Prevention cholera

Proper sanitation including washing hands after

using the toilet

 Ensure careful preparation and supervision of

food

After cooking protect against contamination by flies

and unsanitary handling

Leftover foods should be thoroughly reheated before

ingestion

Persons with diarrhea should not prepare food

Avoid drinking from unknown sources, such

as outside wells and streams, without boiling

the water first.

 Use only clean utensils for eating or handling

foods

 Cook food completely and properly

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Five Basic Cholera Prevention Steps

If you live in or are visiting an area where cholera is occurring or has occurred, be aware of basic
cholera facts and follow the five cholera prevention tips listed below. These tips will help you protect
yourself and your family.

To prevent cholera, you should wash your hands often and take precautions to ensure your food and
water are safe for use. The risk for cholera is very low for people visiting areas with epidemic cholera
when these simple steps are followed:

Print-and-Go Fact Sheet

Five Basic Cholera Prevention Messages fact sheet

Printable Fact Sheet: Cholera Prevention and Control pdf icon[PDF – 2 pages] (English)

Hoja informativa para imprimir: Prevención y control del cólera pdf icon[PDF – 2 páginas] (Español)

1. Make sure to drink and use safe water to brush your teeth, wash and prepare food, and make ice

It is safe to drink and use bottled water with unbroken seals, and canned or bottled carbonated
beverages.

If bottled water is not available, use water that has been properly boiled, chlorinated, or filtered:

Boiling is the most effective way to make water safe. If boiling, bring your water to a complete boil for
at least 1 minute.

If boiling is not possible, you can use a chlorine product (i.e., granules or product tablets) to make
your water safe. To treat your water with chlorine granules or tablets, use one of the locally available
treatment products and follow the instructions.

If a chlorine treatment product is not available, you can treat your water with household bleach. Visit
CDC’s Making Water Safe in an Emergency page for specific instructions on how to treat your water
with household bleach.

Always store your treated water in a clean, covered container.

Clean food preparation areas and kitchenware with soap and safe water and let them dry completely
before reuse.

Piped water sources, drinks sold in cups or bags, and ice may not be safe. If you suspect your water
may not be safe, boil or treat it with a chlorine product.

2. Wash your hands often with soap and safe water*

Before, during, and after preparing food for yourself or your family

After using the latrine or toilet

After cleaning your child’s bottom

Before and after caring for someone with cholera

Follow the five steps to washing hands the right way:

Wet your hands with clean water.

Apply soap to your hands and rub them together. Be sure to lather the back of your hands, between
your fingers, and under your nails.
Scrub your hands for at least 20 seconds.

Rinse your hands well under clean water.

Allow your hands to air dry or dry them with a clean towel.

* If proper handwashing resources are not available, wash your hands using water that is as clean as
possible (e.g. that’s not visibly cloudy) from a safe source (e.g., an improved source like a borehole or
protected spring).

Traveling to an area with cholera?

The FDA approvedexternal icon a single-dose live oral cholera vaccine called Vaxchora®. Vaxchora is
recommended to prevent infection in adults who are 18 – 64 years old and are traveling to an area of
active cholera transmission with toxigenic Vibrio cholerae O1 (the bacteria strain that most commonly
causes cholera). For more information, please visit the cholera vaccines page.

3. Use latrines or bury your poop; do not poop in any body of water

Use latrines or other sanitation systems, like chemical toilets, to dispose of poop.

Wash hands with soap and safe water after pooping.

Clean latrines and surfaces contaminated with poop using a solution of 1 part household bleach to 9
parts water.

What if I don’t have a latrine or chemical toilet?

Poop at least 30 meters (approximately 100 feet) away from any body of water and then bury your
poop.

Dispose of plastic bags that contain poop by putting them in latrines or at collection points, if
available. You can also bury them in the ground. Do not put plastic bags in chemical toilets.

Dig new latrines or temporary pit toilets at least a half-meter (approximately 1 ½ feet) deep and at
least 30 meters (approximately 100 feet) away from any body of water.

