Cholera: Analysis and Prevention Methods

Barzilaay, E., Schaad, N., Magloire, R., Mung, K., Boncy, J., Daharou, A., & Mintz, E. (2013). Cholera Surveillance during the Haiti Epidemic The First 2 Years. The New England Journal of Medicine.

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This paper was concerned with the outbreak of cholera 10 months after the devastating earthquake of Haiti in 2010. Soon after, the government through the Ministry of Health in the country formed the National Cholera Surveillance System (a body tasked with the evaluation of implementation methods of the recommendations on reducing cholera cases). The NCSS was comprised of both governmental and non-governmental organizations that were involved in the process of handling and treatment of the disease. These organizations formed the bodies that provided information on the prevalence of the disease and the measures that were put in place for its eradication. In this case, the NCSS modified the WHO definition of cholera as a watery diarrhea in a patient five years or older. Testing of the patients was done thorough a lab analysis of a stool sample for the purposes of confirming the results.

During the two years of study, cholera was found to have a cumulative attack rate of 5% at the end of the first year and 6% at the end of the second year. At the end of this period, there were also efforts geared towards the eradication of the cholera epidemic within the region. However, their successes were not measured within this study. However, the prima facie conclusion upon look at the results of the analysis will show that there was minimal success of these efforts noting the increase in reported cases of cholera even when considering efforts put in during this period. It is also important, however, to note that during this period, the country was recovering form infrastructure damage which could have hampered the governments ability to reach out to the population.

Farmer, P., Almazor, C., Bahnsen, P., Barry, D., Bazile, J., Bloom, B., & Bose, N. (2011). Meeting Cholera's Challenge to Haiti and the World: A Joint Statement on Cholera Prevention and Care. PLOS Neglected Tropical Diseases.

The issues in this paper further investigated the situation in Haiti for the purposes of looking into government and private efforts to prevent the cholera epidemic and its spread in the country. It is a report on the methods that should be used for cholera response in the course of dealing with the problem in Haiti. Efforts to reduce the prevalence of the disease were quite effective as the rate was seen to drop from 7% to close to 2% at the end of the risk period. This was an exemplification of efforts that the government and non-governmental organizations had put in ensuring that the people were safe from the adverse effects of the disease.

Some of the methods used in ensuring that the disease was eradicated was through the distribution of water and sanitation facilities in the internally displaced peoples (IDP) camps. This was especially a concern because the study found that these places were especially key in the management of the disease because of the likelihood of sanitation concerns where people are crammed. This document foresees the occurrence of another break out because of the prevalence of earthquakes in the region and this offers a summary of the best practice in eradicating the disease in the next instance that it shows itself. Furthermore, the poverty situation in the country has been seen as a risk factor in the spread and management of the disease as people are less likely to be exposed to it if they have the resources necessary for access to sanitary conditions of living.

Gaffgar, N., Tauxe, R., & Mintz, E. (2007). Cholera: a new homeland in Africa? Journal of Tropical Medicine and Hygiene.

This article is concerned with the situation of cholera prevalence in third world countries, and more specifically Africa. Because of the improvement of social infrastructure and economic status in developed countries, this is now no longer a concern for the developed countries in Europe. For the purposes of consideration of third world countries, there is yet sufficient sanitation infrastructure within the countries. Furthermore, the economic status of African countries exposes them to some risks namely the lack of facilities to cater for sanitation and heath. As a result, there has been constant concerns for the disease as there is inadequate response to the outbreak of such a disease.

The fatalities of the disease can be reduced through the simple response by the oral vaccination or focus on proper methods of sanitation maintenance. However, this has been a problem in African countries because of access to healthcare services among other challenges that are faced in African countries. Furthermore, the limited access to such services also hinders the prevention and monitoring of this disease. It was noted that 78% of the countries that reported an outbreak of the disease were from the Sub-Saharan Africa, posing a great question as to whether efforts to eradicate the disease have reached the African countries and their effectiveness in the course of this. Rates in Asia were noted to be up to 3 times higher than the rates in Asia. The article looks to investigate the difference in application of methods of developed countries and in Africa in order to reduce the prevalence rates.

Holmgren, J., Lycke, N., & Czerkinsky, C. (2000). Cholera toxin and cholera B subunit as oralmucosal adjuvant and antigen vector systems. Vaccine.

