Health ministry outlines local response to global cholera outbreak |15 February 2024

Dr Louange (left) and Dr Jouaneau answering question during yesterday’s press conference (Photo: Patrick Joubert)

The Ministry of Health is calling on members of the public to be vigilant, by continuously maintaining a high standard of hygiene, in case cholera, which is not yet present in the country, lands on our shores.

The statement followed an advisory report by the World Health Organisation (WHO) on the rise in the number of cholera cases globally since 2021, 2022 and 2023, especially on the African and Asian continents.

The appeal was made by the acting public health commissioner, Dr Meggy Louange during a press conference held yesterday afternoon at the ministry’s headquarters, Red Roof building, Seychelles Hospital.

Also present was the principal medical officer for community health service, Dr Josapha Jouaneau.

Cholera is an acute diarrheal infection caused by the bacterium vibrio cholera. It is transmitted via ingestion of contaminated food and water. Humans are the only host, even though vibrios can survive for a long time in coastal waters contaminated by human excreta.

After a short incubation period of less than five days, the typical symptoms might develop, characterised by vomiting and watery diarrhea which can also be severe at times. The severe forms of the disease can kill within hours if left untreated.  In most cases, though, symptoms are mild or absent and infected individuals become carriers with no symptoms.

“In Seychelles, to date we’ve never had reported cases of cholera but because of the situation globally, we expect that we may eventually receive an imported case of cholera. In this respect, the Ministry of Health needs to ensure that we have a plan in place and that we are prepared for any eventuality,” said Dr Louange

She added that the ministry was working with various partners, including the Public Utilities Corporation (PUC), Ministry of Education, environment and tourism departments, among others, to keep cholera at bay.  

Dr Louange said so far Seychelles has not reported any case,  because of its high standard in hygiene attributed to access to portable water (95 percent of the population) and sanitation (over 95 percent of the population), as well as basic hygiene performed.

“So we are confident that the ministry will be able in the eventuality that we have a case reported in the country, to be able to manage and control the outbreak. The message for the public is that we already have sanitation and treated water but we have to continue to work to improve on our hygiene,” said Dr Louange.  

Apart from encouraging the use of treated water for drinking and cooking, Dr Louange highlighted the need to practice basic hygiene such as washing hands with soap and water after going to the bathroom and also before handling food or eating.

She also advised people to boil water for consumption, especially water taken directly from river sources, to ensure safe preparation and conservation of food and for local travelers to be particularly concerned about hygiene and food safety while overseas.  

For his part, Dr Jouaneau said the ministry has procedures and protocols in place at the various health centres across the country, including at the Seychelles Hospital, to detect symptoms of cholera and cholera itself.

Given that rehydration therapy is the primary treatment for cholera patients to restore the lost fluids and salts, Dr Jouaneau stated that the ministry has a stockpile of oral rehydration solutions (ORS) and antibiotics at all health clinics including at the ministry’s main storage facility, to treat patients infected by the bacteria.

He noted though that the antibiotics in stock are not for the whole population but for severe cases only.

With regards to isolation of patients, Dr Jouaneau said they would be placed in quarantine centres at the Family Hospital and at the Seychelles Coast Guard (SCG) base, both on Ile Persévérance.

“All of our staff have been undergoing refresher training for the detection of the bacteria and its symptoms and I can say we are ready to face any eventuality of an outbreak in cholera,” he said.

Currently there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral, Shanchol, and Euvichol for the treatment of cholera. All three vaccines require two doses for full protection for three years.

Dr Louange said that WHO has recommended mass vaccination in countries where there is an outbreak. Seychelles does not have the vaccines in stock but in the event of an outbreak, the ministry will import the vaccines.

“Mass vaccination is the last resort. The first resort is hygiene, good sanitation and also to ensure the accessibility of treated water supply to the population,” said Dr Louange

Patrick Joubert