CASE STUDY THE PLANNER The Cholera Epidemic in Goma, Zaire n the spring of 1994,

Question

CASE STUDY THE PLANNER The Cholera Epidemic in Goma, Zaire n the spring of 1994, civil war broke out in Rwanda. In a 3-month period, 500,000 people were killed and 3.9 million were displaced 1. Examine the photo. What risk factors for acquiring diarrheal diseases can you identify? as they fled the areas of fighting. In 10 days in July, approximately 1.7 million fled to Zaire. Refugee camps surrounded Lake Kivu. An outbreak of cholera occurred in the refugee camp. The first case of cholera was confirmed on a Tuesday. Within 1 week Digging latrines to use for toilets was impossible because the official death toll from cholera was 18,000; however, United few feet of top soil. As a re Nations officials estimated the death count at 50,000, with 1800 sult, human feces quickly contaminated Lake Kivu, which was the only source of drinking water for the refugees (see the Figure). dying each day 2. How can diseases such as cholera affect large numbers of people in a short time? Once an airfield was secure, an international effort, led by the United States, immediately provided trucks to filter the water supply and stop the epidemic spread of cholera. Continu- ing relief efforts focused on treatment of the sick, burial of the dead, and providing other basic needs such as food and shelter. 3. REVIEW: What pathogen causes cholera? Data from USA Today, 28 July 1994 pg 1; 4 Aug 1994 pg 6; 25 July pg 1 374 CHAPTER 13 Microbial Pathogenesis

Explanation / Answer

CASE STUDY : The cholera Epidemic in Goma, Zaire.

1. As stated in the case study it was impossible to dig latrines for use of toilet and as a result human feces contaminated the sole source of drinking water Lake Kivu. Hence, drinking of this contaminated water is the risk factor for acquiring diarrheal disease.

2. Disease such as cholera can affect large number of people in short time because when a public source is contaminated then all the consumers are affected equally in short time.

3. Bacterium Vibrio cholerae causes cholera.

CASE STUDY : Problems with Malaria Medication in Mozambique.

1. Based on the graph, sleeping under ITN (Insecticide-treated mosquito net) is neglected in Mozambique.

2. After repeated attacks of malaria a person may develop a partially protective immunity. Such "semi-immune" person often can still be infected by malaria parasite but may not develop serious disease, and, in fact, frequently lack any typical malaria symptoms.

3. If parasite is resistant to chloroquine, then other medicines like primaquine and chloroguanide can be used as an alternative because these drugs have different mechanism than chloroquine.

4. Low dose medication is not harmful but it cannot prevent the growth of pathogen so effectively and therefore cannot prevent the patient from disease. So, medication should be in right dose.

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