Travelers to Nepal must take precautions to prevent cholera

Post earthquake the biggest fear is cholera epidemic. One must learn lessons from the Haitri cholera epidemic where ten months after the largest urban disaster in modern history, a devastating 7.0-magnitude earthquake on January 12, 2010 that killed over 316,000 and affected 3 million, Haiti faced an outbreak of cholera.

By the end of 2011, the outbreak resulted in over 500,000 infections and 7,000 deaths. Cholera also spread to the Dominican Republic which by end of 2011 recorded over 21,000 cholera cases and 363 deaths. In the epidemic patient zero was identified as a 28-year-old Haitian who was exposed to cholera while bathing in, and drinking from, a river near the peacekeepers.

Ending the epidemic requires a concerted, multi-sectoral effort; reconstruction of water, sanitation and hygiene (WASH) infrastructure; hygiene education and free access to cholera treatment.

Cholera is a bacterial disease that can cause diarrhea and dehydration. It spreads through the ingestion of contaminated food or drinking water.

Travelers should drink and use safe water. Bottled water with unbroken seals and canned/bottled carbonated beverages are safe. One should use safe water to brush teeth, wash and prepare food, and make ice. One should clean food preparation areas and kitchenware with soap and safe water and let dry completely before reuse. One should not use piped water, drinks sold in cups or bags, or ice. All drinking water and water used to make ice should be boiled or treated with chlorine.

Safe water can be prepared by boiling it for one minute or treating the water with chlorine purification tablets or household bleach.

One can add 8 drops of household bleach for every 1 gallon of water (or 2 drops of household bleach for every 1 liter of water) and wait 30 minutes before drinking.

One should always store your treated water in a clean, covered container.

Washing hands is the best bet. One should wash hands often with soap and safe water before eating food, before preparing prepare food, before feeding children, after using the latrine or toilet, after cleaning child?s bottom and after taking care of someone ill with diarrhea. If no soap is available one can scrub hands often with ash or sand and rinse with safe water.

One should use latrines or bury the feces. One should not defecate in open. One can use chemical toilets. One should clean latrines and surfaces contaminated with feces using a solution of 1 part household bleach to 9 parts water.

One should defecate at least 30 meters away from any body of water and then bury the feces. One should dig new latrines or temporary pit toilets at least a half-meter deep and at least 30 meters away from any body of water.

Regarding cooking food, one should cook food well (especially seafood), keep it covered, eat it hot, and peel fruits and vegetables.

Remember the formula, Boil it, cook it, peel it, or leave it.

Sea food precautions, be sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through.

Wash children, diapers, and clothes at least 30 meters away from drinking water sources.