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Cholera in Mykolaiv city: How dangerous is it?

Author : Olena Holubeva

23:38, 28 August 2017
Cholera in Mykolaiv city: How dangerous is it?

Author : Olena Holubeva

A causative agent of cholera was found in Ingul river in Mykolaiv. It turned out that this is the toxic vibrio that caused a sharp outbreak of a dangerous disease in 1995: more than a thousand people became ill. Now the local authorities try to prevent infection.

23:38, 28 August 2017

Read original article at 112.ua

112 Agency

What was discovered in Ingul

On August 7 in Mykolaiv near the pedestrian bridge over Ingul river in one of the planned water samples taken from the river, a cholera pattern Vibrio cholerea O1 biotype Eltor serotype Ogawa was discovered. The pattern was confirmed by the Odesa Antiplague Institute.

As told to 112.ua journalists Larysa Burdenko, head of the State Supervision for the Observance of Sanitary Legislation of the State Consumer Protection Service in the Mykolaiv region, a similar causative agent of cholera caused an outbreak in 1994-1995. As you know, then 1370 people became ill with cholera, about a thousand were carriers of infection: this is 80% of all manifestations of the disease in Europe. Since then (for 22 years), the agent did not manifest himself in any way. Nevertheless, the Mykolaiv region was considered unsuccessful for cholera, and therefore the regional laboratory center of the Ministry of Health regularly monitored the condition of local water bodies every June 1. By the way, cholera in Ukraine was also registered in Mariupol. In 2011, 23 people became ill and 11 carriers were identified.

According to Burdenko, over the past year in the Mykolaiv region scientists also found a cholera-like vibrio. It does not cause cholera, but it can cause intestinal infection, enteritis. "At the same time, it is an indicator that on this territory there can be directly toxic cholera vibrio, causing cholera," Burdenko said.

Discovered in Ingul Vibrio cholerea O1 biotype Eltor serotype Ogawa is the same toxic. "This is the classic cholera, this is exactly what causes the disease," confirmed the head of the State Supervision Authority for Compliance with the Sanitary Law of the State Consumer Protection Service in the Mykolaiv region.

It is important that so far, as of August 16, both in Mykolaiv city and in Mykolaiv region not a single case of carriers or patients with cholera has been registered.

As you know, cholera is an acute disease accompanied by severe diarrhea. In the absence of treatment, a person can die in a few hours. According to the World Health Organization, in 2010, 3 to 5 million cases of cholera were reported in the world, of which 100-130 thousand were terminated with death.

How could cholera appear in Mykolaiv

"We have increased the number of monitoring studies and it is positive that the pathogen has been found so far only at one site. Fifty meters upstream, one hundred meters downstream, we find nothing, "said the head of the State Supervision Authority for Compliance with Sanitary Law of the State Consumer Protection Service in Mykolaiv Region.

Now several working versions are considered that could have caused the causative agent in Ingul water. According to one of the versions, the agent could get through an unauthorized sewer connection to the river system.

Now the commission at the State Administration determines whether there was an unauthorized connection to the sewage facilities. All forces are directed to find out what has become the source of infection. "People go abroad, they visit countries with cholera, and today there are such tendencies that there may be up to 100 or more bacterial carriers per patient in countries where cholera is being registered, and the person himself may not know that he Is a bacteriocarrier ", argues Burdenko.

Events could continue in this way: a potential carrier of cholera could defecate in the toilet of one of the catering establishments which illegally connected into the sewage system and send the causative agent into the water of the Ingul river.

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According to the second version, the vibrio could be of local origin and floated out of the silt. "It is very resistant to the effects of low temperatures and could remain in the mud for a long time," Burdenko said.

She emphasizes that it is important to find the source of infection, as this will allow it to be localized. However, this is not so simple, and in practice it can take from 6 to 8 months.

The situation is complicated due to the fact that now there is a terrible heat in Mykolaiv - the temperature rises to +38 degrees and above. "The laboratory of the Ministry of Health is also monitoring water for the maintenance of Escherichia coli, pathogenic microflora, and for several weeks we have unconventional patterns in the samples, water is already a potential factor of the development of intestinal diseases. We have long said that we do not recommend swimming near two city beaches "  Larysa Burdenko told 112.ua.

What authorities are doing to prevent outbreak of cholera

The head of the State Supervision for compliance with the sanitary legislation of the State Consumer Protection Service in Mykolaiv region says that now all forces in Mykolaiv and its region are directed on prevention of cases of infection. "Everything is done in order to rupture the ways of a possible transfer. There is a causative agent, there is a person who can get sick, and we need to break all the possible connections using which an agent can get to him," Burdenko said.

As told 112.ua the deputy head of Mykolaiv district on social and humanitarian issues Vitaliy Kindrativ, all the beaches of Mykolaiv were closed. In total, there are two comfortable beaches in the city: Tchayka and Strilka. Both are on the Southern Bug River, into which Ingul flows. And Strilka is only 150 m from the place where the causative agent was found, behind the pedestrian bridge.

In addition, hyperchlorination of water has been started. Mykolaiv makes a drinking water intake in the Dnieper, and this river is not connected with Ingul. At the same time, because of the high temperature of the air, the water blooms. The water intake in Mykolaiv is superficial, and the water supply networks are old. Thus, hyperchlorination is directed not so much to the prevention of cholera, but rather to the prevention of intestinal infections.

People are advised not to drink raw tap water (also because of the high chlorine content). "We need to boil it," says Larysa Burdenko.

Among other measures, city strengthens control over people who are more at risk of becoming cholera carriers than others. We are talking about people without a permanent residence - homeless people.

In addition, the police forces will conduct raid aimed at combating the points of spontaneous trade. There is a fear that the source of infection can be a cheap fish of home salting. This fish, as a rule, lives in surface waters and can swallow pathogens with sewerage. "They salt this fish, usually without cooking. In such conditions vibrio of cholera perfectly survives," notes Burdenko. According to her, the causative agent of cholera can also remain on the table, the knife that contacted with infected fish.

Also in the near future all public catering facilities that are located along the Ingul river in Mykolaiv will be checked. According to Larysa Burdenko, the checks will be carried out with the aim of "firstly strengthening the disinfection regime, and secondly, checking whether the sewerage facilities are properly connected."

Also all hospitals in the city are brought in the stage of number one readiness. "According to the head of Mykolav department of Health Ministry, the availability of drugs for cholera in Mykolaiv is sufficient, Larysa Burdenko stressed.

How to avoid cholera

The cholera vibrio can enter the human body through water, food, or by contact. "Talking about  contact – it is if you swim in a pond in which the concentration of the pathogen contamination is high, it can get on the skin of your hands, and if you do not wash it and start eating with such hands, the infection is almost inevitable, without even needing to swallow this water," Burdenko said.

You can also get sick by eating a vibrio-infected product or fish. At the same time, with the heat treatment of products such a risk is completely excluded. Vibrio of cholera perishes during treatment for 5 minutes at a temperature of +60 degrees of Celsius.

To protect yourself, doctors advise to observe hygiene: regularly wash your hands before meals, monitor the quality of water for drinking, wash vegetables, fruits, be careful with products that have not been heat treated. Do not buy food, especially fish and crayfish, at spontaneous market places.

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