The Cholera Connection

It is Oktoberfest time in Bavaria, a world-famous festival that has been celebrated annually for a century and a half. However, there have been 5 interruptions to the festivities. Three times war has been the cause  but on two occasions – 1854 and 1873 – Oktoberfest was cancelled in the face of  local cholera epidemics. Cholera, that feared plague whose history goes back centuries, originating probably in land surrounding the Bay of Bengal but potentially a world-wide problem. Cholera spreads whenever water comes into contact with  untreated sewage so it is a disease prevalent,or potentially prevalent, wherever there is unsafe water supply and inadequate sanitation.

This month Kerala authorities in India reported that cholera has made a comeback. Greater Accra in Ghana has seen an upsurge in cases in past weeks causing the Government to institute a nationwide clean-up campaign. In Sierra Leone the President declared the escalating cholera epidemic a “humanitarian crisis”. Cuba has just brought an epidemic under control although newspaper reports suggest that there may still be some cases in the island. The notorious outbreaks in Haiti and the Dominican Republic following the disastrous earthquake continue. Closer to home we have had outbreaks in Papua New Guinea.

The control of cholera is not a medical one, it is an engineering one.

For poorer countries cholera control is a major problem. For travellers, so long as good water and food hygiene practises can be carried out there need be no problem. Where there may be doubt or a high risk a good oral vaccine is available but it is not a substitute for taking sensible precautions. 

So long as we have safe water to drink and good sanitation we need not fear a return of the disease – and the Oktoberfest is unlikely to be cancelled.