Cholera outbreak WASH control — DTM&H MCQ
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Correct answer: B — Restore chlorinated safe water and emergency sanitation
The correct answer is B, restore chlorinated safe water and emergency sanitation. Cholera (Vibrio cholerae) spreads via the faecal-oral route, and the stem describes the classic epidemiological signature of a point-source outbreak: cases clustering around a single water distribution point with no residual chlorine after latrines were destroyed by flooding. Outbreak control therefore hinges on interrupting transmission at that source, not just treating existing cases, by re-establishing chlorinated water supply, safe excreta disposal and hygiene promotion. Global cholera outbreak response guidance places water, sanitation and hygiene (WASH) interventions, including emergency chlorination, at the centre of containing transmission once a point source is identified. Treatment tents manage mortality but cannot stop new infections while the contaminated source remains active. Why the other options are wrong: A. Distribute antidiarrhoeals to households: Antimotility agents are not part of cholera case management and do not address the environmental source; they risk delaying fluid loss recognition and toxin clearance. E. Focus on stool culture before water action: Confirmatory microbiology is useful for surveillance but must never delay source control in an ongoing outbreak with an obvious point source; action should be immediate and pragmatic. D. Provide malaria bednets at water points: Malaria prevention is unrelated to a faecal-oral pathogen outbreak and does nothing to interrupt cholera transmission. C. Begin mass corticosteroid prophylaxis: Corticosteroids have no role in cholera prevention or treatment; the disease is managed with oral or intravenous rehydration and, where indicated, antibiotics, not immunosuppression. Key point: When a cholera outbreak clusters around an identifiable contaminated water source, immediate restoration of safe chlorinated water and emergency sanitation is the priority public health action that interrupts transmission, alongside ongoing case management.
Reference: Global Task Force on Cholera Control (GTFCC), Cholera Outbreak Response Field Manual, 2024, section on water, sanitation and hygiene (WASH) interventions, https://www.gtfcc.org/wp-content/uploads/2020/05/gtfcc-cholera-outbreak-response-field-manual-2024.pdf