That’s not how you get cholera

Look, as a description of the current state (and oh, what a state) of affairs in SA right now, this tweet is pretty accurate.

Fullscreen capture 2016-09-05 104312 AM.bmpHowever, as a description of how you get cholera, it’s wildly inaccurate. That is, unless the carrot in question has been washed in cholera-infested water.
And I wouldn’t put anything past the Gupta family, to be honest.

Cholera is an infectious disease that causes severe watery diarrhoea. It’s spread via the faecal-oral route. That means that the bacterium in question – called Vibrio cholerae – er… “exits” the body of a cholera sufferer and somehow ends up being ingested by another individual. This is often via it getting into the drinking water system through poor hygiene and inadequate water treatment though.
You don’t get it from eating carrots (with the caveat above firmly in place, that is).

And anyway, even if you did cholera from eating carrots, there’s no evidence that donkeys can get cholera. In fact, in their 1996 book “Cholera and the Ecology of Vibrio cholerae“, Drasar and Forrest cite a 1974 study by Sanyal et al. in which 195 animals (including donkeys), living in a cholera endemic area in India were routinely tested for the bacterium over a period of a year. Pathogenic V.cholerae was only isolated from 3 cows, 2 dogs and 2 chickens. (NB – no donkeys).

And then, even if the donkey did eat the carrot and you could get cholera from carrots, and even the donkey could get cholera, it’s a big stretch to suggest that the entire nation would then become infected with cholera, just because a donkey got it from a poisinous [sic] carrot. Just what was this donkey doing? How on earth would it successfully have infected 55 million people? That’s biological warfare on a massive scale. I’m not sure anyone could carry that out, let alone a lone donkey, who, lest we forget, is allegedly rather unwell.

So, no. As an accurate account of the source of a cholera infection and how it might be spread, this tweet is rubbish.
As a metaphor of what Jacob Zuma and his friends have done to South Africa though – pretty good.

Besides Ebola…

While there is a (rightfully) well-publicised Ebola outbreak taking place in West Africa, it doesn’t mean that the usual suspects of the infectious diseases world have gone away. And while the world’s attention is focused on that pesky haemorrhagic fever virus, cholera has been going about its usual business in Nigeria, Ghana and South Sudan.
It’s a reminder that while the “superstar diseases” are widely and enthusiastically reported by the First World’s sensationalist media (like the bubonic plague case (singular) in China that I mentioned last week), the more mundane stuff continues, but goes very much under the radar.

Cholera is unpleasant, acute and life-threatening, especially in children. It’s also fairly simple to prevent, assuming that you can get access to clean water:

“It is the filth everywhere and the lack of hygiene among our people,” the Deputy Director of Health for the Greater Accra Region, Dr John Eleaza said, noting that some patients have been victims of the disease despite using pipe-borne water.
Unfortunately we have some of our pipelines going through some of these drains…some of them are broken” he said.
He is advising Ghanaians to be careful and practise proper hygiene to prevent a deterioration of the outbreak.

And while the mortality rate doesn’t rival that of Ebola, the sheer numbers affected mean that the death toll in these outbreaks is already rapidly approaching (if not exceeding) that of their more famous cousin up the road.

Even the local media is more concerned with the Ebola outbreak than that of cholera, as this story in Nigeria’s Vanguard demonstrates, with nearly half the piece being hijacked by Ebola news, including this spectacular advice from State Commissioner for Health Dr. Joe Akabike:

…avoid touching corpses of victims of the disease and to avoid sexual intercourse with patients of the disease until after three months of their recovery in order not to contact the disease.

He doesn’t mention avoiding sexual intercourse with the corpses, but I suppose that’s just considered common sense.
And common decency.

I digress. All I wanted to remind people is that the Ebola outbreak should be considered an additional problem, and not suddenly the only problem in sub-Saharan Africa.

Baltic Belly

Yay! Microbiology makes the headlines again. For all the right reasons. Sort of.

Numerous reports across the media this morning on this paper which appears to indicate that Vibrio spp. gastrointestinal infections are on the rise in the Baltic states due to climate change and the rising temperature of that sea.
Vibrio is the genus that causes cholera and other nasty bowel disturbances. It’s nothing new, even in temperate climes, but it’s generally more associated with warmer areas, especially – as I recall from my days in the Oxford lab – the entirety of South East Asia. Holidaymakers generally brought more than just memories and a ceramic elephant back from Thailand.

Some Vibrio yesterday (they’re not actually this big though)

It seems that for every degree that the Baltic sea temperature increases, the number of Vibrio cases rises by almost 200%. Not much of an issue there to be honest, because we’re starting from a very low baseline, but since the Baltic “represents, to our knowledge, the fastest warming marine ecosystem examined so far anywhere on Earth” and appears to be getting about 6-7 degrees warmer each century, it may serve as a decent model for other infections and geographical locations.

Changing patterns of infection due to the local environment is nothing new. Malaria was once present across Europe and North America, yet we only see imported cases these days. (That said, I once contracted malaria in London, but that was in a lab at Imperial College.) (Don’t try this at home.)

Anyway, even if you are travelling to Poland, Lithuania, Estonia or Latvia, don’t panic too much. The likelihood of you getting cholera is very, very small. Although, if the photo above is anything to go by, you may want to avoid the local sausages just to make sure.

More great publicity for SA

There’s no such thing as bad publicity? Really?

From the front page of the BBC News website: some more negative stories about South Africa.


Negative perceptions

I’m not saying they’re not true stories. Just that I’m fed up of having to dig deeper for the good news, while the bad stuff is repeatedly thrust into my face.

Crossing borders: South Africa hit by Zimbabwe’s cholera crisis 
HIV drug high: South African teenagers smoking anti-retrovirals