Measles in the UK Cholera in India, South Africa and Uganda
The Health Protection Agency has stated that measles is once again endemic in the UK. It has been 14 years since the local transmission of measles was halted in the UK. Following a decade of low MMR vaccination coverage across the UK the number of children susceptible to measles is now sufficient to support the continuous spread of measles
Outbreaks of cholera are occurring from India (Delhi,) South Africa and Uganda these countries have experienced heavy rains over the last six weeks which are thought to have attributed to this outbreak this is all caused by bacteria causing an intestinal infection and is often linked to contaminated supplies of drinking water. The bacterium is part of the flora of brackish water and estuaries - it is when this water gets into the drinking supply that an outbreak can start. It causes severe diarrhoea and vomiting, and patients, particularly children and the elderly, are vulnerable to dangerous dehydration as a result. Cholera vaccine is an oral vaccine which protects for two years and also gives some protection against some kinds of travellers diarrhoea for up to six months.
Treating the condition - or rather alleviating these severe effects, requires only simple measures. However, the clean water and rehydration salts required are often in short supply in areas where they are needed most. An outbreak of cholera can spread quickly in areas where there is poor sanitation and where water supplies can be tainted.
Most people infected with cholera don't actually get ill, despite this; they are contributing to the problem because the bacteria remain in their faeces for up to a fortnight. Most symptomatic cases are hard to distinguish from other illnesses that cause diarrhoea - it is only in one in 10 that severe symptoms such as dehydration occur.
A well-organised response to cholera, says the World Health Organization, can reduce death rates to 1%. An unprepared community, however, will experience many times this death rate, it says.
Normally, rehydration salts are the only treatment given, although severely dehydrated patients may need intravenous fluids. Antibiotics can reduce the amount of diarrhoea.
There is an oral cholera vaccine - but it is mainly aimed at travellers rather than wider use in a community stricken by the illness.
Control of an epidemic is difficult in a community unless clean water supplies can be restored. Systems for hygienic disposal of human wastes also need to be brought in.