Cholera also has been transmitted by the foodborne route in Africa. Because V. cholerae O1 is rapidly inactivated at acid pH levels, recipes that acidify food can be protective. The findings in Zimbabwe that mahewu was protective suggest that it was less likely to transmit foodborne cholera than other foods available in the community. The demonstrated safety of some traditional foods suggests prevention measures that can be recommended and implemented immediately and have particular relevance where fermented gruels are used as traditional weaning foods for young children. Efforts to control cholera epidemics in Africa and elsewhere by mass chemoprophylaxis, vaccination campaigns, roadblocks, and broad embargoes on commodities have been ineffective and have diverted scarce resources away from the critical activities of providing treatment and improving the safety of water and food supplies.
Adequate surveillance can guide the rational distribution of treatment and prevention supplies.
Rapid and thorough investigation of outbreaks can identify unsuspected sources of the infection, can assess the adequacy of treatment, and are essential to development of future prevention efforts. World Health Organization. Cholera in 1991. World Health Organization. Guidelines for cholera control.