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Control and Intervention of Cholera Outbreaks in Refugee Camps

Abstract

Cholera, a disease with a long history, continues to devastate populations around the world. Due to the route of transmission of Vibrio cholerae, the bacterial pathogen that causes the disease, cholera only seems to affect developing countries, giving rise to a health disparity. For developed countries with adequate water and sewage treatment systems, the threat of cholera is irrelevant. Meanwhile, developing countries which have underlying vulnerabilities of poverty and lack basic access to clean water and proper sanitation are disproportionately affected. There are many factors that put different populations at risk for cholera outbreaks. Epidemiological studies of cholera outbreaks show that the combination of poverty with the effects of conflict or natural disaster produces the most vulnerable population of refugees or internally displaced persons (IDP). Not only are these populations more susceptible to the risk of cholera outbreak, but they are more vulnerable to its devastating effects. Refugee and IDP camps experience higher attack rates and case fatality rates (CFR) due to the scarcity of resources (Brown, Jacquier, Bachy, Bitar, & Legros, 2002). Cholera outbreaks in displaced populations present a public health hazard in an emergency context. If these outbreaks are not properly managed, they can develop into epidemics and pandemics. Thus, it is important to implement a swift and effective strategy to manage cholera outbreaks in refugee and IDP camps. To do this there are two main objectives: control transmission of the disease and emergency medical relief. Control of transmission must be accomplished through short- and long-term solutions: a supply of adequate water and sanitation combined with a public health campaign to promote knowledge and proper practices. Emergency medical relief would consist of establishment of cholera treatment centers (CTC) that would provide urgent intervention to efficiently diagnose and treat cases of cholera to reduce fatality rates.

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