Cholera and acute watery diarrhoea
Fact sheet
Key facts
- Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or person-to-person as a result of poor hygiene.
- There are three clinical types of diarrhoea:
- acute watery diarrhoea – lasts several hours or days, and includes cholera;
- acute bloody diarrhoea – also called dysentery; and
- persistent diarrhoea – lasts 14 days or longer
- Key measures to prevent diarrhoea include:
- access to safe drinking-water
- improved sanitation
- exclusive breastfeeding for the first six months of life
- good personal and food hygiene
- health education about how infections spread
- Cholera is an acute diarrhoeal infection cause by ingestion of food or water that is contaminated with bacterium Vibrio cholera. It affects both children and adults and can kill within hours if left untreated.
- Since 1800, cholera has swept around the world in seven massive waves or pandemics. Six subsequent pandemics killed millions of people across all continents. The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries including Viet Nam.
- New variant strains have been detected in several parts of Asia and Africa. Observations suggest that these strains cause more severe cholera with higher case fatality rates. Careful epidemiological monitoring of circulating strains is required.
- Recent studies indicate that global warming creates a favourable environment for V. cholerae bacteria.
- Early medical care saves lives of both diarrhoeal disease and cholera patients.
- Transmission of diarrhoeal disease and cholera is likely to be linked to inadequate clean water, food safety and unsanitary condition.
- Spread of diarrhoeal disease and cholera outbreak can be prevented through early detection and confirmation of cases, followed by appropriate response.
- A multidisciplinary approach based on prevention, preparedness and response, along with an efficient surveillance system, is key for mitigating outbreaks, and controlling cholera in endemic areas and reducing deaths.
The situation
- Among the notifiable diseases in Viet Nam, diarrheal diseases are one of the top ten causes of morbidity and mortality in Viet Nam recently. In 2009 there were 930 496 cases with four fatal cases reported.
- Cholera is a re-emerging disease in Viet Nam. In 2008 there were 853 cases with no deaths, in 2009 there were 479 cases with one death, in 2010 there were 606 cases with no deaths and in 2011 there were three cases but no deaths.
WHO's response
- In Viet Nam WHO supports the Ministry of Health and other key technical partners by providing technical advice and support aimed at:
- Promoting current policies and guidelines for the management of acute watery diarrhoea and cholera in developing countries.
- Enhancing Viet Nam’s communicable diseases surveillance systems to rapidly detect and respond to outbreaks.
- Containing the spread of outbreaks through early detection, appropriate case management and reporting of cases.
- Supporting the training of health professionals at national and sub-national level.
- Employing the International Health Regulations (IHR 2005) as a framework for evaluating acute public health events that may involve cholera, and the potential to spread across borders.
- Supporting basic, operational, implementation and applied research.