Prevention and control of cholera outbreaks: WHO policy and recommendations
Among people developing symptoms, 80% of episodes are of mild or moderate severity. The remaining 10%-20% of cases develop severe watery diarrhoea with signs of dehydration. Once an outbreak is detected, the usual intervention strategy aims to reduce mortality - ideally below 1% - by ensuring access to treatment and controlling the spread of disease. To achieve this, all partners involved should be properly coordinated and those in charge of water and sanitation must be included in the response strategy. Recommended control methods, including standardized case management, have proven effective in reducing the case-fatality rate.
The main tools for cholera control are:
- proper and timely case management in cholera treatment centres;
- specific training for proper case management, including avoidance of nosocomial infections;
- sufficient pre-positioned medical supplies for case management (e.g. diarrhoeal disease kits);
- improved access to water, effective sanitation, proper waste management and vector control;
- enhanced hygiene and food safety practices;
- improved communication and public information.