Cholera rehydration recipe

For anyone who finds themselves in the situation, this recipe comes from Dr Jon Rohde, an international pediatric expert on Cholera, having studied at ICDDRB (Bangladesh) and having spent many years in Haiti:

1. the amount of fluid taken in must equal or exceed the fluid loss – in kids we usually say, one glass to drink for each liquid stool (depends on glass size but generally one is talking about 200 cc)
2. the fluid should have salt – 5-7 grams/liter of water and sugar (sucrose) 30-35 grams/liter – use of local measures to achieve this are best – this would be one level teaspoon of salt for a rum bottle and 6-7 level teaspoons of sugar. Brown sugar is even better or thick molasses as they have quite a bit of potassium as well as sucrose. If glucose is available – use half as much as the sucrose (sucrose is broken down in the gut to equal amounts of glucose and fructose, the latter does no help in absorbing sodium
3. use the cleanest water available but do not waste time boiling if the water is not normally boiled – all too many rehydration efforts fail due to people worried about the quality of water in the SRO while they drink regular water all the time. You wont get more sick with SRO for whatever water is normally drunk
4. don’t forget that while the above can Rx cholera with less than 3/1000 case fatality, that antibiotics can halve the diarrhea and reduce its duration by 50% – so antibiotics are NOT essential but are very useful in reducing the fluid needs and danger of dehydration – definitely a 2nd priority.
5. While cholera can be contracted from food, it is far and away more likely to be from contaminated water so all efforts to make water safe – chlorine or boiling, even briefly, is well worth the effort to prevent infection
6. just for the record, cholera vaccines are absolutely USELESS in the face of an epidemic – the little protection they offer will occur a couple weeks after the epidemic has passed. Don’t waste any effort on this

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