How Unpurified Water Could Lead to Cholera

On this page, we critically discuss how unpurified water could lead to cholera

Cholera, an acute diarrheal illness caused by the bacterium Vibrio cholerae, is a significant health concern in regions with limited access to clean water and sanitation, including parts of South Africa. The disease is often associated with poverty and insufficient public health measures and can lead to severe dehydration and even death if untreated. Understanding how unpurified water leads to cholera is essential to implementing effective preventative measures.

How Unpurified Water Could Lead to Cholera

Unpurified water can lead to cholera through a process of contamination and ingestion. The cycle begins when the feces of an individual infected with the cholera bacteria, Vibrio cholerae, contaminates a water source, often due to inadequate sanitation facilities or flooding. When people consume this unpurified, contaminated water—either directly, or indirectly through cooking or washing food—they ingest the cholera bacteria. These bacteria then travel to the small intestine where they multiply rapidly and produce a toxin that causes the cells lining the intestines to release increased amounts of water, leading to severe, watery diarrhea—a characteristic symptom of cholera. If left untreated, the resultant rapid loss of body fluids can cause severe dehydration, shock, and potentially, death.

Cholera primarily spreads through contaminated water, especially water contaminated with human feces from an infected person. In communities lacking adequate sanitation facilities, it’s common for waste materials to end up in rivers or groundwater used for drinking, cooking, or washing.

South African Context

South Africa has faced several cholera outbreaks, often traced back to consumption of contaminated water. A notable case occurred in 2008, where the Limpopo and Mpumalanga provinces were heavily affected. The main cause was cross-contamination of drinking water with sewage, largely due to inadequate sanitation infrastructure.

Step by Step Process of how Cholera Infection Occurs:

  1. Contamination: The process starts when the feces of an infected person, carrying the cholera bacteria, contaminates a water source. This usually happens due to poor sanitation or during flooding, common in some parts of South Africa, where fecal matter can be washed into water bodies.
  2. Consumption: When residents consume this unpurified, contaminated water, they ingest the cholera bacteria. This can happen when they drink directly from the source, use the water for cooking, or consume raw or undercooked food washed in the contaminated water.
  3. Infection: Once ingested, the cholera bacteria travel to the small intestine. There, they multiply and produce a potent toxin that causes cells in the intestine to release excess water.
  4. Illness: This leads to watery diarrhea, a hallmark symptom of cholera. If left untreated, the severe dehydration caused by this rapid loss of body fluids can lead to shock and potentially death within hours.

Solutions and Prevention of Cholera

  1. Improvement of Water Infrastructure: Many regions in South Africa, especially rural and informal settlements, lack access to safe, clean drinking water. Improving and expanding water infrastructure can ensure that all communities have access to safe, clean water, significantly reducing the risk of cholera.
  2. Enhancing Sanitation Facilities: The presence of adequate sanitation facilities is crucial to preventing cholera. This includes the construction and maintenance of toilets and proper sewage disposal systems to prevent fecal contamination of water sources.
  3. Community Education: Implementing education programs to increase awareness about the dangers of consuming unpurified water, proper hand hygiene, and the importance of using safe water for cooking and personal hygiene can go a long way in preventing cholera outbreaks.
  4. Vaccination Programs: Oral cholera vaccines are an effective solution for cholera prevention. Though not a long-term substitute for water and sanitation improvement, they can provide immediate protection in high-risk areas. According to the WHO, the cholera vaccine reduces cholera cases by 65% six months after vaccination.
  5. Emergency Preparedness and Rapid Response: Given South Africa’s vulnerability to cholera outbreaks, it’s critical to have a robust disease surveillance system and emergency response plan in place. This includes rapid diagnostic testing, timely reporting, and swift mobilization of medical and aid teams during outbreaks. Rapid response also involves the provision of rehydration treatments, antibiotics, and temporary water purification solutions during outbreak situations.


Access to clean, safe drinking water is crucial in preventing cholera and other waterborne diseases. South Africa’s struggles with cholera highlight the significant health risks posed by inadequate water purification and sanitation systems. Critical steps in preventing cholera include improving sanitation infrastructure, ensuring access to clean drinking water, and educating communities about proper hygiene practices. Understanding the process of how cholera spreads via contaminated water is fundamental to these preventative efforts.


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