Cholera and other Diarrhoeal Outbreak Control

Cholera response is most effective where preparedness measures have already been put in place. It is vital to be aware of the national guidelines on the triggers for responding to cholera. General recommendations for response triggers can be found in the Oxfam cholera control guidelines.


Oxfam Cholera Guidelines

Minimum Standards

  • All WASH staff should be aware if cholera is endemic in the country they are working and they should be familiar with the measures for preparedness, prevention and response.
  • All WASH staff should be familiar with the critical stages in the outbreak curve and key target activities for each stage as specified in the OGB and Oxfam Intermon Cholera Prevention and Control Guidelines.
  • All countries where Oxfam is operational which are classified as cholera endemic by WHO should have:
    • An active Cholera Preparedness and Implementation Plan (including pre-tested, standard IEC materials and messages).
    • A contingency stock of cholera response materials where feasible or at least the materials needed and agreements with suppliers.
    • A system for resourcing a rapid cholera response with local staff (relocated from long-term programmes, secondments etc.).
  • At a minimum a response to a severe diarrhoeal outbreak should entail the following:
    • Intensive campaigns on key actions for cholera and/or diarrhoea mitigation and prevention.
    • Access to oral re-hydration using Oral Rehydration Solution (ORS) or alternatives such as sugar salt solution where they are promoted by the MoH and are known by communities.
    • Chlorination of all drinking water (at appropriate stages along the water chain which may include chlorination at source, along the way or at the point of use).
    • Distribution of NFIs such as soap, water containers and the means to carry out disinfection of household water if necessary.
    • Start a clean-up campaign to ensure the environment is free from faecal matter.
    • Provision of support to Cholera Treatment Centres for water supply, sanitation and isolation.
    • Maintain linkages (formal or informal) with health NGOs or MoH in order to base project design/intervention on disease patterns/stage of the outbreak.
    • Ensure adequate community follow up of cases in conjunction with other agencies