Man-made and natural disasters can intensify the risk of epidemics considerably, as can conditions in crowded refugee camps. Explosive outbreaks with high case-fatality rates are often the result. For example, in the aftermath of the Rwanda crisis in 1994, outbreaks of cholera caused at least 48 000 cases and 23 800 deaths within one month in the refugee camps in Goma, the Congo. Although rarely so deadly, outbreaks continue to be of major public health concern, causing considerable socioeconomic disruption as well as loss of life. In 2001 alone, WHO and its partners in the Global Outbreak Alert and Response Network participated in the verification of 41 cholera outbreaks in 28 countries. In 1961, the 7th cholera pandemic wave began in Indonesia and spread rapidly to other countries in Asia, Europe, Africa and finally in 1991 to Latin America, which had been free of cholera for more than one century. The disease spread rapidly in Latin America, causing nearly 400 000 reported cases and over 4000 deaths in 16 countries of the Americas that year. Economic and social impact
In addition to human suffering caused by cholera, cholera outbreaks cause panic, disrupt the social and economic structure and can impede development in the affected communities. Unjustified panic-induced reactions by other countries include curtailing or restricting travel from countries where a cholera outbreak is occurring, or import restrictions on certain foods. For example, the cholera outbreak in Peru in 1991 cost the country US$ 770 million due to food trade embargoes and adverse effects on tourism.
The most important treatment for cholera is rehydration and antibiotics, which consists of prompt replacement of the water and salts lost. Early rehydration can save the lives of nearly all cholera patients. People living in high-risk areas can protect themselves by following a few simple rules of good hygiene and safe food preparation. These include...