Corpses and the Spread of Cholera

Cholera is readily treated through rehydration with oral or parenteral fluids. When properly treated, the disease has a mortality rate of less than 1%, but a rate of mortality of greater than 50% when untreated. Proper treatment for cholera, although simple and inexpensive, is not available in many parts of the developing world. In some Western African countries, such as Guinea-Bissau, not only is proper treatment unavailable, cultural rituals related to the death of cholera victims help to perpetuate the disease. For example, people who are dying of or who have died from cholera may be washed by family members who then prepare funeral feasts for family and friends held very soon after the death. Outbreaks of cholera commonly follow these feasts. Cholera vibrios are spread through fecal-oral contamination. A large inoculum, however, is needed to produce disease. Outbreaks of cholera occur following such funeral feasts because the handlers of the corpse fail to properly clean their hands before preparing the meal. Cholera vibrios are therefore transferred from the corpse through the handler to the food and/or water used in and with the meal, in which they can replicate enough to cause disease. Such outbreaks could be prevented were handlers to properly wash their hands before preparing food, and drinking water and other water used in preparing food were decontaminated. Other prevention measures could be to discourage the holding of funeral feasts for people who have died of cholera and to have health workers disinfect corpses before they are handled by families.