Introduction
Cholera returns to Nigeria almost every rainy season. In 2021, the country recorded one of its worst outbreaks in years, with more than 100,000 suspected cases and over 3,000 deaths, many of them in the North.
What makes cholera so frightening is its speed: a healthy adult can become dangerously dehydrated within hours. What makes it so tragic is that most deaths are preventable with one cheap, simple treatment: timely replacement of lost fluids and salts.
This guide explains how to recognise cholera, what to do immediately when symptoms appear, and how to protect your family from infection.
What Is Cholera?
Cholera is a bowel infection caused by the bacterium Vibrio cholerae. It spreads when someone swallows water or food contaminated with the stool of an infected person.
Floods, overflowing latrines, shared wells, and unwashed hands all help it spread, which is why cases often rise during and after heavy rains.
Many infected people have only mild symptoms or none at all, but they can still pass the bacteria in their stool for days and infect others without knowing it.
Warning Signs of Cholera
Cholera can begin suddenly and cause dangerous fluid loss within hours.
Common warning signs include:
Sudden, large amounts of watery diarrhoea, often pale and cloudy, described as rice-water stool
Vomiting
Painful leg cramps
Intense thirst, dry mouth, and passing little or no urine
Sunken eyes and skin that returns slowly to normal after being gently pinched
Weakness, dizziness, or a fast heartbeat
In children, also watch for no tears when crying, a sunken soft spot on a baby's head, unusual sleepiness, or refusing or being unable to drink.
Important: Not everyone with cholera develops the typical rice-water stool. Sudden, frequent watery diarrhoea during an outbreak should always be taken seriously.
Start ORS Immediately: At Home and On the Way to Hospital
Dehydration is what makes cholera deadly. The moment watery diarrhoea starts, begin oral rehydration solution (ORS). Do not wait to reach the clinic. Keep giving ORS on the way.
How to Prepare and Give ORS
Use ORS sachets from a pharmacy, mixed exactly as written on the pack with clean, safe water. Boil and cool the water first if its safety is uncertain.
If you have no sachets, you can temporarily prepare a homemade sugar-salt solution using 6 level teaspoons of sugar and half a level teaspoon of salt in 1 litre of clean water.
Measure carefully using standard measuring teaspoons. Too much salt is dangerous, while incorrect sugar measurements can make the solution less effective.
Give small, frequent sips, even if the person is vomiting. If vomiting occurs, pause for 5 to 10 minutes, then continue slowly.
Keep breastfeeding babies throughout. Breast milk helps maintain hydration and nutrition.
Continue age-appropriate food and fluids as tolerated.
Homemade sugar-salt solution is an emergency alternative, not a complete replacement for pharmacy ORS. Proper ORS sachets contain important electrolytes, including potassium, that homemade mixtures do not provide.
Prepare fresh solution daily and discard any unused mixture after 24 hours.
Zinc for Children with Diarrhoea
Zinc supplementation can help shorten diarrhoea, particularly in children older than six months and those who are malnourished.
A health worker may recommend zinc for 10 to 14 days, depending on the child's age and condition.
For babies younger than six months, the benefit is less certain, so professional guidance is especially important. Zinc can also cause vomiting in some children.
Remember: ORS is the priority. Zinc does not replace rehydration, and neither should delay medical care when severe symptoms appear.
When to Go to Hospital Immediately
Cholera can become life-threatening very quickly. Seek urgent medical care if:
Diarrhoea is very heavy or continues rapidly
The person cannot drink or keep fluids down
The person becomes unusually sleepy, confused, or difficult to wake
Hands and feet become cold, the pulse feels weak, or very little urine is passed
A child shows signs of dehydration, including sunken eyes, no tears, or unusual weakness
A young child, older person, or pregnant woman develops sudden watery diarrhoea during a cholera outbreak
Severe cholera requires rapid intravenous fluids and, in some cases, antibiotics prescribed by a qualified healthcare professional.
Do not rely on anti-diarrhoea tablets to stop cholera. They do not correct the dangerous fluid loss and may delay proper treatment.
Even when ORS is available, suspected cholera should be assessed promptly at a health facility, particularly during an outbreak.
How to Prevent Cholera
Preventing cholera starts with clean water, safe food, proper sanitation, and good hygiene.
1. Drink Safe Water
Drink only water that has been boiled, properly chlorinated, or obtained from a reliably safe source. Properly sealed drinking water can be a safer option when its source is trustworthy.
During floods or outbreaks in Gombe and surrounding communities, take extra care with water from wells and other sources that may become contaminated.
2. Handle Food Safely
Cook food thoroughly and eat it while hot.
Avoid food that has been sitting uncovered for long periods, especially during outbreaks.
Peel fruit yourself when possible.
Wash vegetables with safe water.
Keep prepared food covered to protect it from flies and contamination.
3. Wash Your Hands with Soap
Wash your hands thoroughly:
After using the toilet
After cleaning a sick person
Before preparing food
Before eating or feeding a child
Handwashing is one of the simplest ways to reduce the spread of cholera.
4. Use Proper Toilets and Sanitation
Always use a latrine or toilet. Never defecate near wells, streams, or other water sources.
Dispose of children's stool safely, and keep household water containers clean and covered.
5. Clean Contaminated Items Safely
Disinfect clothes, bedding, toilets, and surfaces contaminated by diarrhoea or vomit. Follow appropriate cleaning and disinfection instructions from health workers.
When caring for someone with suspected cholera, avoid direct contact with stool or vomit and wash your hands thoroughly afterwards.
Take extra care when washing or preparing the body of someone who died from cholera. Follow health worker guidance to prevent further transmission.
The Cholera Vaccine
Oral cholera vaccines exist and are used in Nigeria during outbreak campaigns in high-risk communities.
If a vaccination campaign comes to your area and you are eligible, take part.
The vaccine provides meaningful protection against cholera, but that protection is not complete and may decrease over time.
Vaccination does not replace clean drinking water, proper sanitation, safe food preparation, and regular handwashing.
Conclusion: Cholera Moves Fast, but You Can Act Faster
Cholera moves fast, but you can move faster.
Know the warning signs, begin ORS as soon as watery diarrhoea starts, and seek medical attention promptly, especially if dehydration is developing.
Keep ORS sachets in your home first-aid box, particularly during the rainy season. Families with young children can also ask a pharmacist whether they should keep age-appropriate zinc supplements available.
Early action can save lives.
Protect Your Family with Amkamed Pharmaceuticals
At Amkamed Pharmaceuticals, Gombe State, we are committed to helping families protect themselves through trusted medicines, professional pharmaceutical advice, and practical health education.
Visit us for ORS sachets, guidance on appropriate zinc supplementation for children, and advice on preventing dehydration and recognising symptoms that require urgent hospital treatment.
Do not wait until dehydration becomes dangerous. Recognise cholera early, start ORS, and seek medical care promptly.
Amkamed Pharmaceuticals, Gombe State
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