Cholera occurs in pandemics. Pandemic, by definition, is a continuous show or record of sequential dissemination of a disease globally. The most noteworthy feature of the current, "Seventh Pandemic" of cholera is that its causative agent is Vibrio cholera, biotype El Tor. Given the proper circumstances, endemic acute communicable disease have the potential of epidemic flare ups and pandemicity.

Cholera epidemics (of the classical strain) had occurred in Delhi in 1958 and 1960 before the introduction of the El Tor variety. Since 1965, El Tor cholera is being reported from Delhi, The most affected areas were the northern and western suburban colonies, children being the worst affected. Cholera had become endemic in Delhi at low to moderate levels. Delhi experienced a major epidemic of cholera in 1988. The plight of the urban poor and the lack of urban basic services was brought sharply into focus.

The prevention of cholera (and other diarrhoeal disease) is fortunately relatively simple and easily affordable. Safe (piped) water supply and proper disposal of solid and liquid waste is the basic pre-requisite. Groundwater is particularly unsafe for drinking purposes and must be accompanied by some sort of home purification. The safest method is to boil; but often this is practicable only as a short-term measure. Storing drinking water in a narrow mouthed container and using a separate container with a long handle to draw water from the main container with a long handle to draw water from the main container is a safeguard against domestic contamination of an otherwise safe water source. The importance of hand-washing can not be o over emphasized as a preventive measure for all waterborne diseases.

Should acute diarrhea occur, correct home remedies when started early can go a long way in preventing mortality and morbidity, specially in case of children. Prompt replacement of the fluids lost through diarrhoea and vomiting is crucial to avoid further complications. Fluids available at home like lassi, shikanji, rice-water, dal-water , coconut water or light tea should be started early.

The prevention and management of diarrhoeal illnesses, and cholera in particular, continues to be a top priority for all the civic bodies concerned. While the State’s responsibility is to provide the infrastructural setup, simple day-to-day preventive measures can go a long way in controlling this diseases.

[Contributed by Dr. Satpal, dy. Municipal Health Officer (Public Health), MCD, Dr. Dasgupta, Assistant Health Officer (Public Health), MCD.