This paper presents the analysis of the reaction of the cholera vaccine as an overall response to the ability to remove risks from the patients. This kind of treatment has been noted to have certain reactions to the person, some of which are very beneficial because of their abilities to increase the ability of the person to resist the disease. The cholera toxin B antigen in this case has been seen to have better effects to the person as opposed to any other methods of treatment. In this particular treatment, there is a smaller effect to the cells in the body as they remove the cholera disease from the blood system.

In this article, the need of the vaccine to be developed in such a way that reduces the effects to the person is seen. The vaccine in previous instances has had certain adverse effects to the person including the lack of control over reactions to the drugs, where there is excess proliferation of the cells in the body during the intake of the drug. Thereafter, there were clear effects such as an excess loss of body water through the adjuvanticity process. Such effects were not visible during the trials of the Cholera Type B antigen when used for the purposes of the treatment of the disease. The overall finding of this article is that there was more than one way available for cholera treatment, and such treatment could be employed in the eradication of the disease depending on the prevalent strain of cholera in a particular region.

Zuckerman, J., Fisch, A., & Rombo, L. (2007). The true burden and risk of cholera: implications for prevention and control. The Lancet Infectious Diseases.

This article identifies the problem of identification and surveillance of the disease is largely due to the inability of the affected countries to have effective means of ensuring that the disease progress and reporting is well-done, and that such information is passed to the World Health Organization. As such, it is quite difficult to determine the extent to which the disease has ravaged the various parts of Africa, South and Central America. Difference in reporting procedures in these countries among other factors such as failure to report and the shortcomings of the existing surveillance procedures in the countries have rendered efforts to look into cholera cases quite impossible. As such, many of the sources of cholera statistics were reported from Asia something that could pose a huge problem when tackling the problem of cholera.

This article identifies the need to have a system of overall monitoring of the disease through the distribution of the vaccine. Because of the availability of the vaccine to the public, it is now possible to enjoy the full advantages of reporting based on the movement of the vaccine among peoples in Africa and the Central and South American regions. This is especially in sight of the need to have better surveillance systems. An analysis of how the vaccine moves, especially in these countries could give an estimate as to the amount of people that are exposed to the risk of the disease transmission.

Center for Disease Control (2010). Update Cholera Outbreak Haiti, 2010. MMWR Morbidity and Mortality Report.

This paper was an analysis of the efforts that were put into the prevention against the widespread effects of the cholera outbreak in Haiti during the 2010 crisis. Because of the investigation into the causes of the outbreak, there was adequate information onto how the disease could be dealt with to ensure that the people in the country had less exposure to the effects of the disease. Initially, the growth of the outbreak was recorded in many parts of the country, with many people experiencing the adverse effects of the disease, and dying within four days if the disease went untreated. It was thus a major point of concern for the government of Haiti as well as the non-governmental organizations involved in the planning process of the eradication of the disease.

During this time, some of the measures that were put in place by the government included providing access to safe and treated drinking water for the purposes of having sufficiency of water supply to the people. Cholera, being a water borne disease, was mainly spread through water and this was the first concern that the government efforts had. Furthermore, there was education on the need to maintain the hygiene and sanitation standards necessary for the purposes of ensuring the safety of the people from the disease. Further, medical treatment of oral rehydration was advised for the immediate intake of peoples who had been infected. This was seen to be one of the major causes of death as people infected often desisted from fluid intake once the dehydration process had begun after infection of the disease. Further, capacity of cholera treatment was needed to be increased as well as the number of care centers available for the treatment of the disease.

Lucas M., Deen, J., von Seidlein, L., Wang, X., et al. (2010). Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique. The New England Journal of Medicine. 757-67.

The new vaccination available for the disease in sub-Saharan Africa is promising good results if it is going to be applied with the vigor that is expected. This has in fact been seen in its administration in the Mozambican region. However, there are concerns raised about the prevalence of HIV in these countries and the ability of the vaccine to be effective in such circumstances. As such, this research looks into the effectiveness of the mass administration of the cholera vaccine in this region.

The study found that the immunization process resulted in up to 78% of protection against the disease, providing good odds for the person in question noting that other protections were not available at such high rates. Further, there was effectiveness of the diseases across the ages so that older persons have the same effect as those under the age of 5. As such, it was found that the rBS-WC vaccine was a highly effective protector against the cholera disease.

Conclusion

The analysis of these sources prove that the growing need for awareness of cholera issues is presented must be dealt with. Such needs are available in that the person is required to have some exposure on the kind of cholera that they have and seek...