Oral Cholera VaccineCoastal cities like Beira, Mozambique thought they were prepared for cyclones. In 2012, the city built new drainage systems and barriers to help them withstand the rising seas and increased storms from climate change.

Cyclone Idai proved that they weren’t as prepared as they thought. On March 14, the cyclone hit the coast and claimed at least 847 lives in the region, as well as displacing tens of thousands. The cyclone created an inland sea from the mass flooding that spans 80 miles long and 15 miles wide.

How Beira was Affected

Since the cyclone, more than 1,300 people in Beira have been drinking from local ponds, overflowed latrines, and other unsafe water sources. These conditions are ripe for deadly diseases, including cholera.

Thousands of people are currently in displacement camps with few toilets and little clean water. While health workers have responded to the situations quickly, they have restored water supply to only 60 percent of the population. Many are still left to drink unclean water and defecate in the streets.

A cholera outbreak has been declared in Beira. The number of people affected went from five on March 27 into the hundreds. Cholera currently afflicts over 3,100 people and has resulted in six deaths.

Quick Response to Cholera Outbreak

On April 3rd, health workers started distributing oral cholera vaccines in Beira. Gavi, the vaccine alliance, is funding this movement. This Mozambique Ministry of Health is responding with support from the World Health Organization and others. They have given out an estimated 884,953 vaccine doses. They have also opened nine cholera treatment centers in the region, each with a capacity of 500.

Doctors Without Borders has called this distribution the “most ambitious campaign ever conducted using the one dose cholera vaccine strategy.”

This oral cholera vaccine is usually given in two spaced-out doses, but the aid group says one treatment is effective in emergencies. The single dose is effective after seven days and offers 85 percent protection for six months. In turbulent times, it can be hard to find people to distribute the second dose.

The success of distributing the oral cholera vaccine is primarily due to the preparedness of local authorities. They organized a campaign that mobilized 1,200 community volunteers and partners. The Ministry of Health made requests for volunteers soon as the cyclone hit and organized local aid.

The Ministry of Health used its abundant volunteers to set up distribution areas. Vaccine promoters got the word out using microphones and by handing out doses to high traffic areas. Volunteers are also passing out water purification tablets and educating people on precautions they should take with their drinking water.

– Michela Rahaim
Photo: Flickr

Fighting Cholera in Bangladesh and Around the Word

Vibrio cholerae, more commonly known as cholera, is a virulent bacteria that causes the body to flush all available liquids into the intestines. Those infected with cholera suffer from violent bouts of diarrhea and vomiting, and without treatment the sickness will likely be fatal. Symptoms can worsen quickly and organ failure can ensue within hours of the patient beginning to feel sick.

Cholera is treatable, and after years of research, there is now an oral cholera vaccine (OCV), which can be used to provide immediate, short-term protection from the disease. In the case of an outbreak, this vaccine can give aid groups enough time to improve access to clean water and sanitation before the disease has a chance to spread. Cholera is present in 70 countries worldwide, putting over one billion people at risk of contracting the disease.

In the 21st century, there has been a World Health Organization (WHO) initiative to stockpile OCVs in case of an outbreak. Creating the stockpile of vaccines has drastically improved the ability of aid groups to respond to crises quickly and effectively. For example, when Haiti was struck by an earthquake in 2010, there was a devastating impact on the nation’s infrastructure, greatly limiting the availability of clean drinking water. The WHO’s stockpile of vaccines was a blessing for the Haitian people, who were facing the threat of a full-scale cholera outbreak.

Cholera was first discovered in 1817, when the British East India Company sent explorers into the isolated swamps of southern Bangladesh. It was this first emergence of cholera that led to the global spread of the bacteria, which is contracted through contact with feces, usually through contaminated drinking water.

Bangladesh has been the epicenter of the fight against cholera since the emergence of the disease, and in 1960 the United States government founded the Cholera Research Laboratory in Dhaka, Bangladesh. This facility has since been renamed the International Center for Diarrheal Disease Research (ICDDR, B) and has been credited by the WHO as having saved the lives of 50 million Bangladeshi citizens suffering from cholera or diarrhea-related illness.

The ICDDR, B treats 220,000 patients a year, most of whom recover within a few days (young children are at higher risk and tend to require longer treatment). Patients at this facility lie in “cholera cots,” which is a euphemistic way to describe a cot with a hole in the center and a bucket underneath.

The ICDDR, B is leading the fight against cholera in Bangladesh and around the world. The Gavi Vaccine Alliance, in cooperation with the WHO, recently shipped 900,000 doses of OCV to Bangladesh to prevent the spread of cholera in refugee camps and among the general population. The task of stopping cholera in Bangladesh is now in the hands of the international community. The possibility of eradicating cholera in Bangladesh is closer than ever, and soon this disease may cease to exist as a constantly looming threat to the most vulnerable people on the planet.

Tyler Troped

Photo: Flickr