Traders selling food next to a pile of garbage in Muthurwa market, Nairobi. Cholera spreads quickly and widely in such cramped, dirty conditions. [File, Standard]

Nairobi County Health Department yesterday issued an alert of a possible cholera outbreak in the city.

The County Director of Health Lucina Koyio said that all sub-counties in Nairobi were on high alert.

“The county is experiencing a wave of cholera outbreak which was confirmed March 20. In this regard, I am requesting all referral hospitals to reactivate their cholera treatment units to prevent the spread of the disease,” said Dr Koyio.

But according to Nairobi County chief officer of Health, the situation is currently under control with no cases reported lately.

"As a county, we continue to stay on high alert ready to deal with cases that may arise, "said Makodingo.

He added that public health officers were moving from door to door in affected areas, to distribute chlorine tablets used for treating water.

"Our teams have issued about 30,000 chlorine tablets in most affected areas like Ruia, Embakasi, Mathare, Starehe and all major informal settlements in the city," he said.

He added the health department had collaborated with Nairobi Water to conduct a super chlorination process for the water used by the city residents.

The alert came a few days after another that was issued by neighbouring Kajiado County.

Understanding cholera

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholera. It spreads fast in cramped and dirty areas.

Most of those infected will have no or mild symptoms but, in severe cases, the disease can kill within hours if left untreated.

Cholera, an infection that is cheap to treat with rehydration salts, kills about 100,000 people globally every year. In Kenya, the suspected cases of cholera cases in 2018 were 4,954, a rise from 4,059 recorded in 2017.

Just what are the signs and symptoms of this disease that can easily be avoided altogether if people have access to clean water and proper hygiene?

According to the World Health Organisation, it is an extremely virulent disease that can cause severe acute watery diarrhea.

Mayo Clinic, an academic medical center in the USA, say nausea and vomiting occur especially in the early stages of cholera. Vomiting may persist for hours at a time.

Dehydration can develop within hours after the onset of cholera symptoms. A loss of 10 percent or more of total body weight indicates severe dehydration.

One can tell if they are cholera dehydrated if they see: irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry and shriveled skin that's slow to bounce back when pinched into a fold, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).

When you are dehydrated, you may lose mineral in your body, a situation that might cause an electrolyte imbalance. This can lead to muscle cramps and in some instances shock.

Cholera affects both children and adults but children are more susceptible to low blood sugar (hypoglycemia) when they lose fluids. This always manifests with an altered state of consciousness, seizures or even a coma.

One takes about 12 hours and 5 days to show these symptoms after ingesting contaminated food or water.

Some of the steps you can take to prevent cholera include:

Wash hands with soap and water frequently

Drink only safe water

Eat food that's completely cooked and hot 

Stick to fruits and vegetables that you can peel yourself

Maintain a high condition of sanitization and hygiene