CHOLERA OUTBREAK: DON’T WAIT FOR LAB DIAGNOSIS TO TREAT

Posted by Ndivhuwo Mukwevho | May 23, 2023 | News 

Experts have warned healthcare workers not to wait for laboratory diagnoses before treating a patient who presents with suspected cholera symptoms.

Dr Juno Thomas, head of the Centre for Enteric Diseases at the National Institute for Communicable Diseases(NICD), says to avoid delays in the detection of cases, healthcare workers in facilities with onsite laboratories must take cholera samples directly to the laboratory after collection. This will increase the chance of recovering the bacteria. 

She was speaking on Tuesday during a National Department of Health webinar on the cholera outbreak. Fifteen people, including two children, died due to cholera-related complications in Hammanskraal.

“At facilities that do not have onsite laboratories there need to be close coordination and communication between facilities to have an arrangement for collection of specimens, in order for them to be transported to the nearest laboratory,” says Thomas. 

Currently, the country has recorded an alarming 51 cases of cholera. Gauteng recorded 44,  six in the Free State and one in Limpopo. Cholera is transmitted directly through food or water contaminated with faecal material from an infected person. While most people develop no symptoms or only mild diarrhoea. 

IMPORTANCE OF PATIENT MANAGEMENT

“I want to emphasise something that is absolutely critical: that patient management in the cases of suspected cholera cases must never wait for a laboratory diagnosis. The laboratory diagnosis is for public health action, it is not to guard individuals patient’s management,” says Thomas.

Thomas says that areas without confirmed cholera outbreaks must rapidly detect, investigate and respond to any suspected or probable cholera outbreak to interrupt the onset of local cholera transmission.

“Area with a confirmed cholera outbreak must always monitor morbidity, mortality and affected populations to inform targeted interventions to mitigate the impact and spread of the outbreak and eventually end the outbreak,” she says.

Dr Jeremy Nel, Infectious Diseases Division at Wits University, also emphasised that one does not have to wait for confirmation, before potentially treating them for cholera as most cases are asymptomatic or mild.

“Mild cholera cannot be easily distinguished from other diarrhea illnesses. While severe cholera is usually profuse, painless diarrhea. The main thing here is that dehydration can be rapid and fatal. And it is very uncommon for adults to have severe dehydration from diarrhea, if you do you must always think of cholera,” says Nel.– Health-e News.