Cholera outbreak in Kampala

Feb 10, 2008

CLASPING his hand on the right cheek as if very worried, Alan Kagwa, 12, was about to enter Mulago Hospital, when he started vomiting and passing watery stool. The doctor on attendance suspected that it was cholera. <br>

By Frederick Womakuyu

CLASPING his hand on the right cheek as if very worried, Alan Kagwa, 12, was about to enter Mulago Hospital, when he started vomiting and passing watery stool. The doctor on attendance suspected that it was cholera.

After testing, Kagwa was confirmed to be suffering from the disease. The doctor placed him in an isolation ward.

The Ministry of Health has confirmed that cholera has hit Kampala district again. Six patients have been admitted at the cholera isolation camp in Mulago Hospital. There are no confirmed deaths.

Dr. Mohamed Kirumira, the Kampala chief of health services said, four patients are under-going treatment. And other patients are reported to be under-going tests at Asumpta Clinic in Kamwokya.

Dr. Sam Okware, the commissioner of health services, attributed the outbreak to poor sanitation and lack of personal hygiene among the masses and is not new.

“We have been having cholera for the last two to three years in western and northern Uganda,” he said. In 2005, an outbreak of an atypical strain of cholera outbreak killed at least 56 people and made more than 2,000 others ill, says the Ministry of Health.

According to Dr. Peter Kamya, a lecturer at the Infectious Diseases Institute, Mulago School of Medicine, cholera is an infectious gastroenteritis disease caused by the bacterium Vibrio cholerae. The bacteria breed in damp places.

Dr. Michael Odit, a doctor at Kawolo Hospital, says: “Infected water and any food washed in the water, as well as fish living in that water can cause an infection. Cholera is rarely spread directly from person to person.”

Dr. Chris Mayega of Mulago Hospital says: “In its most severe forms, cholera is one of the most fatal illnesses, and a person may die within three hours if treatment is not provided.

The disease progresses from liquid stool to shock in four to 12 hours, with death following in 18 hours to several days without rehydration treatment.”

Dr. Hassan Were, a clinical scientist at Kibuli Stairway Clinic, says acute diarrhea is the main symptom of cholera. “Other signs include; vomiting, and leg cramps but with rapid loss of body fluids leading to dehydration and shock.”

Treatment
“Water and electrolyte replacement are essential treatments for cholera, as dehydration and electrolyte depletion occur rapidly. Prompt use of oral rehydration therapy is highly effective, safe, uncomplicated and inexpensive,” says Were.
Antiboitics such as tetracycline can be used to treat cholera.

Prevention
“Although the disease can be life-threatening, cholera is simple to prevent by proper sanitation practices.

In some homes, due to advanced water treatment and sanitation systems, cholera is no longer a major threat,” says Mayega. “The last major outbreak in Kampala occurred in slum areas where sanitation and personal hygiene are poor.”

He adds that people must be aware of how the disease is transmitted and what can be done.
He says that good sanitation practices, if instituted in time, are usually sufficient to stop the epidemic.

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