• Short Summary

    Cholera, one the world's top killer diseases, is most effectively controlled at the grass-roots level.?

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    Cholera, one the world's top killer diseases, is most effectively controlled at the grass-roots level. The primary means of co-ordinating these efforts is the World Health Organisation (W.H.O.) in Geneva. The current serious outbreak of the disease which began in the Astrakhan region of the Soviet Union has made such efforts of control all the more critical.

    Caused by an organism which attacks the alimentary canal, cholera can kill within 24 hours in its severest form. There are two basic types of cholera: the classical type, endemic in the Indian sub-continent, and the El Tor variant, based on Indonesia. The first is the more virulent, but the El Tor variant lives on longer in the body and is the type that has begun to appear most widely across national borders.

    The symptoms are acute: vomiting and diarrhoea, to the stage where death can occur through dehydration. Within eight hours 10 to 15 per cent of the body's fluids can be lost -- to lose a third is to be in danger of death. Seriously wrinkled skin is a star clue to dehydration. Whether the patient lives or dies often depends upon his state of health at the time of the attack.

    Treatment consists of maintaining body fluids and salts through intravenous injection and the possible addition of antibiotics.

    World Health Organisation authorities, based in Switzerland pinpoint outbreaks of the diseases and are able to coordinate efforts to control them as news of developments are passed to the Geneva headquarters. One source of information is the W.H.O. Calcutta laboratory where water samples are analyzed.

    Because the disease is usually transmitted through contaminated drinking water, it is on the local level that much anti-cholera work can be done. In India, one of the areas where the problem is acute, polluted water is not infrequent -- water which is very often used as communal bathing and washing facilities as well as sewers and major transport arteries.

    Local health authorities in India and elsewhere try to prevent and control the spread of cholera by testing suspected water and by purifying it with chlorine. Prevention also includes the use of vaccines. A vaccine giving protection against cholera was developed in 1893 and is believed to have played a major role in curbing the disease.

    In many areas, health officials visit possible points of out-break and disinfect potential sources of disease. It is also part of their job to teach people of the danger of cholera and the best ways to prevent it.

    The disease is nevertheless a serious problem today. In the Calcutta region of India, local officials said at least 180 died of the disease in May, while a sudden outbreak near Dehra Dun in July killed 34 people in one night.

    In the current outbreak, cholera has been reported in South Korea, where at least four people died, in a refugee camp on the West Bank of the Jordan and in Jerusalem. Preventive measures are being taken throughout the Middle East, and much of Europe. The World Health Organisation fears that the present outbreak may spread to Europe by means of carriers, such as tourists currently in the infected regions.

    But the United Nations agency says Europe should escape a general outbreak because of the high standard of hygiene. Ultimate control of the disease depends upon the development of a higher standard of hygiene in the prevalent areas and one way this can be done is through local education and preventive measures.

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