4. Cook food well (especially seafood), keep it covered, and eat it hot. Peel fruits and vegetables*

Be sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through.

*Avoid raw foods other than fruits and vegetables that you have peeled yourself.

5. Clean up safely in the kitchen and in places where the family bathes and washes clothes
Wash yourself, your children, diapers, and clothes, 30 meters (approximately 100 feet) away from
drinking water sources.

Risk factors

Everyone is susceptible to cholera, with the exception of infants who get immunity from nursing
mothers who have previously had cholera. Still, certain factors can make you more vulnerable to the
disease or more likely to have severe signs and symptoms.

Risk factors for cholera include:

Poor sanitary conditions. Cholera is more likely to flourish in situations where a sanitary environment
— including a safe water supply — is difficult to maintain. Such conditions are common to refugee
camps, impoverished countries, and areas afflicted by famine, war or natural disasters.

Reduced or nonexistent stomach acid. Cholera bacteria can't survive in an acidic environment, and
ordinary stomach acid often serves as a defense against infection. But people with low levels of
stomach acid — such as children, older adults, and people who take antacids, H-2 blockers or proton
pump inhibitors — lack this protection, so they're at greater risk of cholera.

Household exposure. You're at increased risk of cholera if you live with someone who has the disease.

Type O blood. For reasons that aren't entirely clear, people with type O blood are twice as likely to
develop cholera compared with people with other blood types.

Raw or undercooked shellfish. Although industrialized nations no longer have large-scale cholera
outbreaks, eating shellfish from waters known to harbor the bacteria greatly increases your risk.
ECTOPARASITE

What do head lice look like? What is the life cycle of head lice?

There are three forms of lice, namely the nit, the nymph, and the adult louse.

Nit: Nits are lice eggs. Nits are hard to see and are often confused with dandruff or hair-spray
droplets. Nits are found firmly attached to the hair shaft. They are oval shaped, 2-3 mm in length and
usually yellow to white in color. Nits take about a week to hatch.

Nymph: The nit hatches into a baby louse called a nymph. It looks like an adult head louse but is
smaller. Nymphs mature into adults about seven days after hatching. To live, the nymph must feed on
human blood.

Adult: The adult louse is about the size of a sesame seed, has six legs, and is tan to grayish-white in
color. In people with dark hair, the adult louse looks darker. Females lay nits; they are usually larger
than males. Adult lice can live up to 30 days on a person's head. To live, adult lice need to feed on
human blood. If the louse falls off a person, it dies within two days.

Life cycle: The nits hatch into nymphs, which become full grown lice. In order to produce more nits,
the adult lice must mate.

The signs and symptoms are

a tickling feeling of something moving in the hair;

itching (caused by the an allergic reaction to the bites);

sores on the head (caused by scratching);

these sores on the head can sometimes become infected;

irritability.

Treatment of the individual and the infested family members

Over-the-counter (OTC) or prescription medications are used to treat the affected people and their
families. Follow these treatment steps:

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Remove all clothing.

Apply lice-killing medicine, also called pediculicide, according to the label instructions. If a child has
extra-long hair, one may need to use a second bottle. Warning: Do not use a cream rinse or
combination shampoo/conditioner before using lice medicine. Do not rewash hair for one to two days
after treatment.

Have the infested person put on clean clothing after treatment.

If some live lice are still found eight to 12 hours after treatment but are moving more slowly than
before, do not retreat. Comb dead and remaining live lice out of the hair using a fine-toothed comb
(lice comb). The medicine sometimes takes longer to kill the lice.

If no dead lice are found and lice seem as active as before eight to 12 hours after treatment, the
medicine may not be working. See a health care professional for a different medication and follow
their treatment instructions.

Nit (head lice egg) combs, often found in lice medicine packages, should be used to remove nits and
lice from the hair shaft. Many flea combs made for cats and dogs are also effective.

After the initial treatment, check, comb, and remove nits and lice from hair every two to three days.

Retreat in seven to 10 days.

Check all treated people for two to three weeks until you are sure all lice and nits are gone.