fatal cases. The WHO also reports the fear of the cholera spilling over the borders into neighboring countries Burundi, Rwanda, South Sudan and Uganda. Médecins Sans Frontieres (MSF) and its partners blame the outbreak on a lack of potable drinking water.
Patients are being treated with infusions and antibiotics as appropriate, at treatment centres. Interventions to control the epidemic that are being carried out include education and communication; management of cases; increased surveillance; hygiene and sanitation; and provision of safe drinking water.WHO is working to support national authorities in response to the cholera outbreak and the broader humanitarian emergency resulting from conflict and population displacement. Cholera is an acute bacterial intestinal disease characterized by sudden onset, profuse watery stools (given the appearance as rice water stools because of flecks of mucus in water) due to a very potent enterotoxin. The enterotoxin leads to an extreme loss of fluid and electrolytes in the production of diarrhea. It has been noted that an untreated patient can lose his bodyweight in fluids in hours resulting in shock and death. It is caused by the bacterium, Vibrio cholerae. Serogroups O1 and O139 are the types associated with the epidemiological characteristics of cholera (outbreaks). The bacteria are acquired through ingestion of contaminated water or food through a number of mechanisms. Water is usually contaminated by the feces of infected individuals.
Drinking water can be contaminated at the source, during transport or during storage at home.Food can be contaminated by soiled hands, during preparation or while eating. Beverages and ice prepared with contaminated water and fruits and vegetables washed with this water are other examples. Some outbreaks are linked to raw or undercooked seafood. The incubation for cholera can be from a few hours to 5 days. As long as the stools are positive, the person is infective. Some patients may become carriers of the organism which can last for months. Cholera is diagnosed by growing the bacteria in culture. Treatment consists of replacement of fluids lost, intravenous replacement in severe cases. Doxycycline or tetracycline antibiotic therapy can shorten the course of severe disease. According to Wikipedia, North Kivu is a province bordering Lake Kivu in the eastern Democratic Republic of Congo. Its capital is Goma. North Kivu borders the provinces of Orientale to the north and northwest, Maniema to the southwest, and South Kivu to the south. To the east, it borders the countries of Uganda and Rwanda.
- RSOE Edis
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